Is this like the one true church? The iFaith?

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ID#: 54268	Area: Posts	Submitted: 2009-10-26 20:59:00	Posted: 2009-11-03 03:01:04
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QCan you figure out the IPA representation of my alias?

J/k Sorry, that's not my real question, but it is phonetic.

I was really wondering the following:
Are real, actual insane people capable of having more or less stress than sane people, on average? If so, how much difference is there? Does it differ much from one insane person to another?

ADear you,

I had some trouble understanding exactly what you meant by your question, and the Supershrink said that werf did, too. If I missed your point, you have my sincere apologies.

First problem: what exactly do you mean by "insane"? That's not a term that the mental health community uses...ever. It's full of rather nasty and untrue connotations and stereotypes, it isn't politically correct, and it's pretty vague. I thought you meant people who suffered from delusions and hallucinations while the Supershrink thought you meant anyone who suffered with a diagnosable mental illness. (Also, a note: especially if you did indeed mean something like what the Supershrink thought you meant, please be a little more careful about your wording, as us real, actual insane people don't really like to be talked about like a critter on the Crocodile Hunter. [Crikey! A real, actual insane person! They're pretty rare, so let's see what happens when I poke it with this stick!]) For the purposes of this answer, I'm adopting the Supershrink's interpretation of "insane." The Supershrink and I also decided that by "capable of having more or less stress," you meant their ability to deal with outside stressors, though mental illness is in itself a major stressor that can even cause trauma to the people experiencing it.

The other problem that both the Supershrink and I saw when we saw your question is that we don't really know how to research it. Stress is a huge topic in psychology, but neither of us knew how to research how stressors affect people with different disorders and to what extent. It's a very broad question. To answer the last part of your question first, it varies very much among individuals who have the same diagnosis and individuals who have different diagnoses. So, all that being said, I'm going to take a whack at the rest of your question.

I guess one way to address which disorders are characterized by a lesser ability to handle outside stressors is to rate them by patients' functionality. This doesn't account for whether the stressors are caused by the disorder itself or by normal life and the person just doesn't have the ability to cope with them as well as an average person, but it gives you some idea of how they are dealing with life in general. Impaired functioning is a part of what makes a disorder a disorder, so unimpaired or "sane" people would generally be on one end of the functionality continuum, while people with severe schizophrenia or dissociative fugue might be considered to be on the other end. People with certain personality disorders would typically be toward the "healthy" end of the continuum, as would people with certain anxiety disorders and high-functioning people with certain depression diagnoses, while many people with bipolar disorder and PTSD would be more toward the "unhealthy" end. However, some people would have low functionality without the appearance of a disorder, and some disordered people would seem to be quite high-functioning even if they are in quite a lot of psychological distress.

Another problem with looking at how well people with different diagnoses handle stress is that so many disorders are all about how a person deals with stress. For instance, a person with panic disorder has panic attacks because of their own physiological response to stress and their worry that it will cause them to have a panic attack or a serious physical problem. However, if stress does not trigger the physiological symptoms they are worried about, they could potentially handle a great deal of stress with no ill effects. That kind of thing is typical with other anxiety disorders, too. For example, some people with generalized anxiety disorder (GAD) have a very high (perhaps even higher than average) ability to function through their stress, but they feel a great deal of anxiety about their anxiety. Of course, this is not always the case, as some people's anxiety disorders are triggered if they attempt to outstrip themselves. Still others' responses to stress are not nearly as predictable, so sometimes a person with social anxiety, for example, may function perfectly well in social situations, but all of a sudden, even if the stress is no greater or less than before, they are completely unable to function. People with obsessive-compulsive disorder find certain stressors completely intolerable, and so they perform certain activities to make themselves able to deal with that situation. If they live according to their compulsions, they may be able to deal with a very high level of stress, or they may not. People with dissociative disorders (like the famous dissociative identity or "multiple personality" disorder) take their trauma or inordinate amount of stress and remove it from themselves in order to allow themselves to function. The more severe dissociative disorders are debilitating, but the less severe ones may allow people who suffer with them to function, more or less.

You've probably heard of examples of artists and other creative people who functioned incredibly well and turned out masterpieces and dealt with the requisite stress during semi-manic states, but then fell into periods of depression during which they did not function well at all. Manic people can deal with amounts of stress that healthy people would find insurmountable, but once the mania is over, so is their super-coping. Similarly, people with eating disorders may be incredibly high-functioning and may channel all of their anxiety into starvation or binging and purging. If you gave those people additional stress, they would probably continue to be just as high functioning, but their disorder would grow increasingly worse.

Some people with psychological disorders simply do not deal with stress in normal ways, instead acting out like people with borderline personality disorder, turning it into physical symptoms like people with somatization disorders, or being despondent like people with depression. Amp up the stress on people exhibiting these responses and the responses will often become stronger. Then, of course, there are our delusional friends with disorders like schizophrenia, whose symptoms may similarly increase if they are continuously exposed to high levels of stress, as will those of people with post-traumatic stress disorder. For people with these more severe disorders, additional stress will probably never be handled well and will probably always cause a negative response.

I hope somewhere in there I answered your question.

- The Black Sheep

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