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re: dealing with Delusional Disorder

Posted by lil' jimi on September 8, 2003, at 2:35:11

In reply to Re: dealing with the delusional disordered, posted by habbyshabit on September 5, 2003, at 6:04:22

dear habby,

... ... this is my 3rd go round trying to write this ... ... efforts last night went into the wee hours and i was getting more and more off my game ... as sleep beckoned ...

your plight, compounded by your husband’s, makes for an unimaginably painful and difficult home life ... .... and a challenge i would not be handling as well as you ... ...
... ... though, i am with you about the non-viability of the any abandonment option(s) ... ... i am always scandalized by the tales from the posters whose husbands have left or are leaving them and/or divorcing them AS these wives are struggling to recover their mental health .... .... sylvia and i feel a much deeper commitment to each other ... ... and even more so since our battle against infertility about a decade ago now ... ... ... turns out we took the “in sickness and in health” parts of our vows pretty seriously ... ...

dramamine abuse

... ... once upon a time, in my foolish youth, my friends and i would take absurd risks in our self-destructive urge to get high ... ... ... we experimented with dramamine and our technique was to just take an overdose ...
... this resulted in a hypnotic conscious state wherein one would have compelling hallucinations while awake from which nobody and nothing could dissuade you ... ... as i painfully discovered, even the police, handcuffs and jail could not dissuade me ... ... “high”? ... i don’t think so


.... years earlier, while i was coming out of anesthesia from surgery ... ... i had awakened in my hospital room to discover it was practically full with my friends and family .... .... my pals were telling us funny stories and as i was laughing my mom asked why was i laughing and who was i talking to ... ... sometimes she wouldn’t get the point to a story, so i began to introduce my mom to my friends so somebody would explain it to her ... ... she asked who was i talking to again ... ... ... “why, my friends here.” ... ... “but son i’m the only one here,” and as i watched, all of the other people in my room faded away ... ... mom and i were alone ... ... the dream from the anesthetic (i believe it was potassium pentothal) was easily punctured by mom’s gentle reality input ... ... ... although it was a little while before i understood that she hadn’t just banished my friends by her sheer intrusion ...


for maybe a decade before i got married in ’86, i would have these “migraine” episodes ... ... i didn’t know then to call them that ... i just knew i was having undiagnosed neurological symptoms ... ... which i was not going let remain undiagnosed once i was married and had to and wanted to be a responsible and conscientious spouse ... ... i learned that i was describing the classic migraine-induced visual distortions ... ... ... what had defied me was having so little pain with anything called a ‘migraine’ ... ... these episodes which were not even as frequent as once a month, would sometimes subvert as much as 75% of my field of vision ... ... i took some intravenous contrast and had a head CATscan looking for micro-vascular deformities, and of course, tumors ... ... ... neurologist said i had a clean bill of health ... ... ...except he mentioned something about some of my vascular structure(s) being oversized and asked questions to, he said, dismiss this anomaly as causing my episodes or being a risk to my well-being ... ... ... i haven’t an episode in several years now

oliver saks’ ““the man who mistook his wife for a hat””

this is a great book ... ... saks describes some of his clinical experiences (including the title) which have taught us so much about neurobiology ... ... we are all indebted to the patients who’s deficits revealed some of the most surprising aspects of neurophysiology, at the cost of immensely tragic personal suffering ... ... read this book if you haven’t already .. ... restak’s ““the modular brain”” is where i learned about the form of brain damage in which the patient is totally blind due to loss of the vision-processing tissues, while the vision-reporting systems are still fully operational ... ... these folks will insist that they can see ... ... dr. restak recounts, with no small amount of professional shame, allowing himself to be baited by such a patient into challenging the patient to prove he could see ... ... restak’s patient leapt from the hospital bed and ran straight into a wall (where he “saw” the door) breaking his nose ... ... most of these patients come to accept that their “vision” is an illusion ... ... rather more like a cruel hoax to remind them of their blindness, i’d say ... ... sounds as bad as the proverbial rubber bone to the starving dog ... ...

... ... three significant things i learned about neurophysiology:
1) there is no central processing unit for the CNS.
2) the processor modules are all physiologically indistinguishable, despite great diversity of their assigned tasks.
3) every process which would seem singular to us, for instance, vision, turns out to be broken down into more sub-processes than could have been imagined and these processes get assigned to separate locations.

these facts explain many of the bizarre features of some brain damaged patients’ symptoms, such as the blind who believe they can see ... or saks’ title patient

in 1983 i had a motorcycle accident and had an interesting experience with my body wanting to avoid going into traumatic shock ... ... once i came to a stop, having departed my beloved suzuki 1150 which chose to end-o into oncoming traffic, and i could focus through indescribable pain of let’s just leave it at multiple fractures ... ... but endorphins can do amazing things in a big hurry, especially by way of pain relief (to keep me out of shock) ... ... ... once i came to a stop from flying through the air (away from oncoming traffic) one dramatic view of how bad off i was captured my deranged interest ... ... ... as i lie on the asphalt, i could see the consequences of my broken tibia and fibula of my right leg ... i am sure i got to see all four ends of the 2 broken bones exposed to daylight ... once ... i only saw that one time ... ... despite repeated attempts to see it again, every view of my right leg had the fractures’ site edited out ... which drove to really try to see it ... ... my CNS was not going to allow that, once was more than enough ... i wasn’t going to die from my injuries once blood loss was stopped, but dieing from traumatic shock was a threat anyway and my CNS was not going to allow me anymore of that kind of fuel for shock ... and i never got to see it again .. .. i even had other people describe it to me to make sure it really was there ...


delusion disorder is such an enigma for a diagnosis .... .... belief system aberration without neurological basis.
practically unassailable by treatment.

somewhere along the evolutionary line, developing our intelligence required we simulate possibilities, exercise internal virtual reality, relate to a narrative, imagine .. .. .. .. these adaptive needs must have fostered our power to suspend our disbelief ... ... ... for something we must so critically depend on, it has many different ways that it can fail ... ... although the same may be said the CNS and every other vital system .. .. .. such a fragile species; surprising we survive at all ... ... ... our robustness comes from how fully functional we can be even with catastrophic deficiencies ...

... the old view was that we got a finite number of neurons given to us and that we played a zero-sum game with them and it was all down hill from there ... ... now research has shown that we can and do grow new brain cells ... and that these new cells may support healing of damaged brain tissue ... ... new studies indicate the hippocampus shrinks when exposed to stress too long ... ... another study has shown neurogeneisis of hippocampal cells in patients taking antidepressants. ... ... it is being suggested that these new neurons are means of recovery from depression ... ... and that perhaps serotonin levels are merely correlated with depression recovery ... theories
... sorry to bore with information you probably already know ...

mri ?

etiology would be pointless guess work on my part ... ... every evidence suggests this is not a neurotransmitter dysfunction ... ... but the episodic nature of his history suggests that some variable(s) is (are) at work, but it is likely impossible to correlate any influences from the past with any contemporary factors, when the causative forces may never have been visible ... ... but i think about how territorially divided up our cognitive functions are, i get the impression of these shifts in the focus of his deficits, and this reminds me of possibly (slightly?) different areas of the brain being effected ... here lately, first the jealousy area .... then over to the federal persecution area ... ...
... ... ... perhaps, say a vein moves and exerts pressure, then moves back ... ... pressure could then be relieved, but circulation might be decreased elsewhere ... ...
... would it be possible to get any brain imaging done to see if there might be some treatment possibilities there?

more immediately ... ... i’m uncomfortable with your pdoc ... (i know he’ll be concerned} ... ... i want to feel like he can give you the support you need and yet he can not because of your husband’s presence ... ... you are deprived of your therapeutic moment of privacy ... ... and you are trapped in this dilemma by not wanting to alarm him ... ... and non-alarming also precludes accessing support groups ... .. this is bad and needs direct repair ...
... can you contact your pdoc by e-mail confidentially and discreetly?
... just being able to express yourself fully to your pdoc would help your stress from being so pent up and being so trapped ... you need an effective relief and real support ... ... and i do not see you getting it ... ... and my concern is why isn’t your pdoc, or some other of your supporters not seeing this need?


in the last couple of years of my mom’s life she began to show more serious mental problems ... ... for decades dad had come to be slower to speak and showed more frequent memory failures, but it was always in contrast to how sharp mom was ... then mom began to have a personality change and she began to be intensely negative .... and of her 4 children, she became especially hostile to me ... ... it was extremely painful to try to make up with her as she entered her eighties and find her uninterested and distant ... ... i asked my dad what i should do and he told me he didn’t know, but that she remembered every time he had ever made her jealous ... ... they were married for 58 years ...
... ... one day about a year or so before she died, i got a call from her out of the blue ... ... she rarely called us ... my hopes sank .. .. she began, “jim? ... where are my knives? ... don’t fool me! know the ones you took. ... where are they ... i want them back!”
turned out she had obsessed with this for most of the previous year and that my father and 2 of my 3 siblings knew about her delusion with me and her knives ... these were some ivory handled knives she was given in the ‘40s ... ... ... they’d turned up missing and she though i’d stole them.

... both of my parents were on significant numbers of medications, for their hearts as well as for mom’s diabetes ... about 6 months before she died, her doctor changed her regimen and reduced the number of meds and dosages ... ... about 3 months later i talked to her on the phone and she sounded so much better and she was friendly and she didn’t mention the knives ... ... i was overjoyed.

after the accident that took both my parents’ lives, i and my sibs were at their house and of course we found mom’s knives ... ... they were where she had always kept them, but just out of her reach ... ... we had a little celebration and they decided to give her knives to me ... ... i really didn’t want them, but for all the aggravation they had caused, i felt better having them than giving them away ... .. ... it could be tempting to leave then at arlington national cemetery next time we go ... ...

with better care and time, mom managed to find her way back in the end ... ... this was a huge blessing for me ... ... i am grateful for it ...

i think of you and you husband when i consider all these things i had to write to you about here ... ... i want you to keep in touch and to use this as your support group at least until you can get to an in-person support group where you can look people in the eye and feel the love directly that i and the rest of us are trying to offer you through this computer and dr. bob’s servers and the internet ... ... this isn’t bad, but you need better ....


~ jim




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