as small as a world and as large as alone, thepeoplesrecord: The horrible psychology of...

6:42pm July 13, 2013

thepeoplesrecord:
The horrible psychology of solitary confinementJuly 12, 2013
In the largest prison protest in California’s history, nearly 30,000 inmates have gone on hunger strike. Their main grievance: the state’s use of solitary confinement, in which prisoners are held for years or decades with almost no social contact and the barest of sensory stimuli.
The human brain is ill-adapted to such conditions, and activists and some psychologists equate it to torture. Solitary confinement isn’t merely uncomfortable, they say, but such an anathema to human needs that it often drives prisoners mad…
Full article

Yep. That’s how you can literally cause delirium, asking other things, in a totally healthy person. And is why delirium happens in hospitals even in patients not sick enough to become delirious on their own. Because hospitals cause stimulus deprivation too just not as bad.
And delirium is a horrible experience that disorients and even kills people. Yep, delirium actually results in higher mortality rates. So it’s not just unpleasant, it’s also deadly. Plus delirium can be mistaken for mental illness and misdiagnosed and mistreated. (See also why isolation rooms in psychiatry are a really fucking terrible idea.)
The worst kinds of delirium are not agitated delirium, the kind most people are familiar with, but rather quiet delirium, where a person becomes less responsive to their surroundings and may lie in one place doing nothing (but may be hallucinating wildly) for hours at a time. Sometimes a delirious person will be responsive if talked to but slide back into delirium when left alone again, making it hard to detect.
And delirium isn’t just hallucinations and bizarre behavior. It can also involve merely losing a lot of the person’s normal cognitive abilities.
Or, in my own experience, a short if fading process. Where entire areas of my normal cognition fade to white and become unusable. This can result in becoming very disoriented, not knowing where you are at all or what is happening around you, but not hallucinating or having delusions.
(And yes, in some cases delirium can resemble most people’s understanding of psychosis, complete with hearing voices, paranoid delusions, etc. But the causes and treatments are different. In hospitals this is sometimes known as ICU psychosis, but it’s not necessary to be in the ICU to cause it.)
Another characteristic about delirium is that it fluctuates in severity. In my experience, I’ve gone from so unaware that it felt like I’d passed out, to aware but hallucinating and disoriented and trying to yank out a catheter, to somewhat lucid, and back, many times a day. That’s actually a normal feature of delirium.
Another feature of delirium is that it can be affected by one’s surroundings. Sensory deprivation but also some forms of overstimulation can make it worse or even cause it. Talking to the person and keeping them oriented can make it better, which can literally save lives, because delirium is associated with increased mortality rate and worse healing from medical conditions.
Delirium is also a form of brain damage. Having delirium once Can make you more prone to delirium when sick or understimulated in the future. I’ve had a lot of severe delirium over the years, so I get it easily when sick or hospitalized. If your cognitive abilities don’t improve enough by six months after you were actively delirious, that also causes an increased rate of illness and mortality.
And it’s very important to distinguish delirium from mental illness, as the treatments and causes are entirely different. Some treatments for mental illness can make delirium much worse.
This PSA brought to you by someone who has researched way too much about delirium after experiencing severe delirium in the hospital and afterwards for over five weeks last fall. It wasn’t my first experience by far, but it was my worst.

The horrible psychology of solitary confinement
July 12, 2013

In the largest prison protest in California’s history, nearly 30,000 inmates have gone on hunger strike. Their main grievance: the state’s use of solitary confinement, in which prisoners are held for years or decades with almost no social contact and the barest of sensory stimuli.

The human brain is ill-adapted to such conditions, and activists and some psychologists equate it to torture. Solitary confinement isn’t merely uncomfortable, they say, but such an anathema to human needs that it often drives prisoners mad…

Full article

Yep. That’s how you can literally cause delirium, asking other things, in a totally healthy person. And is why delirium happens in hospitals even in patients not sick enough to become delirious on their own. Because hospitals cause stimulus deprivation too just not as bad.

And delirium is a horrible experience that disorients and even kills people. Yep, delirium actually results in higher mortality rates. So it’s not just unpleasant, it’s also deadly. Plus delirium can be mistaken for mental illness and misdiagnosed and mistreated. (See also why isolation rooms in psychiatry are a really fucking terrible idea.)

The worst kinds of delirium are not agitated delirium, the kind most people are familiar with, but rather quiet delirium, where a person becomes less responsive to their surroundings and may lie in one place doing nothing (but may be hallucinating wildly) for hours at a time. Sometimes a delirious person will be responsive if talked to but slide back into delirium when left alone again, making it hard to detect.

And delirium isn’t just hallucinations and bizarre behavior. It can also involve merely losing a lot of the person’s normal cognitive abilities.

Or, in my own experience, a short if fading process. Where entire areas of my normal cognition fade to white and become unusable. This can result in becoming very disoriented, not knowing where you are at all or what is happening around you, but not hallucinating or having delusions.

(And yes, in some cases delirium can resemble most people’s understanding of psychosis, complete with hearing voices, paranoid delusions, etc. But the causes and treatments are different. In hospitals this is sometimes known as ICU psychosis, but it’s not necessary to be in the ICU to cause it.)

Another characteristic about delirium is that it fluctuates in severity. In my experience, I’ve gone from so unaware that it felt like I’d passed out, to aware but hallucinating and disoriented and trying to yank out a catheter, to somewhat lucid, and back, many times a day. That’s actually a normal feature of delirium.

Another feature of delirium is that it can be affected by one’s surroundings. Sensory deprivation but also some forms of overstimulation can make it worse or even cause it. Talking to the person and keeping them oriented can make it better, which can literally save lives, because delirium is associated with increased mortality rate and worse healing from medical conditions.

Delirium is also a form of brain damage. Having delirium once Can make you more prone to delirium when sick or understimulated in the future. I’ve had a lot of severe delirium over the years, so I get it easily when sick or hospitalized. If your cognitive abilities don’t improve enough by six months after you were actively delirious, that also causes an increased rate of illness and mortality.

And it’s very important to distinguish delirium from mental illness, as the treatments and causes are entirely different. Some treatments for mental illness can make delirium much worse.

This PSA brought to you by someone who has researched way too much about delirium after experiencing severe delirium in the hospital and afterwards for over five weeks last fall. It wasn’t my first experience by far, but it was my worst.

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