A Mentalist's Glossary

I have a terrible penchant for the use of acronyms on this blog. Mainly it is to anonymise individuals, but sometimes it’s simply shorthand for something. Furthermore, I am wont to use terms with which I am familiar, but that others aren’t necessarily.

Whatever the case, I do understand how confusing this can be. You could just look some of this stuff up, and often I have provided relevant links in my prose, but since I’m such a nice person I’m going to do it for you.

(Please note, I have mentioned some friends and family here, but not all. I don’t know why I’ve included some and not others; the decision was completely arbitrary. But the full details on the personnel in my life are here).

This is very much a work in progress, so if you think there’s a term that should go in here, you spot any mistakes or whatever, leave a comment at the bottom and I’ll sort it out.

ACRONYMS AND GLOSSARY OF TERMS ON
CONFESSIONS OF A SERIAL INSOMNIAC

A – Boyfriend. A middle-management civil servant 10 years my senior with a penchant for nerdery.

AC – Friend.

B – Friend.

BMcC – Friend of A’s.

BP / BPI / BPIIBipolar (disorder), bipolar I, bipolar II. I tend not to use this acronym with frequency but you never know. I was initially diagnosed with type II in June 2009, but as of September 2011, I believe that this has changed to type I with psychotic features.

Type I involves swings between severe manias (sometimes euphoric, sometimes dysphoric ((see ‘mixed episode’, below))) and equally crippling depressions, as well as periods of euthymia (see below). Type II tends to exhibit hypomanic (see below) symptoms rather than full mania, and is not known to include psychosis and mixed episodes.

BPDBorderline Personality Disorder. I was diagnosed with this illness of considerable disgust in June 2009, but in 2011, my psychiatrist and CPN were agreed that I probably did not have it. Characterised by an intense fear of abandonment, self-harm and suicidality, seeing things in black and white terms, marked disturbance and variability in mood, shaky sense of identity, and other such lovely bullshit. A diagnosis under the DSM (see below); known as Emotionally Unstable Personality Disorder in the ICD (see below).

Often seen in individuals with a history of abuse and/or neglect, but certainly not limited to such people. Many figures suggests a higher incidence in females; others suggest the disorder is equally prevalent amongst blokes.

Called ‘borderline’ under the DSM as it was felt when it was first conceptualised as a distinct illness that those presenting with it were on the border between psychoses and neuroses, though many contemporary psychiatrists feel that this is no longer an accurate description, and psychotic symptoms are certainly not required for diagnosis. Many calls for a change in the name.

C – Doctor of clinical psychology practising psychodynamic therapy and erstwhile shite DBT (see below) in an attempt to make me less mental. He failed. His successor, Paul (see below) had a little more success.

CBTCognitive Behavioural Therapy. Seeks to change one’s negative thinking about things and as such alleviate negative emotions and problematic behaviour. Fundamentally fails for cynical fucks like me because it is considered idealistic nonsense, not to mention the fact that it utterly neglects the idea of why you are mental, merely the symptoms thereof.

Conveniently considered the panacea of mental health treatment in the UK. Obviously it is entirely coincidental that CBT tends to be relatively short-term and therefore less expensive to the NHS (see below).

CMHT – Cunty Mental Health Twats. Oh, sorry, wait. Community Mental Health Team. Supposedly a multi-disciplinary group of professionals who work their magic to make mentals less mental. In reality, mostly fuckwitted, well-meaning but disillusioned tossers who know about as much about the actual experience of mental illness as a dog turd.

Co-morbidity – More than one illness running concurrently. In my case, I initially had a primary diagnosis of BPD which, which was co-morbid with (a ((supposedly)) secondary diagnosis of) bipolar disorder, (as well as) depression and social anxiety. As things presently stand, I think my primary diagnosis is manic depression, but this is co-morbid with C-PTSD and anxiety.

C-PTSD – See PTSD (below).

CVM – Friend. I have not yet met CVM in person, but nevertheless count her amongst my close friends.

D/Daniel – Best friend. Known since school days.

DBTDialectical Behavioural Therapy. Similar to, but distinct from, CBT (see above). Predicated on the principles on dialectics, which is a form of metaphysical argument suggesting that rationality can overcome disagreement in the search for truth.

DBT as devised by its inventor, academic psychologist Marsha Linehan, espouses radical acceptance (wank), mindfulness (wank – I am not a buddhist), regulating one’s emotions (why not just use Valium, for Christ’s sake?) and other stupid nonsense. It initially seeks to tackle suicide/self-harm issues, and then tries to patronise you into simply accepting everything and not making value judgements on it. Hmm.

I have less hatred for DBT than CBT, because I do see some benefit in some of the principles such as meditation. Nevertheless, it is my belief that that kind of thing is merely a complimentary and not a scientifically proven intervention. And bullshit like painting red nail polish on yourself instead of watchng the beauty of your own blood flowing is just a pile of condescending toss.

Delusion – A seriously mistaken belief. Like, seriously. Like my beliefs that my mother and the government had rigged up an entire video system everywhere I went. A pathologically erroneous belief, though the term is used colloquially for non-pathological ideas.

Delusions, especially in the paranoid subtype of schizophrenia, are often persecutory, but are certainly not limited to this. Other types include grandiose delusions, referential, control, etc, etc. The list is a long one.

DB – Friend of A’s.

DI – A’s brother. Sometimes known as Damien.

DIDDissociative Identity Disorder (formerly known as Multiple Personality Disorder). Description to follow.

DL – Friend.

Dr C - See VCB.

Dr M – See NewVCB.

DSM – The Diagnostic and Statistics Manual of Mental Disorders, published by the American Psychiatric Association. Currently in its fourth incarnation, though version five is due for publication in 2013. There is presently considerable debate as to what should be included, ommitted or amended in DSM-V.

Although it is the US standard text of nutjobbery, it is also used frequently across the globe for diagnosis of various labels of insanity. Compare ICD (see below).

Euthymia – a period of normality, between ‘episodes’. What the fuck actually is this? I vaguely remember – that period where you can work, where you don’t freak out every time your even think about a crowd, where you can go out socially yourself…but I can’t foresee it coming back any time soon.

G – Friend of A’s. Hyper-mega-out-there-intellectual who almost made me think DBT was not complete shite with his discussion of the philosophy behind it.

Hallucinations – the quintessence of one’s mind playing tricks on one, and then some. Sensual perceptions, experienced during consciousness, that have no stimulus. The most well-known type of hallucination is hearing voices (such as Tom and ‘They’ – see below), but even auditory hallucinations can be more wide-ranging than this – in my case, music and knocking are known.

Hallucinations can also effect sight (shapes in my case, but others may see people, monsters, whatever), touch, taste and smell. Crazy Mermaid has an excellent post on the range of hallucinatory types here.

Hotel California – The main hub-residence of the McFauls, the sprawling dynasty headed by my aunt Maisie and uncle Paedo. So-called because you can check out any time you like, but you can never leave (see here, if you’re still totally lost).

Hypomania – A milder form of mania (see below). The upside of bipolar type II, hypomania; indeed, bipolar II can be difficult to spot owing to the fact that hypomania can be mistaken for a good mood, rather than a potentially dangerous state. It can have the same symptoms as mania, psychoses excepted; the difference tends to be in the severity.

IBSIrritable Bowel Syndrome. Description to follow.

ICDInternational Statistical Classification of Diseases and Related Health Problems. Published by the World Health Organisation, the ICD is not limited to the diagnoses of mental health problems, but includes physical illnesses also. Currently in its tenth edition, ICD-XI is planned for 2015. As with DSM-V (see above), there is currently debate as to what criteria vis a vis mental disorders should be included in the new ICD. Both it and the DSM try to use the same codes of diagnosis, but they differ distinctly in many ways, especially as regards personality disorders, which the DSM considers a distinct axis of fuckuppery, where the ICD does not.

The document is used frequently internationally for statistical purposes, and outside North America is often – though certainly not always – used as the main diagnostic tool for mental illnesses. Sometimes it’s used in conjunction with the DSM.

K – Friend. Also a ‘diagnosee’ of BPD. Originally from Northern Ireland too, and in a similarly attached relationship with her therapist.

LGP – Lovely GP. My primary medical doctor. Unlike the majority of his counterparts, he is the antithesis of a cunt. That is why I call him ‘lovely’, as he is. He really is.

Mania – Euphoric side of bipolar. Sometimes simply used as a short-hand term for hypomania, though the two are distinct. Mania not only sees eurphoric highs but impulsivity, recklessness, sleeplessness and restlessness, irritability and in extreme cases psychosis. Some people use the term ‘mania’ synonymously with ‘mixed episode’ (see below): it should therefore be borne in mind that not all people with bipolar disorder experience euphorias.

McF(s) – McFaul(s). Discussed in more detail here, the McFaul dynasty are family from my mother’s side: Maisie, the matriarch, is my mother’s slightly-elder sister. Her husband, Paedo, was the person responsible for my childhood abuse.

Mixed Episode – AKA Mixed State, Dysphoric Mania, Agitated Depression (though the latter two are considered distinct). Highly unpleasant mental state in which both symptoms of mania and depression are present. Sound impossible? Trust me, I wish it was.

One might feel suicidal, agitated, restless, paranoid, impulsiveness, tears and sadness, anger, bleakness, racing thoughts/speech, hopelessness. Blah blah blah. They are not fun states in which to be. When I say I am ‘going mental’, this is usually what I mean.

A mixed state is a common feature of bipolar disorder, but I don’t think it’s limited to that illness. Officially, to be diagnosed with a such a state (under the DSM anyhow), it should have lasted for over a week, but in practice this isn’t usually adhered to.

MPD – Multiple Personality Disorder. See DID (above).

NewVCB / Dr M – Second consultant psychiatrist, that I’ve been seeing since late January 2010. VCB (see below) is a reference to the first consultant I saw.

NHS – Nasty Headfucking Sadists. AKA National Health Service. Supposedly a public healthcare system, funding by the national insurance of the UK’s many taxpayers. If you have an acute illness, or even a chronic physical health problem, the NHS ranges from alright to very good. Unfortunately, it isn’t generally that good for mental health, as my rants here, here and here will attest. This has ensured that I have actually developed a strong personal dislike for a service that, in theory, I strongly support.

All that said, whilst I maintain my position that I’ve been horribly mistreated by the NHS, NewVCB and Christine, my CPN, have definitely been a force for good in my life. Ditto Lovely GP.

NPDNarcissistic Personality Disorder.

Olanzapine – An anti-psychotic medication (AKA Zyprexa) that also functions as a mood stabiliser, and, in off-label usage, a sedative. Between November 2009 and late January 2010, I took the lowest daily dose of this, at 2.5mg. It was initially slightly helpful, but didn’t continue to be, and was putting a lot of weight on me. NewVCB therefore changed it to Quetiapine, of which I have taken up to 600mg daily.

Paul – a trauma therapist who treated me in 2010 and 2011. Mostly of a Freudian bent, Paul was nevertheless active in sessions and I feel that we achieved a great deal together.

PDPersonality Disorder. An inflexible, potentially detrimental and long-term pattern of behaviour and personality characteristics. Considered Axis-II illnesses under the DSM (see above) and sub-divided into three categories – cluster A, the ‘odd’ cluster; cluster B, the ‘impulsive’ cluster; and cluster C, the anxious cluster.

The term ‘PD’ is considered offensive by some mental health advocates as it suggests there is something inherently wrong with the individual’s personality, and that it is very hard to determine where the line between ‘individuality’ or ‘eccentricity’ becomes a PD.

Psychopathology – Simply the study of mental illnesses in terms of how they manifest, develop, are caused, etc. The mental form of general pathology, the study of diseases. Also used as general term to indicate the presentation of symptoms, eg. “the individual presented psychopathology consistent with avoidant personality disorder.”

Psychosis – A situation in which one has loss of contact with reality. Manifests most frequently as delusions or hallucinations (see above), though personality changes and disordered thoughts and speech may also feature. Psychoses that I experience include, though are not limited to, Tom and ‘They’ (see below).

PTSDPost-traumatic Stress Disorder. In cases of sustained or protracted interpersonal trauma, Complex Post-Traumatic Stress Disorder (C-PTSD) may be evident. I was diagnosed with complex PTSD in March 2010. Descriptions to follow.

Quetiapine – (AKA Seroquel) Atypical anti-psychotic (and mood stabiliser) used in the management of schizophrenia, bipolar disorder and depression. I currently take 600mg daily.

Rapid Cycling – Term used to describe ‘frequently’ changing episodes of mania, hypomania, mixed states (see above) and/or depression (and sometimes euthmyia) in bipolar disorder. Under the DSM (see above) rapid cycling is (rather laughably) considered to present as more than four different episodes within one year.

In cases where the cycles are much more frequent than this, the cycling is considered to be ultra-rapid. In cases where moods can shift within 24 or so hours, the cycling is known as ultradian.

SADSeasonal Affective Disorder. Description to follow. In some blogs this acronym is used to denote Schizoaffective Disorder (see below), but not in this one.

Schizoaffective Disorder – Mood disorder falling within the schizophrenic, and arguably the bipolar, spectrums. Differs from schizophrenia in that mood disturbance as well as a range of psychotic symptoms are present; however, some argue this is simply a case of co-morbidity (see above) with either severe depression or bipolar disorder, though there is evidence that physiology differs slightly from these diagnoses.

Differs from psychotic depression in that the psychoses also occur outside a depressive episode. Also has two sub-types; depressive and bipolar.

When my psychoses became worse in the summer of 2009, this became my self-diagnosis of choice. As of late 2011, I understand that the quacks consider this at least a possibility, though they are mostly of the view that I have manic depression.

Seroquel – See Quetiapine.

SH / SI / SM – self-harm, self-injury, self-mutilation. Not acronyms I am wont to use, but should I ever do so, that is what they are. Covers obvious things like deliberately cutting oneself, burning, trich (see below) and head-banging (though not in the rocker sense, mais oui). Less obvious manifestations include scratching, picking scabs and suchlike.

Self-harm is often derided and feared by those that do not engage in it, but it is a way to cope. I read the quote somewhere that ‘the scars on the outside are smaller than those on the inside’. Trite, but truthful.

I’ve explored my experiences with self-harm here and here, and in a slightly more bizarre context, here.

‘They’ – auditory hallucinations of abject terror. A cacophony of malicious voices who have tried to get me to kill myself and who otherwise despise me. Discussed in detail in this post, ‘They’ are grammatically and personality challenged and I hate them. Their hold on me has abated since I began taking anti-psychotics – especially a fairly highly dose of Quetiapine – but they occasionally come back to visit.

Tom – auditory hallucination not of abject terror. Tom is a voice whose primary function seemed to be to soothe me and/or befriend me. Full details on him are in this post. I haven’t encountered him since I started taking Olanzapine, though I’m reserving judgement on whether or not he is completely gone, as he was always transient anyway.

Trich – in the context of this blog, trich refers to pulling one’s hair out. I do this when in a particularly nasty mixed state or when especially agitated. Comes from the full term trichotillomania, which is a compulsion to pull one’s hair.

Ultradian Cycling – See Rapid Cycling.

Ultra-Rapid Cycling – See Rapid Cycling.

VCB – Vinegar Cunted Bitch. Dr C. My first consultant psychiatrist, that I saw between May and November 2009. Rather than try to be creative, when I met my second consultant in January 2010, I simply took to calling her NewVCB, even though in contrast to her predecessor, she’s actually nice.

Venlafaxine – Anti-depressant of the SNRI variety, also known by the brand name Effexor. Initially prescribed it in June 2009 at 75mg, which was increased to 150mg in September of the same year. Insidious and evil, Venlafaxine is a back-up drug where other drugs have failed. The problem is it takes you to take the fucking thing to find out how much it fucks with your head. Read about my personal side effects here.

On the other side of the coin, though, I have found a high dose of the stuff (300mg) to have made a real difference to my depressive symptoms. Just make sure I never miss a dose of it again, please.

W – One of A’s best friends. An academic living in England.

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7 thoughts on “A Mentalist's Glossary

  1. Nicely done :) It explains a lot! I’ts interesting the accronym SAD can stand for so many mental illnesses though, I’ve always used SAD for Social Anxiety Disorder.

  2. pedant’s correction – the NHS is funded from general taxation whereas national insurance contributions fund contributory benefits such as old age pension and what used to be called unemployment and sickness benefits

  3. Finally sat down to read this entry. Damned thorough and very well written.

    Were you dx’d with BP (whatever number) AND BPD on the same day, or by the same doc? Not that I really know much about BPD, other than having worked for 18 months alongside a young woman with both dx’s, but gee, you’d think that the diagnostician would have some clue about how to treat the conjunction of the two.

    You couldn’t get mood stabilizers, my son couldn’t get anti-depressant until the rest of his entire care team, including school folks, backed up my plea with the public health pdoc. Something finally snapped hard enough last autumn, and I went through the nonsense needed to get him a private one on our insurance, male this time. The difference was nearly night and day. My first two pdocs were utter jerks and full of themselves, but the ones running studies at Stanford U were great, and made me realize I could do better. I’ve been with Claire almost ten years now–she’s a dear.

    I have very seldom experienced euthymia since I started on the rollercoaster around 1987. I had it for a few months in 2005, but it eventually dissolved into depression. I always saw hypomanias as rewards of sort for having endured the long, deep depressions. Never had them for very long–if I was lucky, they’d last about two days, but these days they might last two hours, or even less if I notice them quickly. Once noticed these days, they go poof. Never had “severely good moods”, nor the near-manic elevated moods, either–at least not without a cause!

    Cognitive therapy doesn’t work on my severe depressions, either, because the cognition I’m able to perform is warped by the depression to the point that there is no rationality, and it takes rationality for CT to work! DBT, I agree, seems like a complete waste of everyone’s time and resources. I agree completely with your analysis of it. Utter hooey.

    I have had pdocs who were utter jerks, and some people, medicos as well, who treat you as utterly idiotic and unable to fend for yourself if you have a DSM/ICD dx. Seems to me that you have to have a certain amount of brainpower to GET mental with. It doesn’t go away, but sometimes cognitive functions hide awfully well. BTW, the current complete version of the DSM this year is the DSM-IV-R. A right mouthful.

    DID: have a friend with friends in his head. He, too, had horrific experiences involving ongoing and varied sexual assaults in his childhood, from a previously trusted person. The Canadian mental health services he received were deemed less than useful, too. He co-exists peacefully with his crowd of others.

    Most of my “hallucinations” are mild, and more likely incorrect processing of stimuli by my brain, rather than true hallucination. Many have been smelling things that weren’t present, usually pleasant. Don’t get visual ones–but I can and do visualize things, with eyes open or closed Some visuals have been dropped into my head at times, but they’ve been things I needed to know. I see no illness in that, nor in the few voices I’ve heard, communications from Goddess. My version of your Them is the IBSC, coined by a friend: the ittybittyshittycommittee. Same function.

    My son had mixed states on a daily basis–if not more often, until the meds were finally at more appropriate levels for him. Occasionally, when my depression is deep enough, I am depressed AND angry, but he, poor guy, had that, and more, to his. I was given Zyprexa for “breakthrough” depressions, but I knew it was very weight-positive and bad for your lipids. I used it sporadically–the only way Claire would let me take it.

    What Effexor did to you is unreal. I haven’t had the symptoms you noted with it, but some have shown up with other meds. When Claire has suggested lithium, which I consider the absolute backup, I’ve said to hold off until no other method is working for me.

    Son was on ithium and depakote–had to stop the depakote because it wasn’t doing much good, and I had him switched off lithium (to Seroquel?) when I discovered the effect on thyroid function (hypothyroid seems mostly to be a problem in the women on my mother’s side, but for all I know, he could pass the gene along), and that no NSAIDs were to be used. At that time, his migraines (they started when he was three, when baby tylenol stopped them if he got it soon enough) were handled with ibuprofen, and unless that stopped being effective, I didn’t want him on prescription meds for his migraines. Last year, we had to go to topomax to hep prevent them, and stronger meds to help stop them.

    Son gained a lot of weight, and went diabetic, while on Seroquel: he’s moved off that to Zoloft, and from Abilify (cost way too much) to Lamotrigine, which I’m on as well. He’s been taking metformin for the diabetes, and attempting to manage his portions and carbs better: he has managed to lose some weight.

    As an eccentric sort in cronehood these days, I would take it amiss were I judged to have PD. I know altogether too many odd people who are just odd, not mental!

    My father/sperm donor had PTSD from WWII, and had undx’d bipolar of some degree, and because of that, and the behavior stemming from those dx’s, imbued my mother with C-PTSD, also undx’d.

    I have SAD, but know it’s there, and combat it effectively with outside light and a lightbox or a full-spectrum lamp when needed, like after a few days of drear and overcast skies/storms.

    I agree with you on the judgement of rapid cycling definitions. I’d say it was rapid cycling if it were once a month, ultra-rapid if it were once a week (me in autumn 2005, I think it was. I was one miserable person to be around, and the down hit every weekend. Took me six weeks to realize the pattern, and then it got treated). Ultradian is what juvenile bipolars (kids under 12) endure: they cycle several times a day, some every waking hour. This was my son’s life for too many years since about five: he was dx’d at seven. While he hates the need to take meds, he hates the result of not taking them even more.

    I haven’t ever cut myself, but I know people who have, and your reasons are pretty much what they’ve given. Closest I ever get to self harm is throwing my head at the wall or doorpost a few times. Now that does hurt.

    A. Marina Fournier
    SaffronRose@me.com

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