To some psychiatric patients, life seems like TV

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Posted on 24th November 2008 by Gordon Johnson in Uncategorized

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Date: 11/24/2008

By JENNIFER PELTZ
Associated Press Writer

NEW YORK (AP) _ One man showed up at a federal building, asking for release from the reality show he was sure was being made of his life.

Another was convinced his every move was secretly being filmed for a TV contest. A third believed everything — the news, his psychiatrists, the drugs they prescribed — was part of a phony, stage-set world with him as the involuntary star, like the 1998 movie “The Truman Show.”

Researchers have begun documenting what they dub the “Truman syndrome,” a delusion afflicting people who are convinced that their lives are secretly playing out on a reality TV show. Scientists say the disorder underscores the influence pop culture can have on mental conditions.

“The question is really: Is this just a new twist on an old paranoid or grandiose delusion … or is there sort of a perfect storm of the culture we’re in, in which fame holds such high value?” said Dr. Joel Gold, a psychiatrist affiliated with New York’s Bellevue Hospital.

In the last two years, Gold has encountered five patients with delusions related to reality TV. Several of them specifically mentioned “The Truman Show.”

Gold and his brother, a psychologist, started presenting their observations at medical schools in 2006. After word spread beyond medical circles this summer, they learned of about 50 more people with similar symptoms. The brothers are now working on a scholarly paper.

Meanwhile, researchers in London described a “Truman syndrome” patient in the British Journal of Psychiatry in August. The 26-year-old postman “had a sense the world was slightly unreal, as if he was the eponymous hero in the film,” the researchers wrote.

The Oscar-nominated movie stars Jim Carrey as Truman Burbank. He leads a merrily uneventful life until he realizes his friends and family are actors, his seaside town is a TV soundstage and every moment of his life has been broadcast.

His struggle to sort out reality and illusion is heartwarming, but researchers say it’s often horrifying for “Truman syndrome” patients.

A few take pride in their imagined celebrity, but many are deeply upset at what feels like an Orwellian invasion of privacy. The man profiled in the British journal was diagnosed with schizophrenia and is unable to work. One of Gold’s patients planned to commit suicide if he couldn’t leave his supposed reality show.

Delusions can be a symptom of various psychiatric illnesses, as well as neurological conditions such as Parkinson’s and Alzheimer’s diseases. Some drugs also can make people delusional.

It’s not unusual for psychiatrists to see delusional patients who believe their relatives have been replaced by impostors or who think figures in their lives are taking on multiple disguises.

But “Truman” delusions are more sweeping, involving not just some associates but society at large, Gold said.

Delusions tend to be classified by broad categories, such as the belief that one is being persecuted, but research has shown culture and technology can also affect them. Several recent studies have chronicled delusions entwined with the Internet such as a patient in Austria who believed she had become a walking webcam.

Reality television may help such patients convince themselves their experiences are plausible, according to the Austrian woman’s psychiatrists, writing in the journal Psychopathology in 2004.

Ian Gold, a philosophy and psychology professor at McGill University in Montreal who has researched the matter with his brother, suggests reality TV and the Web, with their ability to make strangers into intimates, may compound psychological pressure on people who have underlying problems dealing with others.

That’s not to say reality shows make healthy people delusional, “but, at the very least, it seems possible to me that people who would become ill are becoming ill quicker or in a different way,” Ian Gold said.

Other researchers aren’t convinced, but still find the “Truman syndrome” an interesting example of the connection between culture and mental health.

Vaughan Bell, a psychologist who has researched Internet-related delusions, said one of his own former patients believed he was in the virtual-reality universe portrayed in the 1999 blockbuster “The Matrix.”

“I don’t think that popular culture causes delusions,” said Bell, who is affiliated with King’s College London and the Universidad de Antioquia in Medellin, Colombia. “But I do think that it is only possible to fully understand delusions and psychosis in light of our wider culture.”

Copyright 2008 The Associated Press.

Paranoia on the rise, experts say

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Posted on 12th November 2008 by Gordon Johnson in Uncategorized

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Attorney’s Comment: The below story about the increase in paranoia is highly significant, especially as we consider those findings within the subset of brain damaged individuals. While the research out there is in its infancy, we have found that those with preexisting anxiety disorders, have far worse results from concussion and mild brain injury than anticipated. Those with anxiety disorders are extremely vulnerable to long term problems with post concussion syndrome.

While extensive research establishing this correlation is needed, the neuropathological principles pointing towards a connection between anxiety disorders and the development of panic and paranoia post-injury are clear. Both type disorders originate in the lower brain structures of the limbic system (particularly the amygdala). See http://en.wikipedia.org/wiki/Limbic_system While the best of the current thinking about poor outcomes in the mild head injury group looks at the cerebral cortex in the lower frontal lobes, it may be that the area of the injury is correct, but the nature of the neuropathology quite different. The anosmic correlative theories (loss of smell correlates with disability in the brain injured population) focused on the contusion on the surface of the orbital frontal portion of the brain. It may be that it is the white matter injury in these adjacent areas on the underside of the brain that triggers so many subtle frontal lobe problems, and its attendant radical emotional responses.

Attorney Gordon Johnson
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Date: 11/12/2008

By MARIA CHENG
AP Medical Writer


LONDON (AP) _ If you think they’re out to get you, you’re not alone.

Paranoia, once assumed to afflict only schizophrenics, may be a lot more common than previously thought.

According to British psychologist Daniel Freeman, nearly one in four Londoners regularly have paranoid thoughts. Freeman is a paranoia expert at the Institute of Psychiatry at King’s College and the author of a book on the subject.

Experts say there is a wide spectrum of paranoia, from the dangerous delusions that drive schizophrenics to violence to the irrational fears many people have daily.

“We are now starting to discover that madness is human and that we need to look at normal people to understand it,” said Dr. Jim van Os, a professor of psychiatry at Maastricht University in the Netherlands. Van Os was not connected to Freeman’s studies.

Paranoia is defined as the exaggerated or unfounded fear that others are trying to hurt you. That includes thoughts that other people are trying to upset or annoy you, for example, by staring, laughing, or making unfriendly gestures.

Surveys of several thousands of people in Britain, the United States and elsewhere have found that rates of paranoia are slowly rising, although researchers’ estimates of how many of us have paranoid thoughts varies widely, from 5 percent to 50 percent.

A British survey of more than 8,500 adults found that 21 percent of people thought there had been times when others were acting against them. Another survey of about 1,0000 adults in New York found that nearly 11 percent thought other people were following or spying on them.

Dennis Combs, an assistant professor of psychology at the University of Texas at Tyler, has been studying paranoia for about a decade. When he first started conducting paranoia studies, mostly in college students, he found that about 5 percent of them had paranoid thoughts. In recent years, that has tripled to about 15 percent, he said.

In a small experiment in London, Freeman concluded that a quarter of people riding the subway in the capital probably have regular thoughts that qualify as paranoia. In the study, 200 randomly selected people (those with a history of mental problems were excluded) took a virtual reality train ride. They recorded their reactions to computerized passengers programmed to be neutral.

More than 40 percent of study participants had at least some paranoid thoughts. Some felt intimidated by the computer passengers, claiming they were aggressive, had made obscene gestures, or tried to start a fight.

Freeman said that in big cities, many ambiguous events can lead to paranoid thoughts. Because we constantly make snap judgments based on limited information, like which street to take or whether or not strangers are dangerous, the decision-making process is prone to error.

Van Os said Freeman’s virtual reality experiment was solid and confirmed previous research. Experts say not everyone with paranoid thoughts needs professional help. It all depends on how disturbing the thoughts are and if they disrupt your life.

“People walk around with odd thoughts all the time,” said David Penn, a professor of psychology at the University of North Carolina. “The question is if that translates into real behavior.”

Van Os recalled a delusional patient who was convinced that the French singer Charles Aznavour was in love with her, and had been whispering to her before she went to sleep every night for more than two decades.

“You could call it a psychotic experience, but she was very happy about it,” van Os said. “There isn’t always a need for care when there’s an instance of psychosis.”

He hoped that being able to identify milder delusional symptoms in people could help doctors intervene earlier to prevent more serious cases.

The post-Sept. 11 atmosphere and the war on terror have also increased levels of paranoia in the West, some experts said.

“We are bombarded with information about our alert status and we’re told to report suspicious-looking characters,” Penn said. “That primes people to be more paranoid.”

Traumatic events can make people more vulnerable to having paranoid thoughts. Since the attacks, Penn said Americans have been conditioned to be more vigilant of anything out of the ordinary.

While heightened awareness may be good thing, Penn said it can also lead to false accusations and an atmosphere where strangers are negatively viewed.

That can result in more social isolation, hostility, and possibly even crime. And it can take a toll on physical health. More paranoia means more stress, a known risk factor for heart disease and strokes.

Still, some experts said that a little bit of paranoia could be helpful.

“In a world full of threat, it may be kind of beneficial for people to be on guard. It’s good to be looking around and see who’s following you and what’s happening,” Combs said. “Not everybody is trying to get you, but some people may be.”

Copyright 2008 The Associated Press.

Suicides from financial crisis cause concern

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Posted on 14th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/14/2008 9:00 AM

By KELLI KENNEDY
Associated Press Writer


An out-of-work money manager in California loses a fortune and wipes out his family in a murder-suicide. A 90-year-old Ohio widow shoots herself in the chest as authorities arrive to evict her from the modest house she called home for 38 years.

In Massachusetts, a housewife who had hidden her family’s mounting financial crisis from her husband sends a note to the mortgage company warning: “By the time you foreclose on my house, I’ll be dead.”

Then Carlene Balderrama shot herself to death, leaving an insurance policy and a suicide note on a table.

Across the country, authorities are becoming concerned that the nation’s financial woes could turn increasingly violent, and they are urging people to get help. In some places, mental-health hot lines are jammed, counseling services are in high demand and domestic-violence shelters are full.

“I’ve had a number of people say that this is the thing most reminiscent of 9/11 that’s happened here since then,” said the Rev. Canon Ann Malonee, vicar at Trinity Church in the heart of New York’s financial district. “It’s that sense of having the rug pulled out from under them.”

With nowhere else to turn, many people are calling suicide-prevention hot lines. The Samaritans of New York have seen calls rise more than 16 percent in the past year, many of them money-related. The Switchboard of Miami has recorded more than 500 foreclosure-related calls this year.

“A lot of people are telling us they are losing everything. They’re losing their homes, they’re going into foreclosure, they’ve lost their jobs,” said Virginia Cervasio, executive director of a suicide resource enter in southwest Florida’s Lee County.

But tragedies keep mounting:

— In Los Angeles last week, a former money manager fatally shot his wife, three sons and his mother-in-law before killing himself.

Karthik Rajaram, 45, left a suicide note saying he was in financial trouble and contemplated killing just himself. But he said he decided to kill his entire family because that was more honorable, police said.

Rajaram once worked for a major accounting firm and for Sony Pictures, and he had been part-owner of a financial holding company. But he had been out of work for several months, police said.

After the murder-suicide, police and mental-health officials in Los Angeles took the unusual step of urging people to seek help for themselves or loved ones if they feel overwhelmed by grim financial news. They said they were specifically afraid of the “copycat phenomenon.”

“This is a perfect American family behind me that has absolutely been destroyed, apparently because of a man who just got stuck in a rabbit hole, if you will, of absolute despair,” Deputy Police Chief Michel Moore said. “It is critical to step up and recognize we are in some pretty troubled times.”

— In Tennessee, a woman fatally shot herself last week as sheriff’s deputies went to evict her from her foreclosed home.

Pamela Ross, 57, and her husband were fighting foreclosure on their home when sheriff’s deputies in Sevierville came to serve an eviction notice. They were across the street when they heard a gunshot and found Ross dead from a wound to the chest. The case was even more tragic because the couple had recently been granted an extra 10 days to appeal.

— In Akron, Ohio, the 90-year-old widow who shot herself on Oct. 1 is recovering. A congressman told Addie Polk’s story on the House floor before lawmakers voted to approve a $700 billion financial rescue package. Mortgage finance company Fannie Mae dropped the foreclosure, forgave her mortgage and said she could remain in the home.

— In Ocala, Fla., Roland Gore shot his wife and dog in March and then set fire to the couple’s home, which had been in foreclosure, before killing himself. His case was one of several in which people killed spouses or pets, destroyed property or attacked police before taking their own lives.

“The financial stress builds up to the point the person feels they can’t go on, and the person believes their family is better off dead than left without a financial support,” said Kristen Rand, legislative director of the Washington D.C.-based Violence Policy Center.

Dr. Edward Charlesworth, a clinical psychologist in Houston, said the current crisis is breeding a sense of chronic anxiety among people who feel helpless and panic-stricken, as well as angry that their government has let them down.

“They feel like in this great society that we live in we should have more protection for the individuals rather than just the corporation,” he said.

It’s not yet clear there is a statistical link between suicides and the financial downturn since there is generally a two-year lag in national suicide figures. But historically, suicides increase in times of economic hardship. And the current financial crisis is already being called the worst since the Great Depression.

Rising mortgage defaults and falling home values are at the heart of it. More than 4 million Americans were at least one month behind on their mortgages at the end of June, according to the Mortgage Bankers Association.

A record 500,000 had entered the foreclosure process. And that trend is expected to continue through next year, despite the current programs from the government and the lending industry to refinance delinquent homeowners into more affordable loans.

Counselors at Catholic Charities USA report seeing a “significant increase” in the need for housing counseling.

One counselor said half of her clients were on some form of antidepressant or anti-anxiety medication. The agency has seen a decrease in overall funding, but it has expanded foreclosure counseling and received nearly $2 million for such services in late 2007.

Adding to financially tense households is an air of secrecy. Experts said it’s common for one spouse to blame the other for their financial mess or to hide it entirely, as Balderrama did.

After falling 3½ years behind in payments, the Taunton, Mass., housewife had been intercepting letters from the mortgage company and shredding them before her husband saw them. She tried to refinance but was declined.

In July, on the day the house was to be auctioned, she faxed the note to the mortgage company. Then the 52-year-old walked outside, shot her three beloved cats and then herself with her husband’s rifle.

Notes left on the table revealed months of planning. She’d picked out her funeral home, laid out the insurance policy and left a note saying, “pay off the house with the insurance money.”

“She put in her suicide note that it got overwhelming for her,” said her husband, John Balderrama. “Apparently she didn’t have anyone to talk to. She didn’t come to me. I don’t know why. There’s gotta be some help out there for people that are hurting, (something better) than to see somebody lose a life over a stupid house.”

___

Associated Press Writers P. Solomon Banda in Denver, Joann Loviglio in Philadelphia, Juanita Cousins in Atlanta, Samantha Gross in New York and John Rogers in Los Angeles contributed to this report.

Copyright 2008 The Associated Press.

Pa. widow sues US over Iraq vet-husband’s suicide

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Posted on 7th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/7/2008 10:58 PM

By MARYCLAIRE DALE
Associated Press Writer

PHILADELPHIA (AP) _ The widow of an Iraq war veteran who committed suicide while in outpatient care for depression at a Veterans Administration hospital has sued the federal government for negligence.

Tiera Woodward, 26, claims in her lawsuit that her late husband, Donald, sought treatment at a VA hospital in Lebanon after three failed suicide attempts but wasn’t seen by a psychiatrist for more than two months.

She says doctors were slow to diagnose her husband with major depression, and that once the diagnosis was made, a psychiatrist failed to schedule a follow-up meeting with her husband after he informed the doctor he had gone off his medication.

Donald Woodward killed himself in March 2006 at age 23.

“I intend to make them make changes,” said Donald Woodward’s mother, Lori Woodward. “I have too many friends whose kids are in Iraq. I have a nephew now in Iraq, in the same unit, and I can’t have my family go through this again.”

Alison Aikele, a VA spokeswoman in Washington, D.C., said the agency does not typically comment on pending litigation.

The lawsuit, filed in the Middle District of Pennsylvania, seeks an unspecified amount for funeral expenses, lost income and pain and suffering.

It echoes other lawsuits nationwide over VA mental-health services, despite legislation President Bush signed in November ordering improvements.

The family of Marine Jeffrey Lucey, also 23, has a federal suit pending in Massachusetts over his June 2004 suicide. And two veterans groups sued the VA in San Francisco seeking an overhaul of its health system, citing special concerns about mental health, but a judge dismissed the suit in June over venue issues.

More than 150,000 Iraq and Afghanistan war veterans have already sought mental health care from the VA, and another 200,000 have sought medical care, according to Veterans for Common Sense, one of the groups involved in the California lawsuit.

“Each tragic veteran suicide is yet another painful reminder of the human cost of the Iraq and Afghanistan wars and VA’s abject failure to provide timely and appropriate mental health care,” said Paul Sullivan, the group’s executive director. “How many wake-up calls does (the) VA need?”

Copyright 2008 The Associated Press.