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Sanity Score

May 1, 2010

Crossposted from DW, with the appropriate tag fiddling.

Nigel is off gaming today, so I’m taking it easy and have mostly been camping in front of the keyboard. The poor dog claims he is being sorely neglected, but he does whenever at least one of us isn’t petting him.

Update: It turns out that he’s also afraid of heavy rain–not just thunder–so I’m going in there to sit with him after posting this!

Out of slightly morbid curiosity, I went and did the PsychCentral Sanity Score quiz phoneutria_fera mentioned yesterday. It requires a login, which irked me, but I went ahead and set up a throwaway account.

The results, pasted?

Your Sanity Score

Based upon your answers, you appear to be in generally good mental health, with some specific concerns or issues in your life. Most people have such issues to varying degrees — some seek outside help for them from a mental health professional like a psychologist, psychiatrist or psychotherapist, while others are happy with the way things are in their life. People with similar scores sometimes feel overwhelmed by the occasional stress in life, but usually recover and are fairly resilient.

(The Sanity Score is based upon a scientific algorithm with scores ranging from 0 – 288.)

Your specific subscores are below (subscales range from 0 – 100). Under the graph of subscores, you will find additional information regarding the meaning of any significant scores or areas that may be of concern.

General Coping 18
Life Events 31
Depression 9
Anxiety 54
Phobias 42
Self-Esteem 8
Eating Disorders 5
Schizophrenia 0
Dissociation 25
Mania 5
Sexual Issues 0
Relationship Issues 6
Alcohol 0
Drugs 0
Physical Issues 33
Smoking Issues 50
Gambling Issues 0
Technology Issues 0
Obsessions/Compulsions 25
Posttraumatic Stress 58
Borderline Traits 21

Interesting, in a fairly typical psych assessment kind of way. For anyone who doesn’t know, I spent a lot of time in the psych system over things which were neither psychiatric nor psychological. I am autistic with a lot of interesting neurological stuff going on, and ended up deemed bipolar with a clunky mess of other things tacked on to cover all the stuff the mood disorder didn’t.

Bear in mind that, whether they should be or no now that they’re accepted as neurological, ASDs (and Tourette’s) are lumped into the DSM. You wouldn’t know it from this assessment. Things may have changed in practice these days, though an awful lot of kids with ASDs are apparently getting pediatric bipolar labels.

The questions weren’t quite as bizarre as a lot of the ones on the MMPI–which surely gives a lot of false positives for “Hypochondriasis”–but some of them came close. Just a small sample of ambiguous ones which caught my eye:

* “I sometimes vomit after I eat.” Yep, and it’s unintentional, related to my physical health. I answered no. I have had disordered eating behavior, and this is a poor way of ascertaining whether someone does.

* “I don’t eat the way I used to.” Same here. I am diabetic with gluten intolerance, and am also having to eat a lot more than usual right now.

* “I eat more than I should.” How much “should” a person eat? Who is supposed to judge this? Might it reflect social attitudes more than individual mental health? Might 95% of women answer yes? A lot of people might think that I eat “too much”; they sure do give me filthy looks in public sometimes. I’m barely meeting increased energy requirements from the diabetes. Related: the preoccupation with BMI and other indications of “health habits”.

* “I sometimes hear or see things that others don’t hear or see.” Yep, and it’s from a jacked-up nervous system with acute senses, not to mention noticing things other people don’t. (Mosquito ringtones, anyone?!) Sensory sensitivities do not exist to most mental health professionals. Again, I learned pretty damned quickly not to admit this was true, and was still deemed to show “psychotic features” from some of my observed sensory reactions.

* “I often lose track of time.” Yep, also purely neurological (what is this “time” of which you speak?), and I’ve learned to deal with it.

* “I often feel empty or that my life has little meaning.” This really was the case before, as were several other statements of despair and confusion. These feelings had more to do with the way I was getting treated and encouraged to look at things than with any inherent problem. Similarly, “I believe that I will fail at almost everything I try.” This may be simple repetition of what people have been telling you.

* “I often cry for no reason.” Along with the other “for no reason” ones, you may well answer yes if very real problems–including things like migraines–you are experiencing have been dismissed and invalidated. And if other people cannot/don’t want to figure out why you’re doing them. You can be mired deeply enough in an abusive situation that you honestly cannot connect the abuse with the crying and sadness, etc. I used to answer yes to these.

* “I am distressed by the way my life is going.” Most people would be distressed under shitty enough circumstances, especially if the real life difficulties they’re running into are being considered something to be medicated away. See the “for no reason” questions above.

I couldn’t help but get the yes-or-no “Have you stopped beating your wife?” feeling a lot, with a lot of the phrasing.

Yeah, a good mental health professional will be able to sort out what might be contributing to a lot of these things. Some are excellent. Unfortunately, a lot are not so good, and many of those are inclined to view things through certain filters which presume a narrow range of mental illnesses above other explanations for the problems their clients are experiencing. That can work OK for some people’s situations, but not so much for others. Some of the filters which pathologize people’s behavior and communication–eliminating other possible explanations–are unlikely to help anyone.

Going back to the results, the breakdown was interesting–especially in light of the (inappropriate) diagnoses I picked up before. I can’t say much about the anxiety and especially the PTSD, other than that a lot of what has been interpreted and treated as anxiety and phobia is actually coming from purely neurological sensory weirdness. The same with rarely going out of the house; management is very different, depending on whether this is due to real sensory overload (plus some built-up anxiety from that, and other people’s distress over it), or whether it’s based on some horrible trauma in your past (as was assumed). Apples and oranges.

I do have Complex PTSD, and 15+ years of largely getting treated like crap in the psych system did not help with that. On the depression front, the score seems to be so low not because I am not experiencing symptoms these days, but because I am used to dealing with it by now and it doesn’t freak me out; the way I look at this has also changed, as reflected in some of the question quibbles. I’ve learned to do more emotional regulation, not having even known it was possible growing up. Also, some of the relevant questions do not seem to take into account that a person might have experienced chronic depression for long enough that there is not a sharp contrast between “now” and “before”.

Some products of neurological things (executive function, inertia, etc.) were taken as symptoms of depression, and figuring out what’s what to some extent has also helped; these things also require different strategies, depending on what’s behind the difficulty. Are you having trouble getting in the shower because you’re depressed, or does it have more in common with How to make a phone call, in 70 easy steps? Maybe it’s a combination of the two (my, do I know that one), or something else entirely.

Video: Original Song about Executive Dysfunction “I Grinded the Coffee” by P. Lungstuffing. No spoons for a transcript right now, unfortunately.

The “Physical Issues” score does not reflect anywhere near the actual quantity (or quality) of physical problems I am having now. This is probably down to both question bias and similarly increased mindfulness helping me deal with it. On a related note, I had to get a chuckle out of the “Drugs: 0”, the way a lot of people want to act about chronic pain treatment.

“Dissociation”, “Borderline Traits” (ah, that old dumping ground!), and “Obsessions/Compulsions”? A combination of neurological stuff and PTSD. I was diagnosed with mild OCD because of tics which fit Tourette’s criteria. One therapist suggested that I just didn’t want to “improve” when I started ticcing even more under the scrutiny. Seriously.

The test was interesting to mess with, and I think it nicely illustrates a number of systemic problems. I didn’t need this to tell me how sane I am now, and not surprisingly, think this assessment deeply underestimated my coping abilities in some ways while just not taking other areas into account at all. Can I clean my house? Rarely, for multiple reasons. And so on.

(Maybe I should throw in a link to my Psychiatry, freedom, and noninterference post here, for clarification. I am all for truly informed choice, and the last thing I’d want to do is tell people to buck up. Urgh.)

5 Comments leave one →
  1. May 2, 2010 4:44 pm

    “I sometimes hear or see things that others don’t hear or see.” Yep, and it’s from a jacked-up nervous system with acute senses, not to mention noticing things other people don’t. (Mosquito ringtones, anyone?!) Sensory sensitivities do not exist to most mental health professionals. Again, I learned pretty damned quickly not to admit this was true, and was still deemed to show “psychotic features” from some of my observed sensory reactions.

    Oh, this happened to me once when my parents dragged me to a quack psychiatrist in college. He had fluorescent lights that were very loud, and I commented on them… this made him think I was psychotic.

    Luckily, the next time I saw him, my mom came in the room and immediately made a comment on the very loud fluorescent lights… he was quite embarrassed.

    • urocyon permalink
      May 4, 2010 11:54 am

      I think I’ve seen that psychiatrist. 😐 That’s exactly the kind of thing I was talking about. Fluorescent light buzzing and flickering have always , erm, driven me batty, and I’m still amazed sometimes when other people don’t notice a malfunctioning light fixture. Good that you got some validation there!

      • Freya permalink
        May 16, 2010 2:45 am

        Yes, the fluourescent lights at work start flickering and buzzing so that I can perceive it about two weeks before anyone else at work can. Even having been there for years, they still argue with me that the lights are FINE, and they won’t need replacing soon… Mind you, they also argue with me that having flickering lights that they CAN perceive in my working area is FINE and not conducive to migraines AT ALL.

  2. May 3, 2010 10:27 am

    I find it interesting too how neuro issues are being mistaken as psychiatric. I have never been clinically depressed, and still have had more than enough screenings for it while on my former psych ward. Besides overload, inertia, executive dysfunction, etc., it would be logical if I were depressed given the circumstance of 16 months on a locked ward.

    As a side note, ASD is still often considered a psychiatric disability, at least in the Netherlands.

    • urocyon permalink
      May 4, 2010 12:05 pm

      *nods* That would be enough to leave just about anyone depressed and feeling helpless. There has certainly been research in which people who didn’t actually have mental health problems going in developed symptoms after a while under the stress of a locked ward. (That agrees with my experience, though my longest stay was a month. The longest month of my life, but still.) Rarely is this taken into consideration as a possible cause of distress, but rather as further proof that the person needs to be there.

      Maybe I should have said that there’s a lot of research indicating that ASDs are neurological. Unfortunately, this hasn’t always filtered through to the mental health professionals who end up assessing us. I think it’s similar to some public assumptions: you’re behaving strangely by the other person’s standards, so it must be a mental health problem.

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