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Trigeminal Neuralgia and Migraines

As I was saying in an earlier post, my doctors reckon I have Atypical Trigeminal Neuralgia and there seems to be a migraine element there too. So the Atypical TN bit I understand, but the migraine bit confuses me. 

Up until recently I believed that a migraine was a really bad headache that sent you to bed for a day or so and that was it. I have had these episodes in the past and I never realised that it could be connected to my TN pain. I was grilled while I was in hospital by countless doctors, but then a nurse came along with a different set of questions which shocked the hell out of me. Everything she said made sense! I suffered really bad headaches since my teens, the kind of headaches that make you vomit and send you to bed for a day or two. A migraine is not necessarily a headache, but it refers to nerves in the brain. The problem is that analgesic medications can make a migraine worse, so unless you are on preventative medication, you are in trouble.

I don't have those headaches as often anymore, but the nurse is convinced that some of my symptoms have a migraine and cluster headache aspect to it. She feels that once my migraine issues have been treated, it could in a way help my Trigeminal Neuralgia pain. Unfortunately she said that my pain will never go away, but she is confident that it can be reduced. I am awaiting an appointment with her boss, a specialist who may confirm the diagnosis. The Migraine diagnosis would certainly explain what has happened to my eye.

The statistics regarding migraines are staggering. It is a lot more common that I thought, but how many people with migraine symptoms have been misdiagnosed? Is there a Trigeminal Neuralgia element there too? There are several different types of migraine. 

They are:

• Migraine Without Aura
• Migraine With Aura
• Migraine Aura Without Headache
• Basilar Migraine
• Hemiplegic Migraine
• Ophthalmoplegic Migraine

There are so many doctors in the dark about TN that most facial pain is dismissed as a headache and thats that. It seems that we as patients need to do the research. 

I consider migraine and headaches as a horrific addition to my already hellish facial pain. Correct diagnosis is essential. 

If you are unhappy with a diagnosis, get a second, third and even fourth opinion. Nobody knows your body like you do, and you know when something isn't right. I have been fortunate so far with my doctors, but my battle has just begun. The medications have not even put a dent in my pain, and my symptoms are awful, and in addition to the facial pain, I have an eye with little vision, and a left arm that goes numb often and sometimes I lose the power in it. 

Here is the link to Migraine ireland's Website

Migraine Ireland

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SECRETS OF MEMORY Part II Seven Sins of Memory

Memory fails us in multiple ways. Daniel Schacter, former chair of Harvard University's Psychology Department and a leading memory researcher described seven common malfunctions of the mental faculty of memory. He called these malfunctions “Seven Sins of Memory”. He wrote a book: The Seven Sins of Memory: How the Mind Forgets and Remembers. The book tries to establish that "the seven sins of memory" are similar to the biblical concept of Seven Deadly Sins. 
http://en.wikipedia.org/wiki/Seven_deadly_sins 


Schacter asserts: "Memory's malfunctions can be divided into seven fundamental transgressions. These are transience, absent-mindedness, blocking, misattribution, suggestibility, bias, and persistence. The first three are described as sins of omission. These omissions result is a failure to recall an idea, fact, or event. The other four sins (misattribution, suggestibility, bias, and persistence) are sins of commission. After committing these mistakes while encoding and storing an information, event or a fact there is a form of memory present. But it is not of the desired fidelity or the desired fact, event, or ideas. It is a falsified memory. Let us look at each one of these omissions and commissions.

Transience
Transience refers to the general deterioration of a specific memory over time. As time passes memory of an event or information fades and ultimately it would be lost irretrievably. In this case the information fails to be transferred into long-term memory store. Repetition or rehearsal is the way to avoid loss of memory by transience.  

Absent-mindedness
Absent-mindedness is a mental condition in which the subject experiences low levels of attention and frequent distraction. The breakdowns in attention prevent encoding the event in short-term memory in the first place. It may occur in normal persons due to inattention or distraction while hearing or doing something. But there is an abnormal condition called Attention Deficit Disorder [ADD]. Usually this condition is associated with incessant hyperactivity or hyper kinesis. Then the condition is called Attention Deficit Hyperkinetic Disorder [ADHD]. Until recently the notion among psychiatrists was ADHD occurs in children only. But there are adult cases also. Persons under stress cannot pay attention to a particular information or event.

Blocking
Blocking is when the brain tries to retrieve or encode information, but another memory interferes with it. Blocking is a primary cause of “on the tip of the tongue” phenomenon (a temporary inaccessibility of information stored in long-term memory).

Transience, absent-mindedness and blocking are all sins of omission, malfunctions that result in a loss of memory for information that we would like to remember. There are also sins of commission, in which we remember incorrect information or correct information that we would very much like to forget.   

Misattribution
Misattribution of the source of a memory can cause a person to confuse an event that he or she saw in a movie or even dreamed with an event actually experienced. For example, a person who witnesses a murder after watching a television program may incorrectly blame the murder on someone she saw on the television program. This kind of error has profound consequences in legal systems because of its unacknowledged prevalence and the confidence which is often placed in the person's ability to know the source of information important to suspect identification.

Suggestibility
Suggestibility refers to our tendency to become confused in our recollections because of comments made by others or reports in the media about what really happened. For example, a person sees a crime being committed by a redheaded man. After reading in the newspaper that the crime was committed by a brown-haired man, the witness "remembers" a brown-haired man instead of a redheaded man. Eyewitness testimony about a crime can be incorrect because of misattribution and suggestibility, causing miscarriages of justice in our legal system.

Bias
Bias refers to the way in which our current beliefs affect our reconstruction of the past. Retrieval from the long term is biased by the way we think and feel now about the event being remembered. Thus, a contented adult might look back with fondness on their childhood, induced to do so by positive memories from that time which might not actually be representative of their average mood during their childhood.

Persistence
Persistence is not a distortion of memory, but rather an unwelcome imposition of the past in full detail. Repeated retrieval of painful memories that we would much prefer to forget is another sin of commission that we are all familiar with. The remembrance can range from a blunder on the job to a truly traumatic experience, and the persistent recall can lead to formation of phobias, post-traumatic stress disorder, and even suicide in especially disturbing and intrusive instances.

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The Impact of Intervention in Addiction Through an Amy Winehouse Scope

Today's post in a guest post courtesy of Allison Gamble, a writer for psychologydegree.net. 

“They tried to make me go to rehab, I said, "No, no, no"

Yes, I've been black but when I come back you'll know, know, know

I ain't got the time and if my daddy thinks I'm fine

He's tried to make me go to rehab, I won't go, go, go”

           ~ "Rehab" Amy Winehouse

The late singer Amy Winehouse released “Rehab” in 2007, a now haunting song that revealed her struggles with drug and alcohol abuse, her reluctance to seek help, and the role her family and friends played in her life. Some attempted to push her towards treatment, while others seemed to enable Winehouse's destructive behavior and ignored warning signs that may have caused her sudden death. While Winehouse’s plight has gained media attention, her celebrity is one of the only factors that separated her situation from the problems that many individuals who abuse drugs and alcohol deal with every day.

Like many other families who have loved ones with a substance abuse problem, Amy’s family is placing fault on others for her sad demise. It doesn’t take a degree in psychology to smell the denial in the air. Interviews with her parents show they lay blame for her death on detox methods instead of also looking at both their behavior and having not intervened in time to possibly help Amy.  Of course, losing a child is awful enough, but they are likely also feeling tremendous guilt that they had not taken more steps to try to protect her from a fate no one wanted to believe would come to fruition.

In American and the UK alike, due to the absence or failure of family members and friends intervening, many addicts like Amy are left to cycle through pricey rehab clinics and wind up taking endless supplies of anti-psychotics, anti-depressants, anti-anxiety meds and more. Gaining the approval of doctors, rehab clinics and pharmaceutical companies, families are held harmless as they look at addiction as a disease. With this medical model, the one loser winds up being the addict.

While little has been revealed about Winehouse’s upbringing, it is known that her parents separated when she was 9 years old. Father, Mitch Winehouse, claimed in a 2008 interview, titled “How my affair made Amy suffer,” with British newspaper The Daily Mail, that a longstanding affair with a colleague was an open secret in their home. Winehouse’s paramour was even known by Amy and her siblings as “Daddy’s work wife.” Mitch Wineshouse claims he never realized that their family’s dysfunction had impacted Amy so negatively until years later when he heard her song “What it is About Men” that the line “all the shit my mother went through” referred to his deception.

Amy’s mother Janis claims her Amy had always been a rebel but that her defiant streak intensified when Amy became a teenager. In an unusual move by Janis, Amy was allowed to leave home to live with a friend at the age of 15. "It would have been fine but she moved out for her own convenience. She wanted to live with a friend. Perhaps she wanted her mum to fight to make her stay. But I felt she had grown up by then,” her mother said in a January 2008 interview, eerily titled “Amy Winehouse’s mum says she’ll be dead in a year,” with the Sunday Mirror. This is not to say that Janis is solely responsible - there are surely hundreds of children who move out early without overdosing at 27. But could a firmer hand have helped steady the wheel? We’ll never know.

Janis went on to say that she while she doesn’t feel responsible for Amy’s decline into drugs, she reveals being lackadaisical when Amy started running into trouble. "Amy was never an easy child and she was always open to any new bad influence. Her life became a bit muddled when she left home. She started smoking marijuana and got her first tattoo - a Betty Boop on her back. I just said, 'Oh well.’”

Amy’s family always seemed to have a disturbing dynamic. Janis was unhappy; Amy was rebellious, but always trying to please her out-of-the-picture father Mitch. "I don't do happy. [Amy] doesn't, it seems, do emotion either. But it's just her way of coping,” Janis explained.

As a Amy became an adult, her family unit added another dysfunctional member: ex-husband Blake Fielder-Civil. A self-admitted addict, Blake claims to have introduced Amy to narcotics usage. “I’m not trying to defend his behavior and I know him for what he is: he’s an addict and he has done some terrible things. He feels enormous grief and responsibility for some of the things that have happened, as well he should,” Fielder-Civil’s mother, Georgette, told the Daily Mail in “Don’t blame my son for Amy’s death: Blake Fielder-Civil's mother's plea as she insists the couple were still in love.”

Although some families shift the blame for a substance abuse problem on medical issues, they are often the ones who have, perhaps unwittingly, facilitated the problem to a significant degree. In 1991, The Journal of the Academy of Child and Adolescent Psychiatry reported that researcher James R. McKay and colleagues had studied adolescent substance abusers and confirmed what we know anecdotally: that greater perceived degrees of dysfunction were linked to increased levels of substance abuse prior to hospitalization.

With modern medicine focusing on the disease model of addiction, pharmaceutical companies have been instrumental in keeping substance abusers like Amy addicted by flooding the market with painkillers and psychoactive meds, while also profiting from drugs to counter addiction.

In July 2011, financial website This is Money reported that one such company, Reckitt Benckiser Pharmaceuticals, was delighted to announce that its newest delivery system for the heroin addiction drug, Suboxone, would now be a big moneymaker. “As is well known, our Suboxone tablets can become subject to generic competition in the U.S. at any time, and moving more of our business into the film remains a key priority. At the end of June 2011, the Suboxone film had captured a 41 per cent volume share of the U.S. market,” he said.

Talk show host and former journalist Piers Morgan knew Winehouse and told Entertainment Tonight in “Piers Morgan hits out at Amy Winehouse’s record company after singer’s death,” that while the troubled singer ultimately succumbed due to her own addictive behavior, others in her life failed to take responsibility. Echoing a common question, Morgan wanted to know where everyone was when she needed help. He stated, “I do blame people. Where were all the people making money out of her when it mattered? Really, where were they? You know, it's just not good enough that they're all going to make millions out of it now she’s dead.”

Blake Fielder-Civil’s mother seems to agree. “We all played our part in what happened to her. I have had to look deep into my heart and wonder if I could have helped, done things differently,” she said.

While we may never know what caused Amy's death, ultimately she was responsible for her actions. However, family members, “friends,” doctors, rehab centers and pharmaceutical companies must also accept responsibility for the role they played in her destruction. We need to move towards a more cohesive model that merges psychology and psychiatry to prevent more parents from losing their daughters.

LOL

Are you alexithymic

On Friday, I'm going to be posting about alexithymia in us and in our characters. Alexithymia means "without words for emotions" but is a bit more complicated than that. Before I talk too much about it, though, how about heading to this online questionnaire and seeing if you have any alexithymic tendencies? (I've taken it myself. A box will pop up asking if you want to open or save; just click "open" and you can take the test, and at the end your score and its interpretation will appear). It takes about 3 minutes.

No need to share your score unless you really want to. It's just something to think about. And on Friday, I'll talk about what alexithymia is really about--and what writers should know about it when they're writing characters.

And, as it's Monday, don't forget to stop by Lydia's blog for her Medical Monday post, and then hop over to Laura's blog for her Mental Health Monday post!

Dr Allen on HuffPost Live Video News Network

Dr. Allen participated in a panel discussing freeloading family members on The Huffington Post's video news network, HuffPost Live (live.huffingtonpost.com). 

Here's the link: http://huff.lv/19eAnD9

How to Disarm a Borderline Part IX Listen to the Lyrics Not the Tune

Before reading this post, particularly if you are going to try this at home with a real adult family member with borderline personality disorder (BPD) (which is not recommended without the help of a therapist), please read my previous posts Part I (October 6), Part II (October 29), Part III (November 24), Part IV (December 8), and Part V (January 12), Part VI (March 2), Part VII (April 30) and Part VIII (June 5). The countermeasures described in this post do not work in isolation but must be part of a complex, consistent, and ongoing strategy.

This post will continue describing specific countermeasures to the usual strategies in the BPD bag of tricks used by them to distance and/or invalidate you, as well as to induce you to feel anxiously helpless, anxiously guilty, or hostile.

Today I discuss statements made by individuals which sound hostile or critical but which may or may not actually be as critical or hostile as they sound.  A lot of psychotherapists recommend responding to an individual's tone of voice and body language over responding to the content of what that person actually says. 

We all have a tendency to do that anyway - most likely because tone and body language preceded verbal language in the evolutionary development of the brains of primates like ourselves.  Chimps, for example, know whether another chimp is coming to fight with them or mate with them throught the approaching chimp's posturing and the noises it makes. (And if you injure a certain part of their brains called the amygdala, they completely lose the ability to make this call).

Nonetheless, I recommend precisely the opposite: listen to the words (the lexical content) and ignore the tone and posturing, as well as any seeming insinuations implied by what is said that are not stated clearly and overtly.

If you respond only to the words, the individual with BPD will usually change to a friendlier tone.

For example, a client with panic disorder responded to my recommendation for anti-depressant medication for her panic attacks with the sarcastic-sounding remark, "Oh, so you want to mess with my brain chemistry?" It sounded as though she was accusing me of being a devious, malicious mad scientist. Some anti-psychiatry types might agree with that interpretation of my recommendation, but I digress.

I nonchalantly responded, "Yes, anti-depressants do alter brain chemistry, although we don't know exactly how they work," and went on to describe their possible mechanism of action just as one might do with any other patient. She agreed to the drug trial.  (Of course she went off the meds the very next day, but that's another issue altogether).

The structure of all human language is such that ambiguity is extremely easy to generate. Any sentence in any language can refer to a multiple of unclear attributes or objects, or can be interpreted in exactly opposite (antithetical) ways. Negative judgments can come out sounding positive and vice versa through changes in body language, tone of voice, or even choice of synonym.

For example, almost any adjective with a positive or a negative connotation has a synonym with precisely the opposite valence. An optimist, for instance, can be called a Pollyanna. People can be described as stubborn or tenacious, loyal or as being lap dogs, and so forth. A complete discussion of the antithetical nature of language is beyond the scope of this post, but can be found in my book, Deciphering Motivation in Psychotherapy.

Another trick that people with BPD are especially adept at employing is to create ambiguity through the use of unvoiced implications, as I alluded to earlier. Individuals imply something without stating it explicitly, thusly creating opportunities for plausible deniability of having made those implications at a later date.

For example, a mother may admire her daughter in some way, but make it sound as if she were critical about the very behavior that she really admires.

A good illustration of this process occurred in a conversation between a nurse and her mother. The mother was discussing the daughter’s rather assertive (some might say even aggressive) stance towards the mostly male physicians with whom the daughter worked. The mother said, “I can’t believe you talk to doctors that way!”

The patient took this to mean that the mother believed that she should not engage in this behavior. In one sense this was an accurate assessment of the mother’s view, but it was only part of the whole truth. The mother indeed was worried that the daughter might get fired. Such would have been the case during earlier times, when the mother was younger.

As it turned out, however, the mother was also expressing covert admiration for the nurse’s bravery, assertiveness, and feminist leanings. What Mom had difficulty "believing" was that the patient had the audacious nerve that the mother lacked.

Her critical tone of voice obscured the admiration. The actual lexical content of the comment has no positive or negative valence at all.  She was merely expressing surprise. The nurse perhaps should have responded, "Well, is that a good thing or a bad thing?"

Evil Naughty Bad Synopsis!

In order to query certain agents, I have to have a 2–3 page synopsis of my novel. I tried writing one earlier, and I was up to 2 1/2 pages and had not even gotten past chapter three. I was doing something terribly wrong. It had started to read like I was rewriting the book, except this time it had no voice, no lyricism, and was concocted by a fifth-grade dullard. For example (not from my actual book):

Tom gets up. He turns the door handle. He opens the door. He goes outside. He is suddenly attacked by a meerkat!

So I tried again. This time better:

Tom is attacked by a meerkat!

But basically, this whole thing sucketh. I thought writing a query was tough, but this is horrendous. How can I possibly explain the intricacies involved in minor character C's small action which lead to very large revelations, which will play out about six chapters later? How can I include the various time travel sequences in my middle-grade novel, which are integral to the plot but in a synopsis would read as if I wrote it while riding on a tilt-o-whirl, drinking shots, and shouting "whee!"

After attempting this I have realized one nice thing: my novel does not lack in complexity. It has foreshadowing in Chapter One that only pays off at the very end. It is an intelligent person's novel. It defies easy observation. It is a clever tapestry in which, if I untie one thread, the whole might fall apart.

Damn it!

(That was kinda dumb of me to write a novel like that. Maybe I should have tried a debut book such as Billy and Boopsie's Trip to the Grocery Store, Little Cub Gets Lost, or How to Make A Sandwich?)

I would like to trot out this naughty synopsis in the public square and give it a good flogging, as it has been bad, and has treated me unkindly. Maybe a night in the stocks will serve it well. Yes. Yes. I will show it to the Time Out chair and let it know I mean business. It will gaze at me with red, angry eyes, however, and it will win. I will have to finish it.

Right now we are in a stand-off, and I do not like the rude looks it is giving me. 

Fear in the brain

This is one writer's depiction of having his head scanned by a functional magnetic-resonance imaging (fMRI) machine to see how fear works in the brain:

My head was recently scanned by clinical psychologist Philippe Goldin, a researcher in the lab of James Gross, director of the Stanford Psychophysiology Laboratory. Goldin and his team are studying 30 "healthy controls" and about 60 social phobics in an effort to plot the pathways of anxiety—and, more important, how people are able to damp down their impulses to fight or flee.

On the monitor, the story of my mortification is interrupted by a single line of words in bold:

I AM A LOSER

I read more of my story, then this line pops up:

I'M TOO INSECURE TO STAND UP FOR MYSELF

Two primary regions of the brain show increased blood flow in the scanner—to use the vernacular, they "light up"—in response to an anxious or frightening situation. One is the amygdala, which is associated with emotions; the other is the hypothalamus, which gets you ready to take action by increasing your heart rate, respiration, and sweating.

Next, the write is asked to regulate his emotions with reason:

I do what Goldin has asked: I tell myself in the scanner that I'm not a loser; that I do stand up for myself.

In fact, back in the managing editor's office, I did speak up, telling him I'd worked hard on that story and deserved to write it. I also suggested that next time he tell me first before announcing it to the staff. The editor responded by looking me over like he'd never noticed me before.

He said I was right, he should have come to me first, and that I was ready to write the story. But changing his mind didn't change his decision—I'd get a reporting byline, but the other guy would write it. "Next time, though, the byline will be yours," he said.

I kept my cool long enough to casually walk out of his office. Then I ran to the men's room, and nearly threw up. This episode is a key moment for me in learning to push down my anxiety to the point that it bothers me far less today—though it took years of similar episodes.

My struggle to overcome anxiety is exactly what Goldin and Werner are measuring in the f.M.R.I. They can actually see the pathways lighting up from the frontal lobe—the seat of rational thinking, and where we make decisions—essentially telling the amygdala to settle down.

"The amazing thing is that the brain can make changes," says Goldin. "Most of this happens in the amygdala, and it can be tempered to learn and adapt."

My results did show adaptation in action. When I read my story and saw the lines about being a loser, my brain grew anxious. But I was able to modulate its reaction—to tell my amygdala to chill out.

Meditation, cognitive-behavioral therapy...some of the best tools for coping with panic and anxiety depend on exactly this idea: while it might be a struggle, with mindful focus reason can mediate anxiety.

On the Borderline

I was gone last week. Sometimes that happens. Between the day job and the writing and the family ... blogging sometimes gets relegated to the things I wish I could do but can't. Only sometimes, though. But! I have a few updates:

• I am working on Book 3 in The Guards of the Shadowlands series! My editor loved Book 2, and I'll be doing revisions on it soon, but for the moment I'm trying to crank out a first draft of Book 3. I'm hoping to have that draft by the beginning of June, but with everything else that's happening,  I wonder if that's too ambitious. I'll let you know.
• I received cover proofs for SANCTUM and oh, oh, oh, they are gorgeous. I can't wait to show you guys the cover. When I first opened the file, I started crying. There was just something incredibly emotional about seeing a visualization of my story concept. More updates on that very soon!

And now ... today I thought I'd discuss yet another personality disorder. I've already posted about Schizoid Personality Disorder and Obsessive Compulsive Personality Disorder, and you can find my quick-and-dirty primer on personality disorders here.

Borderline personality disorder can be found in approximately 5-6% of the population (that's from the study I link to in this paragraph, which was a pretty thorough one, but other estimates put the prevalence at only 1-2%). A relatively recent epidemiologic survey study (of over 35,000 people) found that there's no gender difference in the prevalence of this disorder, which was previously thought to be more common in women. The study did show that the disorder is associated with more general mental and physical impairment in women, however.

The symptoms, according to the DSM-IV: Like with all personality disorders, BPD is a pervasive pattern (meaning it occurs across relationships, situations, and settings) of impairment. With BPD, that impairment occurs in interpersonal relationships, with self-image, emotion, and impulsivity. To be diagnosed with the disorder, someone must show five or more of the following symptoms:

1. "Frantic" efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense interpersonal relationships in which the person alternates between idealization and devaluation (often referred to as black-white thinking or splitting)
3. Markedly and persistently unstable self image or sense of self (in other words, you like yourself one hour, and despise yourself the next, in a really extreme way)
4. Impsulsivity in at least two areas that are potentially self-damaging (like spending, sex, alcohol/drug use, binge eating, or reckless driving)
5. Recurrent suicidal behavior or self-mutilating behavior
6. Intense mood reactivity (extreme emotions in response to situations)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger
9. Stress-related paranoia or dissociative symptoms

Individuals diagnosed with this disorder account for a disproportionately high percentage of mental health care dollars. In other words, BPD causes a lot of impairment and suffering. Research shows that people who have been neglected or abused (particularly sexually abused) in childhood are more likely to be diagnosed with this disorder, especially if they have a problematic home environment and/or a certain kind of temperament (e.g., high levels of negative emotion).

source

Interestingly, a few psychiatrists have diagnosed fictional character Anakin Skywalker as having BPD, and even used him as a teaching example. There's a great article on that by Dr. Carolyn Kaufman here.

There is an effective treatment for BPD called Dialectical Behavior Therapy (there's no drug that helps, not really).The developer of DBT, Dr. Marsha Linehan (who, by the way, has had a long and productive career in psychology, and has helped a lot of people), disclosed recently that she was actually diagnosed with this disorder as a teenager--and if you want to read a truly inspirational story, go read this article about her. I promise you will not regret the time you spend on it.

Just a note about this disorder: the label "borderline" comes with a whole lot of stigma, so when I hear "I think this person has borderline personality disorder" (or worse: "I think this person is borderline"), I tend to interpret it as code for "I'm not sure how to help this person, so I'm using a label to neatly categorize him/her in a way that allows me to feel less guilty about it." (Hey, it's a complex code.) I'm definitely not saying all mental health clinicians do this, and I certainly don't believe any do it on purpose. But I am saying that my ears perk when I hear the phrase, and I start asking A LOT of questions.

In general, I think our diagnostic system is really useful, and helps us develop more effective treatments for problems that cause a lot of suffering. However, I think these terms are always at risk for being used in ways that dismiss complex human beings or add to the stigma, and of course, that bothers me. <end of rant>

Aaand because it's Monday, go check out Lydia's Medical Monday post, and Laura's Mental Health Monday post (zombies! yipes!).

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