Monday, October 28, 2013

The Dark Side

Does Darth Vader meet the diagnostic criteria for Borderline Personality Disorder? The following passage is taken from the BPS Research Digest (2010).
In a brazen act of arm-chair diagnosis, Eric Bui and colleagues at Toulouse University Hospital in France have written a short academic article arguing that the Star Wars character Darth Vader probably meets the diagnostic criteria for borderline personality disorder (BPD). The authors point to Anakin Skywalker's (as he was originally known) life history, including fatherly absence, early maternal separation and infantile illusions of omnipotence. They go on to claim that Skywalker meets six of the formal nine DSM (diagnostic and statistical manual) criteria for BPD:

'He presented impulsivity and difficulty controlling his anger and alternated between idealisation and devaluation (of his Jedi mentors). Permanently afraid of losing his wife, he made frantic efforts to avoid her abandonment and went as far as betraying his former Jedi companions. He also experienced two dissociative episodes secondary to stressful events. One occurred after his mother's death, when he exterminated a whole tribe of Tuskan people, while the other one took place just after he turned to the dark side. He slaughtered all the Jedi younglings before voicing paranoid thoughts concerning his former mentor and his wife. Finally, the films depicted his quest to find himself, and his uncertainties about who he was. Turning to the dark side and changing his name could be interpreted as a sign of identity disturbance.'
Does this matter? Bui and his colleagues argue that Skywalker's condition could help explain the appeal of the Star Wars films to teenagers - an age group they say presents 'more frequent BPD traits than adults'. They also suggest that promoting recognition that such a famous fictional character meets the criteria for a BPD diagnosis could help combat the stigma associated with mental illness. 'Finally,' they write, 'as [the Star Wars films are] part of most students' cultural background, this case study could prove useful in teaching the criteria of BPD to medical students and residents.'
Bui and colleagues first made these claims at a psychiatric conference in 2007.
Bui, E., Rodgers, R., Chabrol, H., Birmes, P., & Schmitt, L. (2010). Is Anakin Skywalker suffering from borderline personality disorder? Psychiatry Research DOI: 10.1016/j.psychres.2009.03.031

Friday, October 18, 2013

Stigma - A major barrier to Suicide Prevention

According to the WHO and the latest Burden of Disease Estimation, suicide is a major public health problem in high income countries and is an emerging problem in low and middle income countries. Suicide is one of the leading causes of death in the world, especially among young people.

Nearly one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. These staggering figures do not include nonfatal suicide attempts which occur much more frequently than deaths by suicide.

                                                                                                                Suicides in Republic of Ireland from 2001-2013

2001 - 519
2002 - 478
2003 - 497
2004 - 493
2005 - 481
2006 - 460
2007 - 458
2008 - 506
2009 - 552
2010 - 490
2011 - 525
2012 - 507
*2013 - 475 (6% drop, with males accounting for over 83% of all suicide deaths last year.)

A large proportion of people who die by suicide suffer mental illness. Recent estimates suggest that the disease burden caused by mental illnesses will amount for 25% of the total disease burden in the world in the next two decades, making it the most important category of ill-health (more important than cancer or heart diseases.)

A significant number of those with mental illnesses who die by suicide do not contact health or social services near the time of their death. In many instances, there are insufficient services available to assist those in need at times of crisis. Lack of access to appropriate care is one of the many factors that magnify the stigma associated with mental illness and with suicidal ideation and behaviour. This type of stigma, which is deeply rooted in most societies, can arise for different reasons.

For some people, the term 'suicide' alone evokes panic and one of the causes of stigma is a simple lack of knowledge - that is, ignorance. This type of stigma can be directly addressed by providing a range of community-based educational programs that are targeted to specific subgroups within the society (that is, by age, educational level, religious affiliation, and so forth). Negative attitudes about individuals with mental illnesses and/or suicidal ideation or impulses (prejudice) is common in many communities. These negative attitudes often do not change with education about mental illnesses and suicidal behaviour.

Many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes towards such patients. This can result in a failure to provide optimal care and support for persons in crisis.

Stigma is also the underlying motive for discrimination - inappropriate or unlawful restrictions of the freedom of individuals with mental illnesses or suicidal behaviour. Such restrictions can occur at a personal, community or institutional level. One extreme example is the criminalization of suicidal behaviour, which still occurs in many countries. Discrimination can prevent or discourage people affected by mental illness and/or suicidal ideation or behaviour from seeking professional help, or from returning to their normal social roles, after receiving treatment for an episode of illness or crisis.

In both high-income and low and middle-income countries stigmatized conditions such as mental illnesses and suicidal behaviour receive a much smaller proportion of health and welfare budgets than is appropriate, given their huge impact on the overall health of the community.

Unless the stigma is confronted and challenged, it will continue to be a major barrier to the treatment of mental illnesses and to the prevention of suicide. Events like World Mental Health Day (October 10th) and World Suicide Prevention Day (September 10th) are ideal times to highlight and inspire people to work towards the goal of developing creative new methods for eradicating stigma and helping to save lives.
Each morning when you open your eyes, say to yourself:  “I, not external people or events, have the power to make me happy or unhappy today.  It’s up to me.  Yesterday is gone and tomorrow hasn’t come yet.  I only have today and I’m going to be happy in it.” 

Friday, October 04, 2013

Puerto Rico's Private Drug Hell

Deadly and more addictive than crystal meth. A drug with horrific sleep walking side effects - the horse tranquilizer Xylazine, known on the streets of Puerto Rico as 'Anaesthesia'. It's a shocking new drug that is unique to this island. It turns users into zombies, causing them to faze in and out of consciousness even while standing on their feet.

Xylazine first began appearing on the black market in Puerto Rico's horse farming towns in early 2000. It works as a suppressant on the central nervous system. It's so strong, Puerto Rican vets normally use it to tranquilize horses for dental work and castration procedures. Xylazine is cheap and easy to purchase on the black market without a veterinary license. One 100mg bottle can cost between $60 to $80 which can turn over $5-6,000 on the street once it has been cooked and prepared.

One in seven are drug users in Puerto Rico. Often the conditions on the streets are so bad that many addicts are happy to be sent to prison just to receive treatment. It is a country that has double the murders of New York but only half the population (3.7 million). On average there's a murder every 8 hours with 80% drug related.

With 90% of the world's cocaine coming from South America, and Puerto Rico becoming the cartels preferred route into cities on the east coast of America, how long will it be before drugs like Xylazine buries it's hooks further afield? The drugs crisis in Puerto Rico is sinking to new depths, as more and more addicts join the ranks of 'the living dead', turning this paradise into a 'zombie island'