Hypervigilance The Psychiatric Injury

Mental illness or psychiatric injury?

Differences between mental illness and psychiatric injury The person who is being bullied will eventually say something like "I think I'm being paranoid..."; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury. Paranoia

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paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry

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paranoia tends to endure and to not get better of its own accord

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the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia

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sometimes responds to drug treatment

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the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia

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the paranoiac is convinced of their selfimportance

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paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD

Hypervigilance

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is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury

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wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause

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the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularised word "paranoia"

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drugs are not viewed favourably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process

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the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so

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the hypervigilant person is often convinced of their worthlessness and will often deny their value to others

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hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness

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the paranoiac is convinced of their plausibility

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the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")

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sense of persecution

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the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them

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the paranoiac is on constant alert because they know someone is out to get them

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the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)

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the hypervigilant person is hypersensitized but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury

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heightened sense of vulnerability to victimisation

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the hypervigilant person's sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them

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the hypervigilant person is on alert in case there is danger

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the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behaviour is having; they cling naively to the mistaken belief that the bully will recognise their wrongdoing and apologise

the paranoiac is certain of their belief and their behaviour and expects others to share that certainty

Other differences between mental illness and psychiatric injury include: Mental illness •

the cause often cannot be identified

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the person may be incoherent or what they say doesn't make sense

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the person may appear to be obsessed

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the person is oblivious to their behaviour and the effect it has on others

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the depression is a clinical or endogenous depression

Psychiatric injury •

the cause is easily identifiable and verifiable, but denied by those who are accountable

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the person is often articulate but prevented from articulation by being traumatised

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the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery

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the person is in a state of acute self-awareness and aware of their state, but often unable to explain it

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the depression is reactive; the chemistry is different to endogenous depression

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there may be a history of depression in the family

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there is very often no history of depression in the individual or their family

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the person has usually exhibited mental health problems before

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often there is no history of mental health problems

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may respond inappropriately to the needs and concerns of others

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responds empathically to the needs and concerns of others, despite their own injury

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is often in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?" - click here for the answer)

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may experience an unusually heightened sense of vulnerability to possible victimisation

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displays a certitude about themselves, their circumstances and their actions

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may suffer a persecution complex

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suicidal thoughts are the result of despair, dejection and hopelessness

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suicidal thoughts are often a logical and carefully thought-out solution or conclusion

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exhibits despair

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is driven by the anger of injustice

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often doesn't look forward to each new day

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looks forward to each new day as an opportunity to fight for justice

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is often ready to give in or admit defeat

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refuses to be beaten, refuses to give up

Common features of Complex PTSD from bullying People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterise psychiatric injury and differentiate it from mental illness. These include: · Fatigue

with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME) An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear) An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience

A simultaneous and paradoxical unwillingness to talk about the bullying (click here to see why) or abuse (click here to see why) A lack of desire for revenge, but a strong motivation for justice A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty Extreme fragility, where formerly the person was of a strong, stable character Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy) Clumsiness Forgetfulness Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled An enhanced environmental awareness, often on a planetary scale An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat Willingness to try complementary medicine and alternative, holistic therapies, etc A constant feeling that one has to justify everything one says and does A constant need to prove oneself, even when surrounded by good, positive people An unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as "persecution" Occasional violent intrusive visualisations Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable A feeling of being small, insignificant, and invisible An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later.

Source: Tim Field 1996-2005 http://www.bullyonline.org/stress/ptsd.htm