Thursday, May 22, 2014

The Matrix: Was Neo Psychotic?

Auditory Hallucinations
Psychosis is a mental health problem that can  stop the person from thinking clearly, telling the difference between reality and their imagination, and acting in a normal way.

Morpheus: What is "real"? How do you define "real"?

It is a loss of contact with reality that usually includes delusions and hallucinations. Delusions are false beliefs about what is taking place or who one is, such as thinking that someone is plotting against you or that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. 

Neo: What did she tell you?
Morpheus: That I would find the One. 

Signs of Psychosis
The early stage of psychosis is marked by a difficulty in concentrating, depressed mood, sleep changes - sleeping too much or not enough, anxiety, suspiciousness, withdrawal from family and friends and on-going unusual thoughts and beliefs. While the later stages involve being confused and having impaired reality testing; that is, people are unable to distinguish personal, subjective experiences from the reality of the external world. This can progress onto delusions, hallucinations, disorganized speech (switching topics erratically), difficulty functioning, depression and even suicidal thoughts or actions.

Morpheus: I see it in your eyes. You have the look of a man who accepts what he sees because he is expecting to wake up. Ironically, that's not far from the truth.


A Psychoactive Aetiology?
A number of medical problems can cause psychosis, including:

- Alcohol and certain illegal drugs (or blue and red pills?)
- Brain diseases, such as Parkinson's  
- Huntington's disease, and certain chromosomal disorders
- Brain tumours or cysts
- Dementia (including Alzheimer's disease)
- HIV and other infections that affect the brain
- Some prescription drugs, such as steroids and stimulants
- Some types of epilepsy
- Stroke

Psychotic symptoms may include: disorganized thought and speech, false beliefs that are not based in reality (delusions), especially unfounded fear or suspicion, and thoughts that "jump" between unrelated topics (disordered thinking).

Neo: I thought it wasn't real
Morpheus: Your mind makes it real

Exams and tests:
Psychiatric evaluation and testing are used to diagnose the cause of the psychosis. Laboratory testing and brain scans may not be needed, but sometimes can help pinpoint the diagnosis. The type of tests may include; blood tests for abnormal electrolyte and hormone levels, blood tests for syphilis and other infections, drug screens, and sometimes an MRI of the brain.

''Yeah...ehmm...sorry about that''

Possible Complications:
Psychosis can prevent people from functioning normally and caring for themselves. If the condition is left untreated, people can sometimes harm themselves or others (or Trinity).

 Morpheus: You've been living in a dream world, Neo.
''Your 50 minutes are up young man''

Treatment often depends on the cause of the psychosis. It might involve drugs to control symptoms and talk therapy, which can help address the underlying cause of the psychosis.

For example the talking therapy cognitive behavioural therapy has proved successful in helping people with schizophrenia.  Hospitalization is an option for serious cases where a person might be dangerous to himself or others.

''Perhaps we are asking the wrong questions'' ~ Agent Brown 

Social support should also be addressed, so as to help support the person with psychosis, who may have social needs such as education, employment or accommodation.

Agent Smith: It seems that you've been living two lives. One life, you're Thomas A. Anderson, program writer for a respectable software company. You have a social security number, pay your taxes, and you... help your landlady carry out her garbage. The other life is lived in computers, where you go by the hacker alias "Neo" and are guilty of virtually every computer crime we have a law for. One of these lives has a future, and one of them does not.

''The need to prove who you are will vanish once you know who you are''
~ Pierre
Similar to Parkinson's Disease and Schizophrenia, dopamine levels are thought to be too high during psychosis, or better, there is a 'functional excess' of dopamine in the person's brain. This can affect memory, emotion, social behaviour and self-awareness.

Bizarre delusions are often experienced during psychosis.

Examples of psychotic delusions include the paranoid type - more likely to be associated with schizophrenia - and delusions of grandeur.

''Sure ye do''

Delusions of grandeur: clearly false but strongly held beliefs in having a special power or authority - the person with psychosis may, as examples, believe that they are a world leader, very rich, that they are able to bring dead people back to life, or that they can control the weather.
While the classic hallmarks of psychosis are hallucination and delusion, other symptoms persist in disorders such as schizophrenia - known as negative symptoms. That is, cognitive and motivational impairments, which can be disabling and do not respond to drug treatment.

I think he saw me...
Paranoid delusions: these may cause the person with psychosis to be unduly suspicious of individuals or organisations, believing them to be plotting to cause them harm. Such delusions can be very frightening and may result in unusual behaviour to avoid things - for example, staying out of a room with certain devices in it, believing them to be controlling thoughts, or locking up the front door with an excessive number of padlocks.

Similar to Eric Bui and colleagues examining Borderline Personality Disorder and Darth Vader (2010), it is interesting to compare a disorder with something relevant, in an attempt to try and identify with it. While one is the work of fiction and the other a real life debilitating disorder, slight overlap can be seen and the crude comparisons hopefully elucidate the disorder a little.
Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, Biederman J,    Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 28.
Katherine Darton, Mind. Psychotic experiences. London, UK: Mind, 2011. Information published online, accessed November 21st, 2013.

MedlinePlus. Psychosis. Bethesda, MA, US: National Library of Medicine, National Institutes of Health, Department of Health and Human Services.
NHS Choices. Causes of psychosis. London, UK: National Health Service.
Van Os J, Kapur S. Schizophrenia. The Lancet, 2009, volume 374, number 9690, pages 635-645 (DOI: 10.1016/S0140-6736(09)60995-8).

WHO. Chapter V: Mental and behavioural disorders. In: International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Geneva, Switzerland: World Health Organization, 2010.

''Minds that have withered into psychosis are far more terrifying than any character of fiction''
                                                                                                                                   ~ Christian Baloga

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