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 Mental Health and your Fear Blog, or shit you need to watch out for
pullingoffmasks
 Posted: Sep 25 2012, 09:36 PM
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NB: This is likely going to be a longish post. It is also not aimed at anyone particular, but if the Mythos continues to grow, it is likely we will run into more and more issues with people taking the Hollywood approach to anything Mental Health related.

Being one person (with an official dx of anxiety, and a unofficial-official dx of an autism spectrum disorder (Asperger's), my view is limited to what I've got as research and from what I've heard from other neurodivergent folks.


First- basic definitions, why you need to take care, and language you should use

So, the most basic stuff you need to be aware of. Language. Language. LANGUAGE!

First: neurotypical, allistic, neurodiverse, and crazy.

Neurotypical is defined as mental 'normalcy,' eg. the lack of any disorder as defined by the DSM or ICD. It is a very culturally bound term, but gets lobbed around to mean 'normal' in a more specific way.

Neurodiverse is define as any form of deviation from the assumptive mental norm. Thus, I can say, with my official dx of anxiety, that I am neurodiverse.

Allistic is anyone who is not autistic, but may or may not be otherwise neurodiverse. So my friend with bipolar/manic-depressive disorder is allistic, because she is neurodiverse, but not autistic.

Crazy is ableist slur, but can be used in character to define mental state divergent from character norm.

There's other language, outside of defining mental state, so let's go with what the hell the DSM and ICD are.

The DSM is the major diagnostic tool used in the US- DSM stands for Diagnostic and Statistics Manual of Mental Disorders.

It uses Axises to define the larger course of the disorder. The one that is of most note for the Fear Blogging community is Axis 1 ('clinical disorders'- includes mood disorders (depression/mania/manic-depression), Autism Spectrum Disorders (ASD), and substance abuse)

It is currently in its 4th edition (revised, seen often as DSM-IV-TR), and is up for change next May.

The rest of the world uses the WHO's ICD (International Statistical Classification of Diseases and Related Health Problems).

It is currently in its 10th edition (read, you'll see ICD-10 as the shorthand) and is up for change sometime next year.

Why does this matter? Well, simply, it provides for how a disorder is defined, how it is diagnosed, and what therapy is suggested by the psychologist (or psychiatrist).

Please note that neither manual is a perfect tool. They have issues- see the DSM-I through DSM-III defining homosexuality as a mental disorder, see the current issues with gender dysphoria being part of the DSM-IV-TR, see how autism's definition has changed through time- but they are the BEST tool you can have for defining a characters disorder/dysfunction.

Also note: A psychologist is trained to observe and offer a diagnosis, but they cannot sign on any prescriptions or offer any psychoactive drugs. A psychiatrist can observe, offer diagnosis, AND can write prescriptions/sign off on suggested psychoactive drugs.

For the rest of the talk about diagnosis, etc, assume I'm using the DSM-IV-TR. It's the manual I'm most familiar with and it has some of the clearest language of any manual I've ever browsed.

Now onto the more 'fun stuff.'

Disorders such as schizophrenia, autism/Asperger's, any mood disorder, etc are exactly that, they are disorders and/or dysfunctions. They are NOT diseases. PLEASE make sure you're aware of this. The language here is important, as disease indicates, often times, that it can be cured.

As you're likely aware, there's not solid cure for any big mental disorder, only pharmacological stop gaps (which aren't magic bullets, more on that later), therapies, and a whole lot of shitty fake treatments/cures.

The language that people used to talk about disorders also is a BIG thing in a lot of discourse, both fictional and via news.

SO:

Insanity is NOT a diagnosis. It is a LEGAL term defined by the courts, which decides (in the US at least) whether or not a person can stand trial. A person who is ruled to be insane (or mentally incompetent to stand trial) cannot be tried, legally under US law, as the court psychologist has prove that the defendant is not fit.

Contrary to popular belief, it is a bitch to get a legal ruling of insanity, as the process is a complicated one, and includes a set of questions that essentially boil down to 'can you, more often than not, tell what you did wrong, why it was wrong, and given same situation would you repeat your error?'

Sanity, like insanity, is a legal term.

Never call a character insane or sane, unless they have a history with the law.

Now onto another fun discourse topic: Person first language.

Essentially, putting the 'proper person' before their disorder. There's a lot of talk about it in communities (especially ASD) about how it actually devalues a person by separating them from something that may be an integral part of who they are. This is, though, highly variant on the person, and your best bet is to, as a writer, decide who your character is going to be before slapping labels upon them.

If you want more stuff on it, may I suggest Neurodivergent K's blog. She's an amazing disability rights/autistic blogger and she's covered a lot of what I'm talking about in a LOT better way than I can/could.

[examples of person first language]

autistic - 'person with autism' 'they have autism'
epileptic - 'person with epilepsy'

etc.

More later



Tea Time with the Traitor Masks and sewers and trains, OH MY!
525,600 minutes of absolute bullshit and bastardry James appears to be a bit busy with life, blogging shall resume shortly
~+~+~+~+~+~
Mental Health and Your Fear Blog A very brief primer to things to consider when writing a character that is 'going crazy'
~+~+~+~+~+~
Want to find out why my blogs are so slow to update, or real life the blog?
~+~+~+~+~+~
Finished blogs
Pulling off Masks ...but with a whimper...
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RedRockingHood
 Posted: Sep 25 2012, 09:39 PM
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pullingoffmasks
 Posted: Sep 25 2012, 10:28 PM
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Second- more in depth stuff on the four major disorders/dysfunctions I've seen used across the Slender and Fear Mythos (Any dissociative disorders (including dissociative identity disorder), schizophrenia, depression (or more correctly, non-specific mood disorders), and autism spectrum disorders)

Note, that any of these disorders have to cause 'marked distress or disorder to normative function within society' before diagnosis is considered proper and complete.

This is going to be a bit more dense, so hang with me.

Dissociative disorders

Axis 1 disorder.

Is the large umbrella that collects dissociative identity disorder, depersonalization disorder, and dissociative fugues (all of which have been used in many a Fear and Slender blog).

All disorders under this umbrella are marked by a period in time (be it continuous, periodic, or cyclical) where perception of reality is markably different, often with affects on memory and sensory.

Or, in more lay terms, ever had that feeling that you're 'out of your skin' or reality has slid a little to the left? That's depersonalization, and mild moments of it are very common. Severe and/or recurrent ones aren't.

It is VERY different to a psychotic break.

It also is NOT schizophrenia.

The main treatment for any dissociative disorder is therapy, usually talk. In the case of DID, one of the aims of therapy is to 'mainline' or integrate all of the personalities back into one whole.

Mood Disorders

Axis 1

A very, very, VERY large umbrella term that catches mania, manic depression/bipolar disorder, depression, and a few other disorders

Mania is defined as a extremely elevated (up) and/or irritable mood.
Note that it is a big UP! It isn't 2 cans of Red Bull, pack of candy, late at night up. It's flying high, feeling incredibly invincible, NOBODY CAN STOP ME!, I can do no wrong, mildly psychotic UP!

Talking to the same allistic friend I mentioned earlier, said it's a 'happy mood' when you're in it, because often times you're not self aware enough of the mania to go 'hang a sec, I should probably think about the consequences of my actions.'

(There is also hypomania, which is a mood similar to mania, but a little more lower in 'volume. (If full blown mania is the volume up to 11, hypomania is about a 9, and normal mood is about a 6)

Depression is defined as an extremely depressed (down) mood
Like mania, depression isn't the 'oh I've missed an episode of my favorite show' down. It's deep sinking, all encompassing feeling of doom, dread, nononono down.

Often times, severe depression comes hand in hand with ahedonia (lack of pleasure/drive) and suicide.

Mild depression exists, and it's likely that you have (or eventually will) experienced it at least once in your life.

Using the volume analogy again, if 'normal' mood is around a 6, mild depression sits at around 3-4 (depending on the person), and severe depression sits at a 1.

Manic depression, or bipolar disorder, is a disorder defined by a course of 6 or more months marked by 2 or more major manic or depressive episodes.

Contrary to popular belief, manic depression is NOT commonly rapid cycling. There is a form of it which does rapid cycle- which adds the complication of mixed moods into the equation.

Mood disorders are often times treated with a mix of psychoactive drugs (which there are a lot of) and talk therapy.

A note on the psychoactive drugs for manic depression. You can treat mania with anti-psychotics. You can treat depression with antidepressants. You cannot treat both of the poles with one drug.

(Also, lithium is a last resort drug. It causes severe damage to the human body, at the cost of regulating mood, so it's one of those ones that does not get used straight out. Used to tho')

This is something, that if you want your character to have the disorder, you WILL NEED TO DO YOUR RESEARCH!

Schizophrenia is a group of disorders that are marked by psychotic episodes, a break down in thought process, and poor/misplaced emotional responses

It is NOT dissociative identity disorder.

Schizophrenia has two classes of symptoms. Positive and negative.

Positive symptoms add stuff that 'isn't there.' So, hallucinations (hearing voices, seeing things that aren't there, tasting stuff that isn't there, etc), delusions, and disorganized speech/behaviour patterns.

A sudden onset of mostly positive symptoms is something that can be called a psychotic break or 'a break in reality.'

Negative symptoms remove stuff from 'normal function.' So, poverty of speech, flat affect/facial expressions, lack of motivation, ahedonia, lack of wish/drive to be social, etc.

Negative symptoms actually can do more harm than positive symptoms, as they have a tendency to be low level and continual, as opposed to 'moments of.'

Any drugs that are given to alleviate the symptoms of schizophrenia only effect the positive ones. Negative symptoms are unable to be 'treated' and can, actually (depending on the drug), be made worse with psychopharmacy.

There are a LOT of drugs out there, mostly anti-psychotics which are used to 'treat' schizophrenia. Note, there is often times poor compliance with drug courses, as typical anti-psychotics have a whole slew of nasty side effects. (And most of the side effects for atypical anti-psychotics are just heavy drowsiness)

As a side note, if anyone fancies playing with comorbidities- an autistic adult is less likely to be caught as schizophrenic until the disorder has progressed out of it's prodermal (early) stages, as a lot of the most noticed negative symptoms are part/parcel of 'classical' autism.

Autism Spectrum Disorders (including Asperger's Syndrome, Rhett's Syndrome, Persuasive Developmental Delay, etc) are a set of disorders which are characterized by sensory processing dysfunction, social deficit, normal IQ, communication issues, and special interests.

It is not a savant syndrome.

It is not caused by vaccines.

There is no cure. It is not a disease.

It does not 'look' a certain way.

And all the stereotypes you have are wrong.

Once again, I suggest you read Neurodivergent K's blog for any autistic issues. She is, once again, a lot more eloquent than I am on this topic.

Reciprocal language development usually is delayed until 3rd-5th year in classical autism, where as it develops 'normally' in someone with Asperger's.

The biggest thing for this is realizing that often times, you cannot tell a person is autistic in text. There's a flourishing autistic community on Tumblr and everyone is amazingly eloquent.

When writing an autistic character, realize that the largest issues that are faced day to day are sensory. Read, hyperacute hearing is common, meaning shopping malls/markets are a headache because of overhead lighting + music + tannoy + everyone else talking...

Most of the 'treatment' for ASD is therapy, with some drugs being used to treat comorbid conditions such as depression, anxiety, and ADD/ADHD.


Tea Time with the Traitor Masks and sewers and trains, OH MY!
525,600 minutes of absolute bullshit and bastardry James appears to be a bit busy with life, blogging shall resume shortly
~+~+~+~+~+~
Mental Health and Your Fear Blog A very brief primer to things to consider when writing a character that is 'going crazy'
~+~+~+~+~+~
Want to find out why my blogs are so slow to update, or real life the blog?
~+~+~+~+~+~
Finished blogs
Pulling off Masks ...but with a whimper...
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Collen
 Posted: Sep 25 2012, 10:39 PM
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This thread is helpful. I know surprisingly little about various mental conditions, actually.


Blogs in Progress:
Dreamless Darkness: Gotta face the strange.

Finished Blogs:
Misery Always Knows: Deal, or no deal?

Creepypastas:
"Whispers of Mutiny" // "Repeat After Me" // "Cold Oblivion" // "A Feast For Crows"

Assume anything not here is on hiatus.
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pullingoffmasks
 Posted: Sep 25 2012, 10:46 PM
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Part 3- Resources and all the fun shit

On TUMBLR

~ Avoid #autism. It's a load of icky nasty shit, mostly supporting Autism $peaks and bullshit cure stuff. Also, anti-vaxxers.
~ If you want first person voicing, I'd go with #actuallyautistic or #actually autistic - note, unless you are actually autistic, don't fucking post there. It's a collection of personal ranting, political comments, life tales, etc all from autistic folks.
~ If you want to ask questions about life experiences (no sex questions, no slur questions, and no asking inane questions) to folks on the spectrum, go with #askanautistic (I believe)
~ I've a friend who's pushing for the #actuallybipolar and so far, it's a good tag. More first person than anything, but a good tag.

Online Generally

~ Thinking Person's Guide to Autism - They published recently, but from what I've heard, it's an AMAZING resources.
~ Wikipedia. Make sure you use the links at the bottom of the page, but it's very good for brief, clear English definitions of disorders and treatments.
~ Neurodivergent K I'm going to push her blog again, but seriously, it's an AMAZING resource for how to avoid writing under the influence of ableism. (So, you know that first post I made? She's got a breakdown of why the language isn't so hot from an insider's perspective.
~ Google 'online DSM-IV-TR' brings up a good selection of scanned versions of the DSM-IV-TR. Use it. It defines EVERYTHING in clear language.

Books

~"The Center Will Not Hold" - It was recommended to me by a friend who heard I was writing a blog with a schizophrenic character. ...And it's a really good resource for voicing of psychosis, voicing of the fears that go through people's heads, and how schizophrenia is a very interesting disorder both socially and individually

(I have more, and they'll be posted as I remember them)


Tea Time with the Traitor Masks and sewers and trains, OH MY!
525,600 minutes of absolute bullshit and bastardry James appears to be a bit busy with life, blogging shall resume shortly
~+~+~+~+~+~
Mental Health and Your Fear Blog A very brief primer to things to consider when writing a character that is 'going crazy'
~+~+~+~+~+~
Want to find out why my blogs are so slow to update, or real life the blog?
~+~+~+~+~+~
Finished blogs
Pulling off Masks ...but with a whimper...
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DJay32
 Posted: Sep 25 2012, 11:12 PM
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This is seriously a wonderful thread, a great resource for accurate blogging that will surely be invaluable in days to come.

Would anyone have any objections to me stickying this thread?


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Fear (A visual art exhibit in blog format.)
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The Everyblogger Triad: 1, 2, 3 (Embrace the bad writing, give into your psyche.)
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proxiehunter
 Posted: Sep 25 2012, 11:52 PM
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QUOTE (pullingoffmasks @ Sep 25 2012, 05:46 PM)
Part 3- Resources and all the fun shit

On TUMBLR

~ Avoid #autism. It's a load of icky nasty shit, mostly supporting Autism $peaks and bullshit cure stuff. Also, anti-vaxxers.

<Snip>


Fuck autism speaks sideways with one of their puzzle pieces.

QUOTE
Online Generally

~ Thinking Person's Guide to Autism - They published recently, but from what I've heard, it's an AMAZING resources.
~ Wikipedia. Make sure you use the links at the bottom of the page, but it's very good for brief, clear English definitions of disorders and treatments.
~ Neurodivergent K I'm going to push her blog again, but seriously, it's an AMAZING resource for how to avoid writing under the influence of ableism. (So, you know that first post I made? She's got a breakdown of why the language isn't so hot from an insider's perspective.
~ Google 'online DSM-IV-TR' brings up a good selection of scanned versions of the DSM-IV-TR. Use it. It defines EVERYTHING in clear language.


Wrong Planet, a "web community designed for individuals (and parents / professionals of those) with Autism, Asperger's Syndrome, ADHD, PDDs, and other neurological differences." A member there myself although I haven't visited for ages.
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proxiehunter
 Posted: Sep 25 2012, 11:54 PM
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QUOTE (DJay32 @ Sep 25 2012, 06:12 PM)
This is seriously a wonderful thread, a great resource for accurate blogging that will surely be invaluable in days to come.

Would anyone have any objections to me stickying this thread?


Please do.
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Collen
 Posted: Sep 26 2012, 12:55 AM
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beep boop


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Can you tell me what Autism $peaks is? I'm inferring it's some sort of organization, and not a very good one at that. Close?


Blogs in Progress:
Dreamless Darkness: Gotta face the strange.

Finished Blogs:
Misery Always Knows: Deal, or no deal?

Creepypastas:
"Whispers of Mutiny" // "Repeat After Me" // "Cold Oblivion" // "A Feast For Crows"

Assume anything not here is on hiatus.
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proxiehunter
 Posted: Sep 26 2012, 01:15 AM
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QUOTE (Collen @ Sep 25 2012, 07:55 PM)
Can you tell me what Autism $peaks is? I'm inferring it's some sort of organization, and not a very good one at that. Close?



According to them: [url=http://www.autismspeaks.org]Autism Speaks History
Autism Speaks was founded in February 2005 by Bob and Suzanne Wright, grandparents of a child with autism. Their longtime friend Bernie Marcus donated $25 million to help financially launch the organization. Since then, Autism Speaks has grown into the world's leading autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. We are proud of what we've been able to accomplish and look forward to continued successes in the years ahead.[/url]

Their "advocacy" tends to involve silencing actual people with autism and attempting to speak for them. Also they tend to treat autism as a horrific family destroying condition as bad as your child having aids or cancer. Oh, and I don't know if they've backed down but they used to back research for prenatal testing for autistic spectrum disorders. You know, so parents could abort any potentially autistic kids. Their research for a cure is also highly controversial since many adults with autism don't feel they need to be "cured" and in some cases fear they would be pressured or even forced into being "cured" if a "cure" were available. Don't recall if they originally bought into the "vaccination causes autism" bullshit or not.

edit: According to wikipedia they were pouring money into researching the vaccine angle as recently as 2009. Hopefully since it was proven that the only research indicating a connection was falsified they have since stopped.
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tgecko
 Posted: Sep 26 2012, 01:19 AM
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This is my own experience with the social stigma that comes with a mild case of a mental disorder.

I have anxiety and depression. The fact that I needed medication for me to operate in society on a daily basis without absolutely losing my shit just made things even worse.

Comments people made insinuated or outright stated that I was weak for needing medication to function. That I just wasn't "manning up" to my problems. I had a supervisor comment that "only crazies need therapy."

The best analogy I've heard is that anxiety/depression (at least at my level) is like diabetes. It's a quirk of genetics that my brain doesn't produce enough melatonin to keep me operating at the same level as everyone else, like a diabetic doesn't produce enough (or too much) insulin.

So that's another factor to consider when introducing mental illness to your characters. They will most likely hide it from their casual acquaintances for fear of the negative opinions most people have about mental illnesses.


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Collen
 Posted: Sep 26 2012, 01:26 AM
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QUOTE (proxiehunter @ Sep 25 2012, 09:15 PM)



According to them: Autism Speaks History
Autism Speaks was founded in February 2005 by Bob and Suzanne Wright, grandparents of a child with autism. Their longtime friend Bernie Marcus donated $25 million to help financially launch the organization. Since then, Autism Speaks has grown into the world's leading autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders; and advocating for the needs of individuals with autism and their families. We are proud of what we've been able to accomplish and look forward to continued successes in the years ahead.


Their "advocacy" tends to involve silencing actual people with autism and attempting to speak for them. Also they tend to treat autism as a horrific family destroying condition as bad as your child having aids or cancer. Oh, and I don't know if they've backed down but they used to back research for prenatal testing for autistic spectrum disorders. You know, so parents could abort any potentially autistic kids. Their research for a cure is also highly controversial since many adults with autism don't feel they need to be "cured" and in some cases fear they would be pressured or even forced into being "cured" if a "cure" were available. Don't recall if they originally bought into the "vaccination causes autism" bullshit or not.

That's terrible. How were/are they allowed to do that?


Blogs in Progress:
Dreamless Darkness: Gotta face the strange.

Finished Blogs:
Misery Always Knows: Deal, or no deal?

Creepypastas:
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Assume anything not here is on hiatus.
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proxiehunter
 Posted: Sep 26 2012, 01:31 AM
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QUOTE (Collen @ Sep 25 2012, 08:26 PM)

That's terrible. How were/are they allowed to do that?


None of it's illegal, and even if it was they have vast amounts of money that gets spent on things other than their goals (last I heard autism research and awareness is where the least of their money gets spent. Paying their CEO's, office parties, lobbying, and lawyers is where most of the money they raise goes) they can afford a shit ton of lawyers.
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alliterator
 Posted: Sep 26 2012, 01:48 AM
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QUOTE
According to wikipedia they were pouring money into researching the vaccine angle as recently as 2009. Hopefully since it was proven that the only research indicating a connection was falsified they have since stopped.

Fuck them. Fuck them so much.

For those who don't know, please read this Cracked article. Basically: Andrew Wakefield manipulated and outright made up data to "prove" that the MMR vaccine caused a variety of disorders (including autism). In fact, I'll just quote Cracked on this:
QUOTE
First, let's make it clear: The science shows that vaccines do not cause autism. If you don't believe the Centers for Disease Control and Prevention, you can look at the tens of thousands of non-U.S. children whose autism (or lack thereof) hasn't been tied to vaccines (or lack thereof). However, the subject has been the source of fierce controversy over the past few years, and what is so terrifying about the sudden drop in vaccinations (other than the now-epidemic levels of previously controlled diseases) is that most of the controversy came from dime-store scientist Andrew Wakefield.

For starters, Wakefield's own scientist couldn't duplicate Wakefield's results. Wakefield also manipulated his data to ensure that children who were sick before getting the vaccine were reported as only being sick after. He flat-out changed results he didn't like or that didn't completely agree with his hypothesis, all while performing needless, painful tests on children.

We've mapped the whole situation out, in case you find it hard to follow.
So why would he do all that?

Well, there's the patent for a new MMR vaccine that Wakefield filled out before he published his paper, and the money he accepted from a legal aid fund that was trying to sue vaccine manufacturers (it's almost as if he had a massive financial stake in scaring people into believing that the MMR vaccine was dangerous).

The paper was so flawed that 10 authors and the publisher of the journal it appeared in have retracted the work. That's right -- the people who helped create and publish the paper now say that it's bullshit. But don't worry -- stuff like this has a way of hanging around forever -- just ask the people who are still insisting that fluoride is poison 70 years later.


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Knight
 Posted: Sep 26 2012, 02:47 AM
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Corrupted


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QUOTE (tgecko @ Sep 25 2012, 08:19 PM)
This is my own experience with the social stigma that comes with a mild case of a mental disorder.

I have anxiety and depression.  The fact that I needed medication for me to operate in society on a daily basis without absolutely losing my shit just made things even worse. 

Comments people made insinuated or outright stated that I was weak for needing medication to function.  That I just wasn't "manning up" to my problems.  I had a supervisor comment that "only crazies need therapy."

The best analogy I've heard is that anxiety/depression (at least at my level) is like diabetes.  It's a quirk of genetics that my brain doesn't produce enough melatonin to keep me operating at the same level as everyone else, like a diabetic doesn't produce enough (or too much) insulin.

So that's another factor to consider when introducing mental illness to your characters.  They will most likely hide it from their casual acquaintances for fear of the negative opinions most people have about mental illnesses.


I guess I'm kind of blessed in that field. People in my area haven't treated me any different when I've told them I have depression (or at the very least they haven't treated me negatively), but I have seen people online say stuff along the lines of "Depression is stupid. So you're sad, big deal. Get over it, crybaby."

And yes, I've actually seen someone post that exact line. I almost punched my laptop that day because it pissed me off so much.

When you're writing a character who has depression and you've never experienced it... It's not that you're crying all the time, or that you're alone. What I experienced was... well, it's this dread, or... a weight, even, that makes you feel like you're not important. It makes you question life and your part in it...

And what Squeek said in the (first?) post, about not being able to feel pleasure or satisfaction? That's the big thing right there. When I was going through severe depression, I couldn't remember a time in my life when I had been happy. When someone would ask me if I remembered a "fun" time they had with me, I wouldn't even remember it.

Another thing is a change in your habits/interests. I lost interest in playing videogames/writing and started walking almost every day to the point where I'd go after dark, just walking...

Again, most of that is from personal experience and talks with other friends who have depression. It's not the same for everyone, but it's never like the Hollywood version.


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