Asperger Syndrome is an Autism Spectrum Disorder (or Pervasive Developmental Disorder) characterized by significant difficulties in social interaction along with restricted and repetitive patterns of behaviors and interests. Those with Asperger Syndrome, or AS, may exhibit a lack of empathy for their peers, clumsiness, and atypical use of language, though none of these symptoms are required for a diagnosis.1
The pain of coming to terms with having Asperger's is still very real for me right now. There is a tremendous sense of grief. Grief for all that I suffered through to try to be "normal" and grief for how short of "normal" I always have been. There is also great relief to know that I am not crazy and that not everything can be traced back to an abusive past in the sense that some of what I experience is not choice/emotional but neurons/physical. The greatest challenge I face right now is trying to figure out which is which. This is not easy.
One of the most common side effects of a number of antidepressant medications is loss of sex drive. I could forgive our friends at fine companies such as Eli Lilly, Bristol Meyers Squibb, and Pfizer if dry mouth, irritability, disrupted sleep patterns, loss of appetite, sloth, and social phobia were the sole issues related to the medications I take on a daily basis. However, it is the sex thing I find most challenging.
Anhedonia is the technical term for the inability to experience joy. When people are in the depths of depression, nothing touches them, not the most intensely pleasurable activities, not the most familiar comforts. They are emotionally frozen. In this state, people either have to get professional help or simply wait for weeks or months until the depression lifts by itself; nothing is going to make them feel better.
Schizophrenia is a mental illness which affects one person in every hundred.
Depression is perhaps the most common of all mental health problems, currently felt to affect one in every four adults to some degree. Depression is a problem with mood/feeling in which the mood is described as sad, feeling down in the dumps, being blue, or feeling low. While the depressed mood is present, evidence is also present which reflects the neurochemical or "brain chemistry" aspects of depression with the depressed individual experiencing poor concentration/attention, loss of energy, accelerated thought/worry, sleep/appetite disturbance, and other physical manifestations. When this diagnosis is present, the individual will exhibit at least five of the following symptoms during the depressive periods:
Phineas Gage was a 25 years old construction foreman who lived in Vermont in the 1860s. While working on a railroad bed, he packed powdered explosives into a hole in the ground, using tamping iron. The powder heated and blew in his face. The tamping iron rebounded and pierced the top of his skull, ravaging the frontal lobes.
In 1868, Harlow, his doctor, reported the changes to his personality following the accident:
He became "fitful, irreverent, indulging at times in the grossest profanity (which was not previously his customs), manifesting but little deference to his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate yet capricious and vacillating, devising many plans for future operation which are no sooner arranged than they are abandoned in turn for others appearing more feasible ... His mind was radically changed, so that his friends and acquaintances said he was no longer Gage."
In other words, his brain injury turned him into a psychopathic narcissist.
Similarly startling transformation have been recorded among soldiers with penetrating head injuries suffered in World War I. Orbitomedial wounds made people "pseudopsychopathic": grandiose, euphoric, disinhibited, and puerile. When the dorsolateral convexities were damaged, those affected became lethargic and apathetic ("pseudodepressed"). As Geschwind noted, many had both syndromes.
The DSM is clear: the brain-injured may acquire traits and behaviors typical of certain personality disorders but head trauma never results in a full-fledged personality disorder.
"General diagnostic criteria for a personality disorder:
F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma)." (DSM-IV-TR, p.689)
From my book "Malignant Self-love - Narcissism Revisited":
"It is conceivable, though, that a third, unrelated problem causes chemical imbalances in the brain, metabolic diseases such as diabetes, pathological narcissism, and other mental health syndromes. There may be a common cause, a hidden common denominator (perhaps a group of genes).
Certain medical conditions can activate the narcissistic defense mechanism. Chronic ailments are likely to lead to the emergence of narcissistic traits or a narcissistic personality style. Traumas (such as brain injuries) have been known to induce states of mind akin to full-blown personality disorders. Such "narcissism", though, is reversible and tends to be ameliorated or disappear altogether when the underlying medical problem does. Other disorders, like the Bipolar Disorder (mania-depression) are characterised by mood swings that are not brought about by external events (endogenous, not exogenous). But the narcissist's mood swings are strictly the results of external events (as he perceives and interprets them, of course).
But phenomena, which are often associated with NPD (Narcissistic Personality Disorder), such as depression or OCD (obsessive-compulsive disorder), are treated with medication. Rumour has it that SSRI's (such as Fluoxetine, known as Prozac) might have adverse effects if the primary disorder is NPD. They sometimes lead to the Serotonin syndrome, which includes agitation and exacerbates the rage attacks typical of a narcissist. The use of SSRI's is associated at times with delirium and the emergence of a manic phase and even with psychotic microepisodes.
This is not the case with the heterocyclics, MAO and mood stabilisers, such as lithium. Blockers and inhibitors are regularly applied without discernible adverse side effects (as far as NPD is concerned).
Not enough is known about the biochemistry of NPD. There seems to be some vague link to Serotonin but no one knows for sure. There isn't a reliable non-intrusive method to measure brain and central nervous system Serotonin levels anyhow, so it is mostly guesswork at this stage."
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