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PSYCHIATRIC INJURY vs MENTAL ILLNESS

I. THE INVISIBLE INJURY, 2005 edition, by David Kinchin

ISBN 0952912147Published by Success Unlimited 2004Paperback, 16 chapters, 224 pages, resources, index

The person who is being bullied will eventually say something like " I think I'm being paranoid... "; however they are correctlyidentifying hypervigilance , a symptom of PTSD, but using the popular butmisunderstood word paranoia . The differences between hypervigilance andparanoia make a good starting point for identifying the differences between mentalillness and psychiatric injury.

PARANOIA HYPERVIGILANCE

paranoia is a form of mental illness ;the cause is thought to be internal,eg a minor variation in the balanceof brain chemistry

is a response to an external event(violence, accident, disaster,violation, intrusion, bullying, etc)and therefore an injury

paranoia tends to endure and tonot get better of its own accord

wears off (gets better), albeitslowly, when the person is out of and away from the situation whichwas the cause

the paranoiac will not admit tofeeling paranoid, as they cannotsee their paranoia

the hypervigilant person is acutelyaware of their hypervigilance, andwill easily articulate their fear, albeitusing the incorrect but popularisedword "paranoia"

sometimes responds to drugtreatment

drugs are not viewed favourably byhypervigilant people, except inextreme circumstances, and thenonly briefly; often drugs have noeffect, or can make things worse,sometimes interfering with thebody's own healing process

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the paranoiac often has delusionsof grandeur; the delusional aspectsof paranoia feature in other formsof mental illness, such asschizophrenia

the hypervigilant person often has adiminished sense of self-worth,sometimes dramatically so

the paranoiac is convinced of theirself-importance

the hypervigilant person is oftenconvinced of their worthlessnessand will often deny their value toothers

paranoia is often seen inconjunction with other symptoms of mental illness, but not inconjunction with symptoms of PTSD

hypervigilance is seen inconjunction with other symptoms of PTSD, but not in conjunction withsymptoms of mental illness

the paranoiac is convinced of theirplausibility

the hypervigilant person isaware of how implausible theirexperience sounds and oftendoesn't want to believe itthemselves (disbelief anddenial)

the paranoiac feels persecuted by aperson or persons unknown (eg"they're out to get me")

the hypervigilant person ishypersensitized but is often awareof the inappropriateness of their

heightened sensitivity, and canidentify the person responsible fortheir psychiatric injury

sense of persecution heightened sense of

vulnerability to victimisation

the sense of persecution felt by theparanoiac is a delusion, for usuallyno-one is out to get them

the hypervigilant person's sense of threat is well-founded, for the serialbully is out to get rid of them andhas often coerced others into

assisting, eg through mobbing; thehypervigilant person oftencannot (and refuses to) see thatthe serial bully is doingeverything possible to get rid of them

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the paranoiac is on constant alertbecause they know someone is outto get them

the hypervigilant person is onalert in case there is danger

the paranoiac is certain of theirbelief and their behaviour andexpects others to share thatcertainty

the hypervigilant person cannot

bring themselves to believe that thebully cannot and will not see theeffect their behaviour is having;they cling naively to themistaken belief that the bullywill recognise their wrongdoingand apologise

Other differences between mental illness and psychiatric injury include:

Mental illness Psychiatric injury

the cause often cannot beidentified

the cause is easily identifiableand verifiable, but denied bythose who are accountable

the person may be incoherent orwhat they say doesn't make sense

the person is often articulatebut prevented from articulationby being traumatised

the person may appear to beobsessed

the person is obsessive, especiallyin relation to identifying the causeof their injury and both dealing withthe cause and effecting theirrecovery

the person is oblivious to their

behaviour and the effect it has onothers

the person is in a state of acute self-

awareness and aware of their state,but often unable to explain it

the depression is a clinical orendogenous depression

the depression is reactive; thechemistry is different toendogenous depression

there may be a history of there is very often no history of

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depression in the familydepression in the individual or theirfamily

the person has usually exhibitedmental health problems before

often there is no history of mental health problems

may respond inappropriately to theneeds and concerns of others

responds empathically to theneeds and concerns of others, despite their own injury

displays a certitude aboutthemselves, their circumstancesand their actions

is often highly sceptical about their condition and circumstances and is in a stateof disbelief and bewilderment which they will easily and oftenarticulate ("I can't believe thisis happening to me" and "Why me?" - click here for theanswer)

may suffer a persecution complex

may experience an unusually heightened sense of vulnerability to possiblevictimisation (ie hypervigilance)

suicidal thoughts are the result of despair, dejection andhopelessness

suicidal thoughts are often a logicaland carefully thought-out solution orconclusion

exhibits despair is driven by the anger of

injustice

is often ready to give in or admitdefeat

refuses to be beaten, refuses togive up

Features of Complex PTSD from bullying

People suffering Complex PTSD as a result of bullying report consistent symptomswhich further help to characterise psychiatric injury and differentiate it from mentalillness. These include:

Fatigue with symptoms of or similar to Chronic Fatigue Syndrome

http://www.bullyonline.org/workbully/bully.htm#Whyhttp://www.bullyonline.org/workbully/bully.htm#Why

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An anger of injustice stimulated to an excessive degree (sometimesbut improperly attracting the words "manic" instead of motivated,"obsessive" instead of focused, and "angry" instead of "passionate",especially from those with something to fear)

An overwhelming desire for acknowledgement, understanding,recognition and validation of their experience

A simultaneous and paradoxical unwillingness to talk about thebullying (click here to see why) or abuse (click here to see why)

A lack of desire for revenge, but a strong motivation for justice

A tendency to oscillate between conciliation (forgiveness) and anger(revenge) with objectivity being the main casualty

Extreme fragility, where formerly the person was of a strong, stablecharacter

Numbness, both physical (toes, fingertips, and lips) and emotional(inability to feel love and joy)

Clumsiness

Forgetfulness

Hyperawareness and an acute sense of time passing, seasons changing, anddistances travelled

A constant feeling that one has to justify everything one says anddoes

A constant need to prove oneself, even when surrounded by good, positivepeople

An unusually strong sense of vulnerability, victimisation or possiblevictimisation, often wrongly diagnosed as "persecution"

Feelings of worthlessness, rejection, a sense of being unwanted,

unlikeable and unlovableA feeling of being small, insignificant, and invisible

An overwhelming sense of betrayal, and a consequent inability andunwillingness to trust anyone, even those close to you

http://www.bullyonline.org/workbully/standup.htmhttp://www.bullyonline.org/related/abuse.htm#Reporting%20abusehttp://www.bullyonline.org/workbully/standup.htmhttp://www.bullyonline.org/related/abuse.htm#Reporting%20abuse

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In contrast to the chronic fatigue, depression etc, occasional false dawns withsudden bursts of energy accompanied by a feeling of "I'm better!", only to befollowed by a full resurgence of symptoms a day or two later

Excessive guilt - when the cause of PTSD is bullying, the guilt

expresses itself in forms distinct from "survivor guilt"; it comes outas:

a proneness to identifying with other people's suffering

a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)

a heightened sense of indebtedness, beholdenness and undue obligation

a reluctance to earn or accept money because one's sense of poverty andinjustice throughout the world is heightened

an unwillingness to take ill-health retirement because the person doesn'twant to believe they are sufficiently unwell to merit it

an unwillingness to draw sickness, incapacity or unemployment benefit towhich the person is entitled

an unusually strong desire to educate the employer and help theemployer introduce an anti-bullying ethos, usually proportional to theemployer's lack of interest in anti-bullying measures

Fatigue

The fight or flight mechanism is designed to be operational only briefly andintermittently; in the heightened state of alert, the body consumes abnormally highlevels of energy. If this state becomes semi-permanent, the body's physical,mental and emotional batteries are drained dry . Whilst the weekendtheoretically is a time for the batteries to recharge, this doesn't happen, because:

the person is by now obsessed with the situation (or rather, resolving thesituation), cannot switch off, may be unable to sleep, and probably hasnightmares, flashbacks and replays;

sleep is non-restorative and unrefreshing - one goes to sleep tired and wakesup tired

this type of experience plays havoc with the immune system; when the fightor flight system is eventually switched off, the immune system is impairedsuch that the person is open to viruses which they would under normalcircumstances fight off; the person then spends each weekend with a cold,

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cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteriesnever have an opportunity to recharge.

When activated, the body's fight or flight response results in the digestive,immune and reproductive systems being placed on standby. It's no

coincidence that people experiencing constant abuse, harassment andbullying report malfunctions related to these systems (loss of appetite,constant infections, flatulence, irritable bowel syndrome, loss of libido,impotence, etc). The body becomes awash with cortisol which in highprolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in thehippocampus, an area of the brain linked with learning and memory. Thehippocampus is also the control centre for the fight or flight response, thusthe ability to control the fight or flight mechanism itself becomes impaired.Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome- see health page for details.

http://www.bullyonline.org/stress/health.htm#CFShttp://www.bullyonline.org/stress/health.htm#CFS