In all the Meta reflections that have been carrying on these past months on this site, which I have followed too closely for my own good, there has been occasional reference to the mental/psychological condition of various posters, but not much. Most often when the issue of mental health is mentioned at all, it's in the context of disparaging accusations about a user ("crazy", "insane", "forgot to take your meds"), although sometimes a poster will mention his/her own past or present medical condition.
As someone who has unfortunately become rather intricately knowledgeable about mental illnesses through experience, I think that a lot of the interactions that take place here tend to overlook or discount the possible influence of some members' mental conditions, and this tendency can be a major contributing factor to many flame-wars and troll fights, and to the general discomfort that a great many users have expressed feeling recently.
I debated whether to try writing a diary about this for some time, because it would be all too easy for any discussion of this topic to quickly degenerate into hurtful accusations, name-calling, or worst of all, Frist-like "on-line diagnosis". But to leave it unaddressed, it seems to me, is to ignore a pretty large elephant in the blog. So I'd like to raise a number of points on the topic of MEnTAl illness, but I will utterly refrain from identifying or insinuating the behavior or condition of any specific Kos poster, and I would respectfully request that any commenters do the same.
There are several distinct, but often related, psychological/emotional disorders that I think are evident in a significant number of posters and posts, some of which are more severe than others, and which have particular relevance to Meta concerns such as troll and flame wars. I'm not going to provide a lot of clinical description, except to try to clarify and highlight the features of different conditions that I think it is useful for people to keep in mind when thinking about these issues in context.
Depression
Let's start with Depression. Depression is variously signified by feelings of sadness, lethargy, hopelessness, indifference, etc. It's the most common mood disorder in America, pretty much our disease of choice. For most of us, it's not debilitating, and a shot of Java once a day is enough to keep it in check, but for others depression can be far more disabling, especially if not diagnosed and treated properly.
My guess is that a majority of Kossacks probably suffer from depression to one degree or another, most of us to a relatively mild degree. This is pretty much the nature of the beast, in my opinion. First of all, we're Democrats, we've suffered under the heinous abuse of the Republican hegemony in our government and media for years, and we're acutely aware of how screwed up our country and our world have become.
Such awareness does not really "cause" depression - and it's perfectly possible to be outraged by Republican policies and be in excellent mental health. But if one is otherwise pre-disposed to depression, having to face a battery of hateful and tragic news reports on a daily basis can certainly contribute to keeping one's mood in the dumps. Moreover, it wouldn't surprise me to learn that a disproportionate slice of liberals/Democrats on the whole suffer from depression in comparison with Republicans (their illnesses are more serious), and that this condition actually contributes to one's tendency to adopt a liberal world view: i.e., we tend to be more compassionate, more feeling, more aware of others' tribulations.
To the extent this is true, I'm not claiming that DKos is a den of self-pitying depressives; in fact, various studies suggest that more than half of the U.S. population suffers from depression, so it's not really a stretch to assume we're at least representative, and possibly more so. Obviously those who are active and productive, both here and in real life, are not debilitated by whatever level of depression they may endure. Anyone who was very severely depressed would likely be unable to bother even posting comments.
This implies that our most deeply depressed members are probably lurkers. But depression is a notably inconstant condition (see Bi-polar, below), so we may sometimes see lurkers arise out of nowhere to post inflammatory comments or diaries, possibly because of a burst of energy accompanied by some long-lingering sentiments that have finally managed to find an outlet. More often, I suspect that those of us dealing with moderate but fluctuating depression levels find that we can be in a good mood or a bad mood on any given day, and occasionally lose our cool.
However, this is not to discount altogether the effect that various actions and comments on this site can have upon those who do suffer from depression. Troll-rating, for example, can "hurt" someone who is depressed far more than a "normal" person might understand. We see countless examples of people complaining about one or two troll ratings, and just as many responses telling these people to stop "whining" and "get over it".
I'm not passing judgment here on the merits of anyone's actions or attitudes, I'm just pointing out that when one is dealing with the illness of depression, even the littlest form of negativity, rejection, or perceived attack can have a much more powerful impact than a non-depressed person would ever experience. In real life, the admonition to "just get over it" is not particularly helpful to a depressed person: it is often no easier for someone to "get over" depression than it is to "get over" any other medical disease you can name.
(By the way, I'm not addressing alcoholism or other substance addiction in this diary, in the interests of brevity, but there are obvious close linkages, especially with depression.)
Bi-Polar Disorder
Sometimes called "Manic-Depression" or similar names, Bi-Polar disorder involves one part depression, one part mania, and the tendency to bounce back and forth between the two. Again, this can be severe or mild; in its mildest form, we could simply describe someone as "moody", having "ups and downs". In its most severe manifestations, bi-polar disorder leads to wild and catastrophic mood swings which can ruin people's lives.
It's pretty difficult to guess the extent to which mild bi-polar disorder may be prevalent among Kossacks, but again I suspect it's pretty common. When some of us get the urge to write several mega-diaries and contribute dozens of lengthy comments over the course of a few days, only to disappear into near invisibility not much later, this could simply be a sign of having some free time and a burst of creative energy, but it could also indicate a manic episode followed by a depressive crash.
Again, most such instances are not likely to be severe; in a truly out-of-control manic state, the victim is often so hyper that he/she can't even think clearly, and is likely to spout long, incoherent strings of non-sequiturs, typing so fast that spelling and grammar are abandoned, responding instantly and compulsively to any and all reply comments, etc.
We sometimes say people in this state are "losing their grip", and it's a reasonably accurate metaphor. But there's actually a fine line between that lost grip and very acute insight. People in a manic state often have extraordinary clarity of thought, as brain synapses are flashing with unusual speed; they often just can't slow down long enough to express the ideas that they're perceiving. However, when they are able to travel just slightly below the speed limit, these people can produce some of the most eloquent and inspiring expositions we'll ever read. Many of our greatest thinkers were, or are suspected to have been, at least partly subject to bi-polar conditions. It wouldn't surprise me if some of our most prolific Kossacks were the same.
But don't lose sight of the fact that manic disorder is almost inevitably combined with the depressive down-cycle; indeed, the overheated output of the manic phase basically precipitates the crash. So there can be a price to pay for intimate contact with the Muse, and I think we may have seen the consequences of that type of cycle more than once.
Anxiety Disorder
As with all of these disorders, there is a lot of overlap and linkage. Anxiety disorder can be closely related to the manic side of bi-polar disorder, but it has its own uniquely disruptive traits. Fundamentally, this is what it sounds like: abnormally high and chronic bouts of nervous anxiety, which can affect one's thinking patterns as well as many basic functions, due to such symptoms as shaking, inability to swallow, sleeplessness, and such notorious related conditions as anorexia and bulimia.
This can be an utterly debilitating disease, in part because it can arise unexpectedly from other conditions (such as depression), and virtually incapacitate someone with little warning. On the other hand, once again there can be more mild variations, which mainly lead to an agitated state, perpetual worry and nervousness, or eating disorders and such.
I imagine that blog posters who may suffer from moderate to acute anxiety disorder would exhibit a tendency to post regularly and repetitively on a given topic or topics, and to be especially hung up on personal vendettas, getting in the last word, disputes over apparently trivial misunderstandings, etc. This is not to claim that anyone who engages in those types of exchanges is a victim of neurosis, just that this could be expected behavior in some cases.
The problem can be that a poster becomes unable to extract him/herself from a given thought pattern (see OCD, below), thinking about a perceived or real insult or attack incessantly, so that the only action that he/she can focus on is responding, perpetuating the argument, clearing his/her name, etc. When other, uninvolved posters insist that such people should "take a step back" or "give it a rest", they may or may not understand how utterly difficult it is for someone with a strong anxiety disorder to do that. Even if the person physically walks away from the computer and doesn't read DKos for days, that person may still be running over the dispute in his/her head, formulating "what I should have said" follow-ups, imagining all sorts of future retorts. When we later see what many refer to as the "stalking" of a user by a poster who was previously "wronged", and such disputes being revisited in thread after thread, I think this may often be the manifestation of the inability to suppress such thoughts, the virtual need of the anxiety sufferer to get it all out of his/her head.
I also suspect that this factor plays a role in some GBCW diaries (not pointing to anyone specific, recent or otherwise). People dealing with anxiety disorder are usually quite aware of their illness, and of the focus of their obsessive thoughts. They may conclude that the only way to rid themselves of the problem is to abandon the entire venue, and try to turn their mind in other directions. On this, they may be right, although by itself such a tactic is unlikely to "cure" an anxiety disorder, if the underlying biochemical, environmental, and other psychological factors are not addressed at the same time.
Obsessive-Compulsive Disorder
OCD is, from what I've seen, often misunderstood as a disease, almost as much as schizophrenia (see below). Many of the symptoms that I've described above with respect to anxiety disorder are often misconstrued as indicators of OCD; and indeed there are again similarities and mutual influences. People with anxiety disorder can and do become "obsessive" about the objects of their anxiety. However, OCD involves a more generalized, typically more irrational degree of obsessiveness, combined with compulsiveness. Most of us have probably heard about (or known) severe OCD sufferers who must compulsively wash their hands or take showers countless times per day, and there are many similar examples of the disease in its most serious and tragic forms.
The basic defining trait of OCD is a virtual inability to control one's impulses to do certain things, repetitively and unproductively. The person simply acts like a Pavlov dog in response to certain stimuli, every time, and even seeks out those stimuli in order to be "forced" to produce the same reaction, again and again. It appears that some dysfunction in the brain causes it to go into an infinite loop, and the minuscule degree of "gratification" that arises from assuaging some imaginary need (such as feeling dirty) disappears very quickly, so the person keeps looking for new excuses to scratch the same itch.
The worst and most horrendous versions of this disorder have manifested themselves in serial killers and rapists and the like. But victims of in much milder OCD conditions can function quite successfully in society (as can victims of nearly any mental illness), despite their obsessive/compulsive tendencies, and sometimes only those who know them well may be aware of the disease.
In the case of blogging, my guess is that mild OCD could be an explanation for posters who seem to exhibit an uncontrollable tendency to post the same comments on the same topics, over and over. This is a difficult line to draw, because many of us simply have a strong interest in certain issues, and we're likely to be found repeating ourselves when the topic arises in multiple diaries, whether all at once or over time. But there seem to be others who go beyond merely highlighting important opinions, but who seek out and even try to create opportunities to repeat, often verbatim, comments that they have made on a given topic dozens and dozens of times, frequently in diaries or threads that were not originally on that topic at all.
Sometimes this behavior is readily identified as "spamming" and trollish, but not always. And when users who object to such repetitive posting label the culprit as "obsessed", I think they may not really be considering the extent to which, in a clinical sense, they may be entirely correct. But where such activity is driven by a true case of OCD, it's again important to understand how difficult may be for the poster in question to restrain her/himself from such compulsiveness.
Also, there is often another key difference with OCD, in that the sufferer, while they may be "aware" in an abstract sense of their illness, may not easily be able to distinguish their own obsessive/compulsive behavior from "normal" behavior, since they are also quite capable of acting "normally" much of the time. In fact, accusing a (closet) OCD sufferer of acting obsessively can ironically trigger an obsessive response, simply by exposing that uncomfortable facet of their personality. For this reason, my view is that it is best to leave people alone altogether who appear to be acting in an irrationally compulsive and obsessive manner, because engaging them - especially in an impersonal and distant virtual environment such as this - is highly unlikely to achieve any kind of positive result, and much more likely to exacerbate both the condition and its symptoms, to the unpleasant detriment of all involved.
This does leave, however, an even more difficult question: what happens when two (or more) closet OCD type individuals encounter one another, and become the object of each other's obsession? I'm not sure. In the real world, you'd separate them and try to get professional help to intervene. In the on-line world, the only truly safe response, in my view, is to stay out of the fight and hope that one or the other regains his/her self-control eventually; the more that others fuel the obsessions, however well-intentioned, the more the flare-up is likely to continue unabated.
Paranoid Psychosis, Schizophrenia
Finally (although there are many other disorders we could discuss), I want to make some especially serious points about schizophrenia and related paranoid psychoses. These disorders are generally much more rare, as well as more severe, than most of the others I've mentioned. They're also probably the most misunderstood.
I try not to get caught up in so-called political correctness with respect to labels, in spite of how important I think this subject is, but when you refer to someone as "crazy", "insane", or "schizo" (even in jest) you are, intentionally or not, maligning and degrading many otherwise good real people who have fallen victim, through no fault of their own, to these horrible conditions. If you have never had the misfortune to know or love someone who succumbed to psychosis, consider yourself lucky, but I also ask you to make an effort to be considerate of both those who suffer from the disease, and those who deal with it on a daily basis.
Schizophrenia (as shorthand for many related disorders) has nothing to do with multiple personalities, despite the frequent colloquial usage. It has to do with a disconnection from the ability to perceive reality in the same way as "normal" people do - and as the afflicted person does most of the time. The causes and inner workings of the disease are still not well understood by medical science, at least partly because it is very difficult to find patients who are suffering from schizophrenia who can coherently (and truthfully) describe what they are experiencing.
If you saw the movie "A Beautiful Mind", you should know that, while this was based on a true story, it did not accurately portray the way that typical schizophrenics think and act. It gave a superficial and Hollywood-tainted image of the disease, with some helpful insights, but for real-world schizophrenics and their loved ones, it was misleading at best.
The bottom line is that schizophrenics cannot tell the difference between "real" reality and the reality that their brain creates for them. They really do hear voices; they don't "imagine" that they hear them. They fully and utterly believe the most absurd paranoid conspiracies and persecutions. They are liable to react to virtually any insignificant incident or offhand remark and interpret it as a Signal or a Message or some other insidious emblem of the hidden world that their mind tells them is right beneath the surface of their everyday life. They can hold a perfectly logical and sensible conversation with you, and in the next breath say something like, "if only the scientists would remove the chip from my brain, I could explain it to you more clearly" - and they are exactly as serious and sincere as they were a minute before.
A large number of schizophrenics end up homeless and hopeless, as their disease prevents them from functioning minimally in society, and they are ostracized for their strangeness anyway. But many others are actually quite capable of holding jobs, participating in social interactions, and yes, writing on blogs. Like I said, I'm not prepared to suggest any specific at-home diagnoses, but it has seemed eminently clear to me on numerous occasions that certain posters and diarists on this site are suffering from some degree of paranoid psychosis, in some cases possibly quite severe.
If you haven't encountered, and especially tried to engage in conversation, with a schizophrenic, it may be difficult not only to recognize their characteristics, but in particular to understand how their minds work (or don't work). Please try to understand this: NOTHING you say to someone in this condition will cause them to change their perception or "see the light", nor indeed to acknowledge the reasonableness of your viewpoint. If you attack and insult them, they are likely to become belligerent in response, but even if you try to be kind and helpful, they will not be capable of accepting any interaction that does not embrace their unique world view. Most often, they will go off-topic perpetually, and return to the focus of their internal world, whether or not anyone's paying attention.
This does not mean that we shouldn't treat schizophrenic trolls any different than other trolls. As a matter of fact, I would bet that a pretty high proportion of "regular" (i.e. right-wing infiltrating) trolls are actually also suffering from some degree of paranoid psychosis, at least as evidenced by the degree of rational thinking they display, as well as their apparent paranoia about liberals in general. I don't think that we should really bother to try to diagnose and "excuse" those who may be fundamentally impaired if they act as trolls, any more than schizophrenics in real life should be allowed to urinate in public or verbally berate total strangers without consequences.
But I do think that it makes the most sense not to pile on and attempt to humiliate and verbally destroy posters who are "bat-shit crazy," to use the vernacular. We wouldn't gang up on a homeless person on the street who was ranting about the End of the World or proclaiming that controlled explosions brought down the World Trade Center, and stand around laughing at and insulting him/her in front of a crowd. (We might, however, bemusedly show a few pictures of ponies to each other.)
Concluding thoughts
In the end, mental is not a political issue at all. There have even been numerous Republicans who have endorsed higher health insurance coverage for mental illness, as these diseases strike regardless of ideology. But of course other conservatives have hypocritically fallen back on the "personal responsibility" meme to reject nearly any recognition of the suffering and needs of the mentally ill. On the other hand, there have been well-meaning but (in my opinion) misguided liberals who have inhibited families' abilities to obtain treatment for afflicted loved ones, in the name of individual liberty. And of course whenever the pharmaceutical lobby gets involved in any health-care issue, it becomes increasingly difficult to separate "legitimate" research and concern from the profit motive.
At a minimum, I hope that we on this site can approach our own interactions with the thousands of strangers of very mixed and unknown backgrounds and circumstances with a bit of restraint, and respect, when it appears that psychological/emotional illness could play a role in someone's actions or statements. We'll help our cause much better that way, instead of reinforcing pains that we may be in a very poor position to understand, and for which we might express far more sympathy if we did. That way, we can focus much more positive collective energy on our most important goal: getting those lunatics out of the White House and Congress!