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psychiatric disorders

Mental Illnesses on Movies

Movie attractions about mental illnesses

Recently I wrote about the premiere of a new movie, Mania Days, which stars Katie Holmes and is based on the life of the author who has Bipolar disorder.  One of our Facebook friends asked where it could be seen.

Well, the answer, in short, is “not yet”.  It is an independent film and caught my eye because it premiered in Austin TX, near where Old Fox MovietoneI live. Unfortunately, no matter how good it is, it won’t be released on the “big screen” until the writer/director/producer has an offer from a large movie production company – for a lot of money.

He may get one of those offers at upcoming independent film festivals, and the prospects look good as the film has received positive reviews.  It is likely that no matter how good the film is, we won’t see it in theaters for several months, if not longer. (It will probably be available on DVD though)

Sorry if it was a big tease.  In any case, it got me thinking that there are some well-known and available movies that you can see.  Maybe you have seen them, but you probably haven’t seen all or even most of them.

The good news is that since mental disorders tend to produce notable or even outrageous and shocking behaviors, they do make good subjects for movies.  This list is only a few of the movies that I have seen – and in many of them, there is no clear “diagnosis” for the characters but the symptoms are there.

Borderline Personality Disorder

Most of the films that feature characters that may have borderline personality disorder focus on murderous women.  Certainly BPD doesn’t only affect females but it does make good movie fodder.

•    Fatal Attraction
•    Single White Female
•    Casino
•    The Cable Guy
•    Margot at the Wedding
•    The Crush

Anxiety Disorders –

Anxiety disorders are harder to see in a movie as a single issue as they often occur with other disorders – as they do in real life.

•    Ordinary People
•    Parenthood

Social Anxiety Disorder

Can result in avoiding being in public, speech disorders and fears of other social situations.

•    The Kings Speech

Obsessive Compulsive Disorder

OCD is a real problem, but many people don’t realize how debilitating it can be.  In addition, it is also an anxiety disorder but doesn’t show as well on the screen.

•    The Aviator
•    As good as it gets

Post-Traumatic Stress Disorder

PTSD often follows a “war” event – but can follow other traumatic events. In most cases, these events are “acute” but in some cases they are chronic, occurring over a period of many years.

•    Prince of Tides
•    Forrest Gump
•    Born on the Fourth of July
•    First Blood
•    Sudden Impact
•    Reign Over Me
•    The Hunger Games: Catching Fire

Autism

There is really only one good example that I know of – and it is a classic.  That said, it is not an exact example as Autism is a “spectrum disorder” that ranges from high-functioning to non-functioning.

•    Rain Man
•    The Boy Who Could Fly

Bipolar Disorder

There are actually a lot of movies that can be seen showing bipolar disorder though. Rarely do they discuss the actual diagnosis but here are a few good ones.

•    Mad Love
•    Blind Date
•    Michael Clayton
•    Manic
•    Of Two Minds

Clinical depression

In most cases, clinical depression doesn’t look good on a screen.  Unless the character has some other event going on, watching someone not do anything doesn’t attract movie attention.  In these cases, there were other things going on in the movie that made them interesting.

•    The Fire Within
•    Leaving Las Vegas
•    Rushmore

Silver Linings PlaybookAnd the winner for “Most Psychiatric Disorders Featured in One Movie” goes to:

•    Silver Linings Playbook
•    Girl Interrupted

Both movies show a number of intertwining psychiatric disorders including anxiety, depression, borderline personality disorder, bipolar disorder, and eating disorder, are great films and two you really shouldn’t miss.

Most of these movies should be available on DVD.

Melissa Lind

List of films featuring mental disorders

Face of Borderline Personality Disorder

Pro Football Player Brandon Marshall Wants to be the “face” of Borderline Personality Disorder

Brandon Marshall - The Face of Borderline Personality DisorderIf you don’t follow professional sports in the U.S., you may not know who Brandon Marshall is. He is an NFL Wide Receiver, recently acquired by the New York Jets. His long history of violent outbursts, brushes with law enforcement and behavioral issues that have affected both his personal and professional life.

Marshall had played professional football since 2006 when the Denver Broncos drafted him. He has since played for the Miami Dolphins, the Chicago Bears and was recently acquired by the New York Jets. The Wide Receiver played in five Pro-Bowls, receiving an MVP award in 2011 and has set several receiving records during his NFL career.

Brandon Marshall - BPDThough he has played for four different teams in only nine years, most of the trades have come after a series of injuries. Not all of those injuries, however, have come from football and Marshall has a long history of legal trouble, and those issues have affected various team’s willingness to put up with his erratic behavior.

One notable injury was sustained in 2008 when he slipped on an empty bag in McDonalds. While this seems like a complete accident, the incident occurred during a physical scuffle with “family members”. Shortly after the event, he fell through a television set at his home, causing a severe arm injury.

Marshall has faced multiple fines with the NFL including two penalties for violating the team’s dress code by wearing brightly colored cleats during a game. The list of legal troubles he has had include drunk driving charges, domestic violence, assault, battery and disorderly conduct. Marshall was diagnosed with Borderline Personality Disorder in 2011.

Borderline Personality Disorder is not a well-known disorder and is highly stigmatized, with many people unwilling to disclose the condition. It is characterized by severe abandonment issues, risky behavior, personal identity issues, rapid changes in an Borderline Personality Disorder - Brandon Marshallemotional level, and high potential for self-harm. Treatment is largely comprised of behavioral therapy. However, some patients receive medication for other psychiatric disorders that may improve BPD symptoms. There is also some thought that medication treatment may be useful in Borderline Personality Disorder. However, no drugs are approved to treat the condition.

Marshall’s diagnosis of BPD likely comes as no surprise to those who understand the disorder. His willingness to come forward and publicly announce his condition may help others to understand BPD. He has been and is currently undergoing treatment and is in the process of filming a documentary about his battle with BPD. Marshall has stated that his goal is to be the “face” of Borderline Personality Disorder to bring public awareness for those who struggle with the condition.

Though he has been forthright, many in the sports world had stated that the New York Jets will have their hands full when he joins the team as his troubles have decreased only slightly since he began treatment.

Melissa Lind

Intermittent Explosive Disorder

Intermittent Explosive Disorder – More Than Just Anger

Intermittent Explosive Disorder (also called IED, that is appropriate as it can go off unexpectedly and cause significant damage)

Intermittent Hulk Explosive DisorderProbably everyone knows that teenage boy (or girl) who punched a hole through the wall.  Perhaps for some, this became a regular pattern of behavior during adolescence but most of those teenagers outgrew it.  In fact, at least one-quarter of teenage boys has done something dumb like punching a wall.

One boy I knew in high school even broke his hand by punching the roof of his car, and some boys were routinely doing stupid stuff.  Despite that, all of it was teenage angst and changes that can be attributed to the massive amounts of testosterone flowing through the male adolescent body – none of them had intermittent explosive disorder.

Intermittent Explosive Disorder is worse than punching a hole through a wall.

It typically is first identified in the early teens – but can be seen much earlier in some cases.    In order to be actually characterized as intermittent explosive disorder, an individual must have had three episodes of explosive behavior that is severely out of proportion to the stressor.

Intermittent Explosive Disorder HulkinsectThey must have broken or smashed something that is monetarily valuable (more than a few dollars), physically attacked or made explicit threats to attack someone with the intent of causing harm.  If these three episodes occur within the space of 12 months, the disorder is considered to be more severe.

Here is the catch.

How do you distinguish between IED, average – though extreme teenage behavior and other psychiatric conditions?  It turns out that IED is probably a diagnosis of “if nothing else fits” as other psychiatric disorders certainly overlap with similar symptoms – and you have to rule out the adolescent hormone issue.

Bipolar disorder may cause outbursts of extreme anger and agitation, Borderline personality disorder may cause outbreaks, ADHD patients can exhibit a severe lack of self-control, and drug abuse is always a potential cause.  Even though those diseases may cause IED-like events, a sustained behavior pattern is something to address.

Intermittent Explosive Disorder WarningA recent study reported by the National Institutes of Health shows that IED can actually affect up to 4 percent of adults and lead to an estimated 43 attacks over a lifespan.  The disorder may also increase that chance of depression, anxiety and substance abuse disorders.  People with IED have an obvious increased risk of legal trouble, financial difficulties, and divorce – that’s a no-brainer.

So the biggest problem for mental health professionals, like many other disorders, is to untangle all of the information leading in and out with a mix of behaviors and a mix of causes.  What came first – the chicken or the egg?  What came first – the drug abuse or the anger?  Which illness is more important – bipolar disorder or the IED?

One of the biggest clues may be in examining (or better, paying attention to) behavior that occurs before puberty.  In other words: What came first – the behavior or puberty?  Clearly if the behavior started before puberty, there was and is an issue.  If the behavior begins during adolescence – you have to wait (and hope) to see if the behavior goes away once the hormones are settled.

IED is not a simple diagnosis.

It requires a careful examination of an entire psychiatric and behavioral history – and the “ruling out” of a lot of other disorders that may be to blame.  Unfortunately, in the end – unless an underlying cause can be found, there is no medicationAnger management and cognitive behavioral therapy are likely the only answer – minimization of harm, not very satisfactory if it was your car window that got smashed in a fit of rage.

Melissa Lind

Borderline Personality Disorder or Traumatic Stress Disorder

Borderline Personality Disorder – What if it is a traumatic stress disorder?

When most people think of Borderline Personality Disorder – they think of bad behavior.  It is someone that is very difficult to deal with, someone that you have to be on guard against, Borderline Disordersomeone who will try their best to manipulate you.
But, while that may be the outcome, just like most psychiatric disorders, it isn’t exactly their fault.

One of the problems with BPD is that since it is a “personality disorder“, there is often no recognized medical treatment.

We simply expect that the patient should self-monitor and control their behavior.  Therapy may help this, but how many of us (psychiatric patients, in general) really want to go to therapy.

Many of us have already spent hundreds of hours with a therapist – who may or may not help.  In addition, the best therapists are likely people who can “see through the bullshit” and refuse to be manipulated.  This obviously goes against the nature of someone with Borderline Personality Disorder.

In fact, the stigma is so bad that some therapists won’t even work with Borderline patients.

Co Morbid DisordersOne theory may help.  Some therapists have developed an automatic assumption that a Borderline patient is also a trauma victim.  While this co-morbid condition may not always be true, it can help some therapists feel more comfortable treating the patient.

Due to many soldiers returning from impossible battlefields in the Middle East, Post Traumatic Stress Disorder is fairly well recognized.  Remember; I am not saying that it is easily treatable, but to some extent, the stigma is less.

When therapists look at Borderline patients as truly a PTSD patient, they may be more willing to treat the disorder. And they will attempt to get to the underlying causes of abandonment, impulsive and destructive issues, loss of control and poor self-image.

While PTSD is well defined by the professional psychiatric community, a longer-term disorder currently known as complex traumatic disorder is not.  Most examples of CTSD still involve soldiers, or they may involve women who had difficult pregnancies or who were violently sexually abused, repeatedly.

However, what if you don’t fit any of those recognized categories?

There are more ways to treat traumatic stress disorders such as Cognitive Behavioral Therapy or a newer one, Dialectical Behavior TherapyDBT focuses on four major areas:

•    Regulation of emotionsPost-Traumatic Stress Disorder
•    Tolerance for distress
•    Interpersonal effectiveness
•    Mindfulness

Unlike CBT, there is no “processing” component – making it work well as an initial treatment, starting before the patient has developed coping skills.  It builds up the feeling of emotional safety so that coping skills may develop.

Differentiating between “plain” Borderline patients – and those whose behavior is brought on by traumatic experience may help to eliminate some of the stigma still associated with BPD.  It may also offer actual, more effective treatment than CBT or other approaches.

Melissa Lind

Bipolar Disorder and Suicide Risk

Physical Proof and a Big Shocker – Bipolar Disorder and Suicide Risk

Bipolar HeadI read a lot of news about bipolar disorder and other psychiatric disorders (OCD, ADHD, chronic depression, borderline personality disorder, etc.).  In my reading, I came across an article that describes brain scan abnormalities in teens and young adults who have attempted suicide but I found a lot more.

A study conducted at Yale School of Medicine examined brain scans of 26 young adults and teenagers with bipolar disorder who had attempted suicide.  These were compared with scans of 42 bipolar patients who had not attempted suicide and with 45 non-bipolar subjects.  The results were not really surprising – as many research studies are not.

The bipolar patients, who had attempted suicide, showed abnormalities when compared to the other two groups, specifically in the  which showed “less integrity”.

Frontal lobe animationThis means that the frontal lobe (which controls impulses) is not as “connected” to areas that control emotion, motivation and memory.  Researchers indicate that the brain abnormalities may disrupt the ability of the impulse control mechanism to filter emotion and motivational messages appropriately.

In short this means that those patients can’t stop negative emotions and impulses to do something drastic… like attempt suicide and not surprisingly, less integrity or more abnormality – likely means more suicide attempts.

While it is good that they are discovering some physical proof of actual defect, eventually to move bipolar disorder into a category that can be scientifically documented, it doesn’t offer a lot of real-life solutions.  Most of us who are bipolar or know someone who is bipolar, know that there is something wrong or at least different about our brain…and it only makes sense that a person, who is trying to kill himself, is probably a little worse off.

As usual, I found myself thinking “…and… the point is…” which I often do when I read a synopsis of a largely inconsequential research study but then something caught my eye.  It was something that was a lot worse than I thought – statistics.

About 4 percent of Americans are afflicted with bipolar disorder, though sometimes we feel like it is others who are afflicted.  That is not surprising either.  Some groups show a slightly lower percentage at about 2.6 percent of the population.

Bipolar SuicideWhat surprised me was the statistic regarding suicide.  The article – that is from a reputable source – indicates that 25 to 50 percent of people with bipolar disorder are likely to attempt suicide and that 15 to 20 percent are likely to succeed.  Wow.  I didn’t know that.  Funny thing that I didn’t know since of the 20 or so bipolar people I have been close friends with at one time or another – at least four of them are dead.

When searching for confirmation (which I found from the NIH that about 1 in 5 bipolar patients complete suicide), I also found a number of additional shocking statistics:

  • Bipolar disorder results in a 9.2 year reduction in lifespan
  • Bipolar disorder is the 6th leading cause of disability, worldwide
  • Bipolar disorder is found in all races, ethnicities, ages, genders and socioeconomic groups
  • A child with one bipolar parent has a 15-30% chance of having the disorder
  • A child with two bipolar parents has a 50-75% chance of having the disorder
  • There are 3.4 million CHILDREN with depression in the US but up to one-third of those kids may actually have bipolar disorder
  • Bipolar disorder criteria have likely been met for at least 1 percent of all adolescents

Maybe these aren’t shocking for you.  Maybe you already knew all this – but maybe you didn’t.

I have known I had bipolar disorder for a long time – and have known a lot more people with bipolar disorder and I didn’t know all this stuff or maybe like everything else, I chose not to remember.

Food for thought; Take your medicines!

Melissa Lind