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Week #1, Borderline Personality Disorder: 
Girl, Interrupted, movie

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Week #1, Borderline Personality Disorder: 
Girl, Interrupted, movie

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Girl, Interrupted (1999) is a movie about a girl named Susanna Kaysen who has been sent to a mental institution for young girls after being diagnosed with Borderline Personality Disorder. She spent two years in the institution, where she loses her sense of self to the seduction of other young patients in the institution. She and a few others escape the institution and is then set to leave and reclaim her life after being institutionalized.

The DSM-V explains BPD as follows:

A known pattern of unstable interpersonal relationship, sense of self, self-image, and marking impulsivity, as indicated by five (or more) of the following:

A: frantic efforts to avoid real or imagined abandonment.

B: a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

C: identity disturbance: markedly and persistently unstable self-image or sense of self

D: impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).

E: recurrent suicidal behavior, gestures, threats, or self-mutilating behavior

F: affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

G: chronic feelings of emptiness

H: inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

I: transient, stress-related paranoia or severe dissociative symptoms

Susanna met these criteria:

A: Susanna attempted to stay in relationships with her professor and a different boy so that she felt wanted and loved, and not rejected or abandoned.

B: She lacked any interpersonal relationship with her family and friends who just wanted her to be normal. She was often thought to be an out-cast by her family. She also experienced a falling out with a professor whom she had been sleeping with.

C: Susanna had no self-esteem or sense of worth.

D: She was having an affair with one of her professors and a boy she met after high school at the same time, both having unsafe sex. Susanna, also, snuck out of the institution with a neighbor patient named Lisa; knowing they could get in trouble.

E: She made what she called a "half-hearted attempt" to kill herself before checking herself into the mental institution by taking a bottle of pills with vodka. She also indulged in self-harm.

F: She experienced a shift in mood from the beginning of treatment until the end. Susanna checked herself in, meaning that she had some sort of passion about getting better. However, later on while at the hospital, she felt like she had no sense of herself at all. She stopped caring about her health and just wanted to ignore her diagnosis.

G: Susanna often experienced feelings of emptiness caused by not being where she wanted to be in life. Susanna felt as if nothing was going how she wanted it and she was the only person feeling that way.

H: During one scene in the movie, Susanna goes from half-asleep to kicking, screaming, cussing and spewing bouts of racial slurs at her nurse.

After watching the movie, I believe that Susanna portrays symptoms of BPD very accurately. However, I question how much of her symptoms can be accredited to any 18 year old girl in the modern world trying to discover her sense of self and becoming one on her own. In terms of stereotyping, I believe it is important to discuss the labeling of “normal” that Susanna’s parents used within the movie. Her family believes that because she is dealing with mental issues that she is not normal and may otherwise be “crazy.” This can be harmful to those dealing with any mental disorder while trying to get treatment or needing help otherwise. Additionally, I believe that the portrayal of the institution was quite unfair, but not different from other portrayals of mental institutions. Susanna’s nurse was rude towards her and made the hospital seem like a prison, which is what they are often referred to as. This makes it difficult for others to want to receive help from institutions.

**Note: The video clip contains very crude language and racial content.

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Girl Intterupted ( what's your diagnonsense?! )

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Week #2, Substance Use Disorder: 
"Sober" by Demi Lovato, song

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Week #2, Substance Use Disorder: 
"Sober" by Demi Lovato, song

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"Sober," written by Demi Lovato, discusses her lifelong struggle with substance abuse and how it has affected her in recent years despite her past with substance abuse. Her substance abuse began in 2009, where she began partying and getting involved with drugs and alcohol. In 2018, Demi released her song "Sober" where she states she had returned to substance abuse after being 6 years sober. Shortly after this song was released, news stated that Demi had been rushed to the hospital due to a drug overdose, however she is now stable.

The DSM-V explains SUD as follows:

Multiple patterns of symptoms resulting from the use of a substance that one continues to take, despite experiencing problems as a result.
Criteria includes:
A: taking the substance in larger amounts or for longer than meant to.
B: wanting to cut down or stop using the substance but not managing to.
C: spending a lot of time getting, using, or recovering from use of the substance.
D: cravings and urges to use the substance.
E: not managing to do what you should at work, home, or school because of substance use.
F: continuing to use, even when it causes problems in relationships.
G: giving up important social, occupational, or recreational activities because of substance use.
H: using substances again and again, even when it puts you in danger.
I: continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
J: needing more of the substance to get the effect you want (tolerance).
K: development of withdrawal symptoms, which can be relieved by taking more of the substance.

Demi meets these criteria:

A: Demi has experienced more than one instance of overdosing on a substance, taking large amounts. She experienced an overdose in 2011 and 2018.
B: Before getting sober, Demi mentions wanting to stop using the substances, but not being able to manage her other psychological impairments without it. In 2010, Demi entered rehab to get clean, where she is later diagnosed with Bipolar Disorder, and Bulimia, along with Substance Use Disorder. She was released later that year.
C: In 2012, she was re-admitted for a second time to a rehab center and left sober once again on a 6 year path, where she spent a lot of time recovering and relapsing. In "Sober," she says "to the ones who never left me we've been down this road before." stating that this has happened on multiple occasions.
D: In 2011, Demi explains that she was either craving drugs every 30 minutes or was finding a way to sneak them wherever she was, including a plane. In "Sober," she writes "sometimes I just wanna cave and I don't wanna fight."
E:  In 2010, Demi canceled a concert tour after punching a back-up dancer while high and afterwards slept the rest of the day.
F: Demi mentions in "Sober" that she felt sorry for making love to someone other than her man while on a substance. She also apologizes to her parents, fans, and to herself for relapsing.
G: She canceled a concert tour after punching a back-up dancer while high.
H: After experiencing an overdose, she continued to use the substance. In "Sober," she says "call me when it's over 'cause I'm dying inside. Wake me when the shakes are gone and the cold sweats disappear," suggesting that she knows it is bad for her health.
I: Demi was made aware of her other psychological impairments in 2010, and was relapsed in 2018 knowing her psychological ailments. She explains in "Sober" that she only craves substances when she is lonely.
J: Overdosing is caused by taking more of a drug and considering she has been using substances since 2009, her tolerance would be very high.
K: It can be assumed that she experiences withdrawals while recovering, which is why it is so difficult for her.

Demi Lovato has seemingly every symptom of Substance Abuse Disorder, which saddens me as she is one of my biggest inspirations and role models. I question how much of a biological component has impacted her throughout these years considering her father was also an addict of many substances. I believe she has taken her diagnosis with grace and is trying her best to live her life openly in the public eye. She is extremely open about her struggles and she has helped and inspired thousands of young people and fans who deal with substance abuse, bipolar disorder, bulimia, self-harm, etc. However, while in the public eye she has received a lot of hate and negativity for her most recent overdose. She has recently tucked herself away from social media and has not been mentioned in the press since. This has the opportunity to teach those who deal with these issues to fight for life and to get help regardless of what the circumstances are, and that people are cruel, but that shouldn't stop people from standing up for themselves and their lives.

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Demi Lovato - Sober (Official Lyric Video)

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Week #3, Anorexia Nervosa:                                                                       The Good Doctor S2E5 "Carrot", TV show

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Week #3, Anorexia Nervosa:                                                                       The Good Doctor S2E5 "Carrot", TV show

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The Good Doctor (2017-) is a TV show about a young, autistic doctor who is hired as a resident doctor for his genius ability to see outside of the box in terms of medical knowledge and treatment. In "Carrot", a patient named Louisa is suffering from anorexia nervosa. Because she has starved herself, her heart is damaged. She needs heart surgery, but is not able to undergo it without building up her nutrition (i.e force-feeding). Dr. Shaun begins feeding her through a nasogastric tube (NG tube), and despite the effort to get her ready for surgery, she ends up taking the tube out and is unable to continue the force-feeding despite her being a mother and a wife. She eventually receives a neurological deep-brain stimulation surgery that changes her cognition towards food and her disorder. She is then able to eat and receives the heart surgery she needs.

The DSM-V explains AN as follows:

To be diagnosed as having Anorexia Nervosa a person must display:
A: persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health).
B: either an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain (even though significantly low weight).
C: disturbance in the way one's body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Louisa met these criteria:

A: Louisa explains having issues with food beginning at the age of 14. She is very persistent to keep herself from digesting anything with substance. She shows this when the hospital gives her food and she only eats 2 oz of her entire meal. Her BMI levels ranged from 13-16 during the course of her disorder.
B: Louisa's husband explains that she skips meals frequently, lies about eating, and exercises excessively. She explains that in previous attempts at the NG tube she was unable to stand being fed and it did not work. After receiving another NG tube, she explains that she has a constant voice in her head telling her that the tube has "1,200 calories in it," which is causing her anxiety. She then rips the tube out after not being able to stand the thought of putting substance in her body.
C: While Louisa does not clearly mention having trouble with body image, she is clearly very bony. Her collarbones, cheekbones and other parts of her that are shown are severely skinny. She admits that she understands that the anorexia has caused her body detrimental issues, but at the same time she continues the behavior. She desperately begs the doctors to help her stop, knowing that she is killing herself.

After watching this episode, I believe that Louisa portrays symptoms of AN accurately. Dr. Brown recommends a brain surgery that will reduce her anxiety to food, which will then allow her to eat. Unfortunately, the surgery could change her entire personality. I question how often deep brain stimulation surgery is used to treat psychological disorders and what the criteria is in order to be able to do this surgery. If this type of surgery could be useful is treating other psychological disorders, then I hope that there will be more research done in the future. In terms of stereotyping, Louisa does not fit the typical stereotype of having anorexia. Dr. Brown mentions that Louisa was very lucky to be pregnant and that she was able to temporarily recover and eat for her son, Graham, who was born and lives to be a healthy child. It is important that patients with this disorder know that while there are risks to treatment, there are also hopes for improvement to some extent. Quality of knowledge given to the patient is crucial. Louisa and Graham get into an argument where he says, "It can't be that hard, just eat." This statement is powerful due to it's inability to understand the psychological trauma of anorexia nervosa. Louisa explains that she has tried every other form of psychological therapy and physical therapy there is to treat her AN, however all have failed. To make for a cliffhanger ending, after undergoing the brain surgery, she feels as though she is hungry again. However, due to the side effects of the surgery, she feels less maternal towards her son.

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Watch The Good Doctor Streaming Online | Hulu (Free Trial)

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Start your free trial to watch The Good Doctor and other popular TV shows and movies including new releases, classics, Hulu Originals, and more. It's all on Hulu.

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Week #4, Attention Deficit/Hyperactivity Disorder:                                The ADHD Life, radio podcast

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Week #4, Attention Deficit/Hyperactivity Disorder:                                The ADHD Life, radio podcast

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The ADHD Life (2016) is a radio podcast for people seeking to understand ADHD, including its weaknesses and strengths. The purpose of this podcast is to help others with ADHD improve their lives. The host shares his experiences as both a recently diagnosed person with ADHD as well as his entry into the world of ADHD coaching.

The DSM-V explains ADHD as follows:

A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by A and/or B:

A: inattention which can be expressed by at least 6 (or more) of the following symptoms that have persisted for at least 6 months in which has affected functioning:

a: often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities

b: often has difficulty sustaining attention in tasks or play activities

c: often does not seem to listen when spoken to directly

d: often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace

e: often has difficulty organizing tasks and activities

f: often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort

g: often loses things necessary for tasks or activities

h: is often easily distracted by extraneous stimuli or unrelated thoughts

i: is often forgetful in daily activities

B: hyperactivity and impulsivity which can be expressed by 6 (or more) of the following symptoms have persisted for at least 6 months in which has affected functioning:

a: often fidgets with or taps hands or feet or squirms in seat

b: often leaves seat in situations when remaining seated is expected

c: often runs about or climbs in situations where it is inappropriate

d: often unable to play or engage in leisure activities quietly

e: is often “on the go,” acting as if “driven by a motor" and may be seen as restless or difficult to keep up with

f: often talks excessively

g: often blurts out an answer before a question has been completed

h: often has difficulty waiting his or her turn

i: often interrupts or intrudes on others

C: several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years

D: several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work, etc)

E: there is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning

F: the symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder.

The host meets these criteria:

A: inattentive:

a: He says that whenever he works on a project, or anything in general, he can always find mistakes.

b: He explains that there are often times when he is distracted by other things. He mentions how he has a habit of noticing things that are undone and going back to fix them regardless of what he is doing in that moment.

d: He says “nothing gets done if it's not urgent, and even then it may not happen.” He explains that he often deals with decision paralysis. He often delays housework.

e: He explains that he has difficulty making lists as it overwhelms him.

f: He says that he is often a procrastinator because he finds difficulty doing things that require effort. He finds it tiring due to his rushed mind.

g: He explains that he has a collection point at one point in his home to put his wallet and keys in that way he doesn’t lose it.

h: In the middle of one of the podcasts, he began going on a rant about the stock market and apple products. This was unrelated to the topic which was perfectionism.

i: He talks about how he often received less opportunities for jobs due to his ability to miss deadlines at work or during school.

B: hypersensitivity and impulsivity

a: He explains that he often fidgets with his seat belt while driving. He has a hypersensitivity to fabrics.

e: He explains that oftentimes he makes impulsive decisions that others have a hard time keeping up with.

f: He talks continuously, and I notice that the more passionate he gets about something, the more off topic he got. However, he relatively stayed on topic.

D: He experiences both symptoms at work and at home.
E: He says that there have been often times where his symptoms has affected him from doing well in school, keeping the house clean, and receiving better job opportunities, or even keeping a job.
F: The symptoms are not part of a schizophrenic, etc disorder.

While the host clearly has mostly inattentive characteristics, he speaks for those with all symptoms. He explains that having a support system is key to getting the most out of treatment and the most out of life with ADHD. In terms of stereotyping, the host explains that he is more of a perfectionist, which is the opposite of most stereotypes of people with ADHD. He says that he often will repeat tasks and do them repeatedly until they are “perfect.” He also states that people with ADHD do some of their best work when they are passionate about something (i.e. entertainers with ADHD are usually the life of the party). This makes me question how much of ADHD can be related or attributed to OCD and how likely OCD and ADHD are comorbid with each other. The host also mentions that people with ADHD have lower self-esteem than the general public and have higher suicide rates. This is because they are aware of how their symptoms and the stigma that comes with it. He explains that nowadays most people are sarcastic about ADHD and most don’t really believe that it is a real disorder. Therefore, people are thought down-upon because others believe that they are making up symptoms for attention. When in fact, people with ADHD don’t want the attention that it given to them and often just want to live functional lives. ADHD is not a negative condition, it is simply a disorder or inattentiveness and activity, meaning that people can live functional lives with this disorder. I hope that more people will become willing to listen to their stories and decrease the stability of the stigma that rests on those with ADHD.

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This ADHD Life is a podcast for people seeking to understand ADHD better, its weaknesses AND strengths, and how to improve their ADHD life. The host shares his experiences as both a recently diagnosed person with ADHD as well as his entry into the...

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Week #5, Post Traumatic Stress Disorder:                                     Veteran's Mental Health, cartoon

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Week #5, Post Traumatic Stress Disorder:                                     Veteran's Mental Health, cartoon

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This Veteran's Mental Health cartoon (2010) edited by Joel Pett's, depicts one of America's harshest realities. Our country sends soldiers to fight our wars, yet we don't have enough funding to psychologically or physically take care of them when they get back. The leading cause for psychological dysfunction for war veterans is PTSD, as depicted in the cartoon.

The DSM-V explains PTSD as follows:

All criteria must be present in individuals age 6 and above:
A: exposure to actual or threatened death, serious injury, or sexual violence.
B: presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
C: persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred.
D. Negative alterations in cognition and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Inability to remember an important aspect of the traumatic event(s).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world.
3. Persistent, distorted cognition about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state.
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions.
E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance.
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. The disturbance is not attributable to the physiological effects of a substance or another medical condition.

The cartoon depicts these criteria:

A: War veterans have been either directly exposed or indirectly exposed to war deaths and other tragic events. The cartoon depicts a veteran who has lost a leg.
B: The veteran describes dealing with flashbacks, nightmares, stress, and panic from being exposed to the events.
D: The veteran describes dealing with depression and suicidal thoughts, along with anxiety.
E: The veteran describes dealing with anger and insomnia.
F: The veteran in the cartoon is an older gentleman, meaning that he has been dealing with psychological consequences of war for a long time.
G: He experiences depression, anxiety, panic attacks, etc. that can effect social functioning.
H: There is no substance abuse mentioned.

This cartoon does a great job of explaining what veterans deal with psychologically after being involved in the war. The cartoon also also shows the lack of funding that we have in order to take care of them. Currently, it seems that the government is unwilling to provide them with the means necessary due to money going elsewhere. This can cause veterans to become homeless, without work, without family, and other distressing events to occur in their lives once they return home. In terms of stereotypes, the cartoon depicts that all people are like this. Most of the american people want better funding for veteran care. Additionally, it can be interpreted that all veterans experience PTSD in this way. This is not true. PTSD is exclusive to each person who deals with it and should be treated as such. I wonder when our country would be able to fully fund our war veterans so that this disease may become less prevalent.