The Link Between Intelligence and Mental Health

genius and madness

High I.Q. and Mental Stability

Geniuses and highly creative people with high I.Q.s have always been linked to mental health problems such as depression, bipolar disorder, and schizophrenia.  Often we may picture a brainy computer geek who may be a programming whiz but prone to social awkwardness and withdrawals.  We admire masterpieces and learn of its gifted creators who oscillate between mania and depression.  Indeed, in the pantheon of great achievers, there are a number of personalities such as Beethoven, Virginia Woolf, Ernest Hemingway, Buzz Aldrin, and Jackson Pollock who have struggled with mental health issues during their lifetimes.  Even Aristotle was quoted to have said, “There is no genius without having a touch of madness. “

Some individuals with above average to superior I.Q.s commonly tend to exhibit symptoms from these three mental illnesses:  bipolar disorder, schizophrenia, and obsessive-compulsive disorder.  There are about 20-30 studies that support the “tortured genius syndrome,” the strong link between genius and madness.  One decade-long study on a 700,000 Swedish adolescents turned up surprising evidence, which was published in 2010.  Those teenagers that excelled in intelligence tests were four times more likely to have developed bipolar disorder.  Another study on children gifted with superior I.Q. above 130 showed that 65% of these kids had some sort of major depressive disorder.

Why is genius or superior intelligence linked to mental and emotional instability?  Brilliance instils the ability of being able to construct an inner world to fit their views and preferences.  However, when that worldview clashes with reality, it often leaves the person lost and unable to cope well.  Moreover, highly intelligent people are more sensitive to stimuli than average individuals.  Ellyn Saks, a University of Southern California mental health professor reiterates that “people with psychosis do not filter stimuli as well as others without the disorder, meaning that they’re able to ponder contradictory ideas simultaneously and gain insight into loose associations that the general unconscious brain wouldn’t even consider worthy of sending to consciousness.”

A Swedish study also found that many people diagnosed with schizophrenia or bipolar disorder are or have been in highly creative jobs that demand highly functioning cognitive skills and artistic cleverness in levels not usually employed by the average or normal individuals.  This is why artists seem to be functioning at a perspective so different from non-artistic or creative people.

Highly intelligent individuals have the ability to see novel patterns and innovative connections of things which the average intellect may not discern.  This ability also makes a very creative and smart individual, very vulnerable to feeling strong emotions, hallmarks of bipolar disorder.

It is however not entirely accurate to stereotype intelligent people as mentally unstable individuals.  Not all people with very high I.Q.s are unhealthy, mentally; but, there is a percentage of the gifted population that have developed depression and other major mental disorders because of their intellectual gifts.

As high I.Q. can be factor of developing mental illness, low or below average I.Q. can be contributory element as well.  Studies have also pointed out a direct correlation between low intelligence and depression.

Low I.Q. and Depression

Low I.Q. or a low intelligence quotient means lower than average cognitive abilities and problem-solving skills.  People with a 70-79 intelligence rating (below average I.Q. rating) have been surveyed by the Adult Psychiatric Morbidity Survey in England to be generally less happy than those with average or high I.Q.  People with less than average intellectual abilities often have difficulties catching up in school, getting hired in good paying jobs, earning sufficiently for their families, and earning peer respect and regard.  Because of these inabilities, people with below average I.Q.s tend to have poor relationships, low income, scant employment opportunities, and a lot of personal frustration.  These conditions alone are enough to drive a person into clinical depression.

 

Scientists are still unsure about the precise mechanisms on how intelligence affects mental health.  Perhaps there will come a time in which formulated cures would be available to help people balance their intelligence, high or low, against their propensity to develop mental illness.  Until such time, people need to understand that people with low or high I.Q.s may carry the extra burden of ill mental health and therefore should be treated with more understanding.

Tardive Dyskinesia (TD)

Pills macro

There always exists a caveat with medications.  It is for this reason that doctors and patients must discuss the risks of side effects involving drug treatments.  One side effect of long-term use of antipsychotic drugs may be tardive dyskinesia.

What is Tardive Dyskinesia?

The term tardive is an adjective that refers to late appearances or delayed onset of something such as a disease or symptom.  Dyskinesia denotes abnormal movements.  Tardive dyskinesia then means a neurological disorder characterized by involuntary and repetitive movements of the face, lips, cheeks, tongue, torso, and limbs.  Examples of these movements are uncontrollable chewing motions and tongue darting.  These symptoms are often a belated onset of side effects of long-term neuroleptic drug intake.

TD was first discovered in the 1950s when chlorpromazine and other psychotic drugs were introduced.  A large percentage of patients with tardive dyskinesia at present are schizophrenics or have a neuropsychiatric disorder, conditions which expose them to long-term use of neuroleptics and anticholinergics or to substance abuse of other drugs or agents.

Symptoms of Tardive Dyskinesia

Common symptoms of TD are chronic and involuntary:

  • Lip puckering                                                                                                       tardive dyskinesia
  • Lip smacking
  • Tongue thrusting
  • Grimacing
  • Pursing of lips
  • Blinking
  • Jaws swinging
  • Chewing
  • Movements of legs, sometimes to the point where the spasms can interfere with locomotion
  • Movements of the limbs, torso, fingers, hands, or toes

Sometimes a TD patient may have difficulty breathing and may make grunting sounds.

It is important to diagnose TD for what it is, a neurological disorder, not a mental illness.  The danger of misdiagnosing tardive dyskinesia as symptoms of a mental illness may lead to prescriptions of neuroleptic drugs which may further exacerbate the condition toward a severe and debilitating case.

Drugs that May Cause Tardive Dyskinesia

Listed below are medications that have been linked to TD.  Note that a few are not antipsychotic drugs:

  • Flunarizine
  • Metoclopramide
  • Fluphenazine
  • Prochlorperazine
  • Chlorpromazine
  • Haloperidol
  • Trifluoperazine
  • Flunarizine — medication for migraine, dizziness, and vertigo
  • Reglan (metoclopramide)  — used to treat heartburn, nausea, and gastric disorders

High Risk Groups for TD

Patients on neuroleptic drugs for several months or years are at high risk for developing TD.  In some, however, TD can manifest in as short as six weeks.

Women, especially those with diabetes mellitus, organic brain injuries, or with negative schizophrenic symptoms, are more prone to developing TD.  The elderly are also at higher risk for this disorder than young patients.  In addition, people with a history of alcoholism and drug addiction are also at risk for developing tardive dyskinesia.

Patients who have undergone electroconvulsive therapy (ECT) may also be included the high risk group for TD.

Treatment of TD

Tardive dyskinesia has not been thoroughly studied and as such no adequate cure is on offer for this condition.  Prognosis looks hopeful for TD patients who have been diagnosed correctly very early at the onset so that the medication that may be causing the disorder is stopped or gradually reduced.  Stopping the offending drug, however, is a not a guarantee for TD symptoms to go away.  Despite being off the medication, a few patients may still exhibit the symptoms which may become permanent and may even take a turn for the worse.

Botulinin toxin or botox, for short, has helped reduce the degree of movements in severe cases.  Benzodiazepines such as Clonazepam have also proven some effectivity in treating TD, although these are limited by the body’s natural increasing tolerance of the drug.

It should also be of interest to know that Vitamin B6 has shown effectivity against TD symptoms in two randomised double-blind trials published in the American Journal of Psychiatry in 2001.

Mental health doctors have also turned to Tetrabenazine to tread TD.  This drug reduces the levels of dopamine and blocks dopamine receptors.  It does, however, come with its own arsenal of side effects such as drowsiness, Parkinsonism (characterized by body tremors), anxiety, depression, insomnia, and restless leg syndrome.

For the most part, tardive dyskinesia unfortunately has no real cure so prevention is still the best way around it.

Electroconvulsive Therapy (ECT)

 

What is Electroconvulsive Therapy?

Electroconvulsive Therapy or ECT is a form of medical therapy for people with severe mental illness who do not respond to counselling, medication, or other forms of treatment.  The therapy involves sending carefully controlled electric impulses to the brain to stimulate a brief epileptic fit with the goal of relieving extreme depression, mania, or catatonia.  The electric stimuli seem to provoke changes in brain chemistry which help alleviate the patient’s mental symptoms.

When ECT is administered, the patient is given a muscle relaxant and put to sleep with anaesthesia.  Electrodes are placed on the head after which a finely channelled electric current is sent to stimulate the brain.  These impulses trigger slight seizure-like movements in the sleeping patient.  The session is painless and lasts only several minutes after which the patient awakes with no memory of the treatment or the events leading up to it.  He may also wake up disoriented but this will last only for a while.

Improvements in patients are noticed usually after the first three sessions and major improvements are palpable after six.  These improvements could manifest as better sleeping patterns, less lethargy, or better appetites.

Is Electroconvulsive Therapy Dangerous?

ECT today is a generally safe method as it involves no pain or bad shocks.  There is a side effect though which involves memory impairment lasting about several weeks after the treatment.  Although memory is usually resolved in the short-term, there are rare cases in which patients do lose personal and skill memories and have difficulty processing new information.

In cases of extreme depression, the benefits however may outweigh the risks of a memory disadvantage especially in patients whose need for some symptom alleviation are urgent.  For instance, a mother with severe postnatal depression may require the symptom alleviation ECT may provide, when other therapies have failed to, in order to for her to adequately nurture her infant.

ECT has gotten a bad reputation because of the errors done during its early developmental phase.  ECT’s stigma stemmed from misuse of equipment, inadequate information and staff training, and improper treatment administration.  These errors had proved to be injurious to some patients who were administered with high electric charges without anaesthesia causing memory loss, fractured bones, and other serious injuries.  Electroconvulsive therapy has evolved to today’s relatively safe administration of finely controlled charges, anaesthesia, and strict supervision.

electroconvulsive-therapy-adverse effects

Who are Candidates for ECT?

Patients who merit a prescription for electroconvulsive therapy may be:

  • suicidal because of severe depressive symptoms.  About 80% of these cases report a mood improvement with ECT.
  • unresponsive to drugs or talking therapies
  • in a severe manic episode lasting for a long period of time
  • catatonic
  • those that have a history of responding well to ECT therapy in the past
  • aggressive or extremely agitated because of dementia
  • pregnant and cannot take medications
  • intolerant of the side effects of drugs
  • mothers with severe postnatal depression.  As electroconvulsive therapy works more quickly than counselling or medication, it helps cut down the time that the mother spends away from infant nurture.
  • nutritionally compromised because patient refuses food or sustenance owing to extreme depression
  • severely psychotic or schizophrenic

Is ECT Effective?

There is a huge body of evidence now that ECT is an invaluable treatment tool for those with acute depression and psychosis.  Although electroconvulsive therapy can go a long way in treating patients, this must be followed up with talking therapies and medication to avert recurrence of extreme symptoms.

Types of Electroconvulsive Therapies

There are two types of ECT administration which is differentiated by the location of electrode placement:

  • Right Unilateral Treatment

Right unilateral treatment involves the placement of one electrode at the crown of the head and the other, at the right temple.  The placement produces milder stimuli and therefore has lower risks of side effects concerning memory.  The patient response rate, however, is also slower compared to bilateral ECT, the other type of treatment.  If patients do not respond to right unilateral treatment, they may be switched to the stronger bilateral one.

  • Bilateral Treatment

Bilateral treatment is a full-on type that requires electrodes to be placed on both the left and right temples of the patient’s head.  In this case, the electric stimuli are much stronger, but still controlled, and therefore more effective in resistant patients.  Bilateral ECT however carries more risk of some memory loss.

Bilateral ECT

The patient and doctor should work out which treatment type is best.  This usually involves taking into consideration the patient’s medical and psychiatric history, severity of symptoms, and personal concerns as well.

 

 

Major Mental Disorders (MMD)

The acronym MMD stands for Major Mental Disorder of which there are five broad categories:  anxiety disorder, mood disorder, psychotic disorder, dementia, and eating disorder.  These mental illnesses are not a result of one cause but rather an interplay of a variety of factors which include environment, genetics, and lifestyle.

mmd

Anxiety Disorders

An anxiety disorder is positive in a diagnosis if the patient has any of these three symptoms:

  • illogical or inappropriate fearful and anxious response to objects, events, people, and situations
  • inability to control these fear responses
  • having no control over anxious feelings so much so that it disrupts normal functioning

Anxiety disorders are specifically manifested by these mental sub-illnesses:

  • Generalized Anxiety Disorder (GAD) — GAD is characterized by excessive or chronic worrying about one or many areas of life such as family, income, career, friends, and school, among other things.  The fears may often be unfounded and skew off tangent; if there is some basis, the amount of worrying is excessively way out of proportion to the real situation.  A person afflicted with GAD may find himself unable to go about his life normally because of excessive dread.
  • Panic Disorder — characterized by feelings of terror and fear which may or may not occur suddenly.  These are repeated panic attacks accompanied by physical symptoms such as rapid heartbeat, chest pain, sweat, tremors, and disorientation.
  • Phobias — intense fear, often irrational, of something that actually does not pose any immediate or even potential danger.  Ex.  fear of enclosed spaces (claustrophobia); fear of crowds (agoraphobia);  fear of darkness (achluophobia)
  • Post-Traumatic Stress Disorder (PTSD)  — often characterized by emotional numbness and recurring vivid memories of traumatic incidents.

 

Psychotic Disorders

Psychotic disorders are known as a set of mental illnesses that involve a distortion of reality.  To someone plagued with psychosis, delusions (assignations of unreal meaning to normal and innocent events) and hallucinations (experiences of non-existent things that are not connected to any genuine sources such as hearing voices) are perceived to be as real as normal people see things to be.

Mental maladies under psychotic disorders are:

  • Schizophrenia — a serious mental disorder that is marked by distorted thought patterns, hallucinations, delusions, and paranoia, all of which lead the individual toward strange, irrational behaviours.  Schizophrenics may hear voices not attached to any source or may believe in delusions such as being a real princess or warrior.
  • Schizo-affective Disorder — a variant of schizophrenia mixed with mood disorders such as mania or depression.

Mood Disorders

Mood disorders are also known as affective disorders.  Persistent feelings of sadness or abnormal elation over a certain period of time may qualify under this mental malady.  Extreme emotional fluctuations also characterize this category under which these illnesses belong:

  • Bipolar Disorder — a disorder identified by extreme changes in mood from mania (“high” mood state) to depression (“low” mood state).     major mental disorder
  • Clinical Depression — surpasses the normal feelings of sadness and puts one in a chronic state of pessimism, hopelessness, emptiness, worthlessness, anxiousness, and other severely low mood situations.  Patients cannot just bounce back from their low moods, unlike unafflicted individuals who have the abilities to cope with abysmal feelings.  Clinical depression has been known to be the cause of some suicide cases.
  • Dysthymic Disorder — an illness marked with constant low-grade depression for more than two years.  Symptoms include low energy, feelings of hopelessness and low self-esteem, sleep and appetite problems, poor focus, and indecisiveness.

The danger to these depressive mood disorders is that the risk for suicide among sufferers is high.

Dementias

Dementia refers to a slew of mental health problems symptomised by rapidly declining memory and other cognitive functions.  Dementia is diagnosed when the one or more of the following are impaired:

  • Memory
  • Ability to concentrate or pay attention
  • Visual perception
  • Language and communication abilities
  • Judgement and reasoning

The cause to all these impairments are brain cell damages which hinder these cells from communicating adequately with each other.  Alzheimer’s disease makes up a large percentage of dementia cases, followed closely by vascular dementia and dementia due to medical problems such as Parkinson’s and Huntington’s disease.  Toxic substances such as drugs, alcohol, mercury, lead, etc. can contribute to the development of dementia as well.

Eating Disorders

Eating disorders involve extreme thoughts, attitudes, and behaviour towards food and weight.  These disorders manifest as either of these issues:

  • Anorexia Nervosa  — a condition that is indicated by an overwhelming and all-consuming dread of being fat.  Anorexics have a distorted body image and obsessive thoughts about food, calories, and weight on which they impose severe restrictions.  For sufferers, one can never be too thin.  Anorexia is dangerous because the condition can cause death from suicide, cardiac arrest, starvation, and other medical complications.
  • Bulimia Nervosa —  an eating disorder in which the sufferer chronically binge eats and then frantically purges the calories consumed as an attempt to lose weight or not gain the pounds from overeating.  Bulimics, like anorexics, have an obsession with food; only they overeat with the thought that they can purge their “sins” later.  A person with bulimia can consume between 3,000 – 5,000 calories in a short hour.  In the next, he often guiltily purges what he has consumed by inducing vomiting, applying enemas, exercising voluminously, or going on crash diets.  The constant binge-and-purge cycle wreaks havoc on the metabolic system, forcing bulimics to gain weight over time.
  • Binge Eating Disorder — chronic overeating without any purging involved.  The cycle moves around binge eating, feeling guilty and ashamed for gluttony,  then emotional eating again to assuage the guilt.  Binge eaters are usually obese and may suffer from hypertension, cardiovascular disease, depression, and anxiety.

 

These major mental illnesses are treatable but need the help of professional mental health practitioners.  The stigma associated with mental maladies however is the main cause of why  people avoid treatment or fail to recognize that they need treatment.  More information and education about mental illnesses should be provided so that early stages may be recognized and tended to correctly.

Paranoia

paranoia (1)

Understanding Paranoia

Paranoia is a state of mind in which the individual thinks other people are out to do him harm, physically, socially, or otherwise.  It encompasses an irrational dread of some present or impending disaster or bad thing for which other people are responsible.  Paranoid thoughts are often unfounded but the paranoid person believes all these as realities.

Being on one’s toes or being rightfully distrustful of other people do not make one a true paranoid; but, when this same individual starts weaving complex scenarios justifying their suspicions and experiencing intense suffering and fear from their thoughts to the exclusion of rationality, then he may be diagnosed as paranoid, possibly with schizophrenia.

Psychotic or schizophrenic people often have these persecutory delusions so that they live in fear of being harmed, controlled, plotted against, vilified, and socially disparaged.  These individuals often feel they are of particular importance and that is why they feel singled out for persecution.  Severe cases of paranoia may include hearing of voices, all malicious or threatening.

Causes of Paranoia

By itself, paranoia is not classified as a mental illness as schizophrenia and bipolar disorders are.  Instead, it is an indicator that something is wrong and that there is some underlying mental health issue or even a neurological disease such as Parkinson’s and Huntington’s disease.

Paranoia may also be caused by street drugs such as barbiturates, LSD, marijuana, and cocaine.  Impaired cognitive functions and chronic fatigue from chronic sleep deprivation may generate paranoia as well.

Traumatic life experiences such as a spouse’s betrayal or sudden loss of a job can cause a person to have extreme thoughts of persecution.  Uncontrollable environmental disasters such as bombings and high crime may understandably trigger paranoid delusions, some justified but most not.

Recent research has also discovered that individuals who have problems understanding other people’s perspectives and have low empathetic abilities tend to make negative assumptions of other people’s behaviour.  While these characteristics by themselves do not automatically make one paranoid, stressful life events may push such an individual toward feeling more threatened and consequently, paranoid.

paranoid-person-quotes-2

 

Treatments for Paranoia

One unfortunate side effect of paranoia is that the individual may not think of himself as needing any kind of help.  In fact, a genuinely paranoid person may think that their patterns of thoughts have developed from rational deductions and inferences of their personal observations.  While their beliefs are far from reality, paranoid people may scoff at treatments unless they suspect that they could partly be wrong.  Herein lies the difficulty in persuading a paranoid person to accept psychological or psychiatric intervention.

Treatments for paranoia may include:

  • Talking Treatments

Talking treatments refer to therapies that encourage patients to talk about their thoughts and emotions with a mental health professional.  Talking to trained therapists help paranoid persons come to terms with their fears and to perceive them as they are.  Doing so also help individuals take more control over their thoughts, allowing them to make positive thought and behavioural changes.  Talking treatments may involve the following therapy types:

  • Medication

Antipsychotic drugs such as clozapine, risperidone, and olanzapine may be prescribed for severe paranoia.  Know that paranoid people may be highly suspicious of drugs, even prescribed ones, as they may have delusions of their own doctor conspiring against them.

  • Hospitalization / Day Care Centres

In cases when a severely paranoid person becomes violent or is threat to himself and others, the person may be admitted to the hospital whether he goes voluntarily or not.  Once, he has been stabilized, he may be discharged and entitled to a treatment plan.

Care centres also exist as aftercare hostels where patients have the opportunity to live under a supportive environment.  Under such an arrangement, acute paranoia sufferers may be given the chance to develop the skills needed for getting back in society and reacquiring some independence.

 

Schizophrenia

Schizophrenia is a mental disorder that affects an estimated 26 million people globally.  About 60% of patients worldwide are moderately to severely disabled with this mental illness.  The number of diagnosed schizophrenic cases in England and Wales totalled to about 220,000 in 2007 and accounted for about 30% of the country’s expenditures for adult mental health and social care services.  As this is quite a substantial piece of the expenditure pie, let us take a closer look at this debilitating mental disease.

What is Schizophrenia?

schizophrenia

Schizophrenia is a major illness that may strike 1 in 100 people at least once during their lifetime.  This long-term psychotic illness disrupts a person’s sense of reality.  During a schizophrenic episode, a person may:

  • see or hear non-existent stimuli or things that are not there
  • not be able to distinguish between reality and hallucination
  • be delusional or believe in irrational situations.   Ex.  The patient may believe that people everywhere are spying on him when the reality is, no one isn’t.
  • act strangely in response to hallucinations and delusions
  • feel disconnected from his emotions

Contrary to popular belief, schizophrenia does not involve the “split personality” syndrome.  It also usually does not endow a person with the propensity toward violence, although there are unusual cases, such as if the person already has a criminal bent.  In fact, schizophrenics are more likely to be victims of violence rather than perpetrators of it.  The danger these patients pose are predictably more to themselves than others.  The chances of suicide for sufferers are 1 in 10 within 10 years from the time of diagnosis.

Because schizophrenia compromises one’s cognitive functions and judgement, this mental illness is highly disruptive to a person’s day-to-day life so much so that work, relationships, and even self-care and hygiene may be affected.

 

schizophrenia stats

Risk Factors

Schizophrenia often manifests in people between the ages of 15 and 35, although it may occur at the late age of 70.  The disorder has the following high risk factors:

  •  Genes

Schizophrenia is a hereditary disease.  One can inherit the disorder from relatives related up to the second degree.

  • Dopamine

Dopamine is a neurotransmitter functioning as a messaging system between brain cells.  Scientists have found a link between too much dopamine in the brain and the occurrence of schizophrenia.

  • Stress

A huge amount of stress or life-changing events such as death of a loved one, homelessness, poverty, joblessness, social isolation, and physical and verbal abuse can trigger schizophrenia.

  • Drug abuse

Drug addiction can cause schizophrenia.  A study published in the medical journal “Lancet” have shown that smoking marijuana can actually make one psychotic, even years after one has stopped using cannabis.  Those who smoke cannabis everyday run the increased risk of psychosis by 200%.

  • Other Risks

Women with hormonal imbalance (especially those undergoing menopause) may be at risk for developing the mental illness.  Brain injury may be linked to the disorder as well.

Treatment for Schizophrenia

Early diagnosis is key in treating schizophrenia.  Treatment is a must because the long-term symptoms are the most dangerous.  These often lead patients toward self harm or suicide.  Some of these long-term symptoms usually include:

  • Loss of interest in anything
  • Listlessness, lethargy, dullness
  • Unemotional responses
  • No interest in self hygiene
  • No interest in doing daily chores such as dishwashing, cleaning, and doing laundry

Treatment usually consists of a combination of antipsychotic medications and psychotherapy.

Antipsychotic medications

These prescription drugs help people live with their mental illness.  They reduce the impact and frequency of hallucinations and delusions, enabling patients to think more clearly and have more motivation to take care of themselves.  These usually inhibit the overreaction of dopamine in the brain.  Unfortunately, like all drugs, these medications have their side effects:

  • Fatigue
  • Sexual difficulties
  • The drug group of chlorpromazine, haloperidol, and zuclopenthixol is particularly responsible for restlessness, shakes, or stiffness.
  • Olanzapine, risperidone, and quetiapine cause diabetes and weight gain

Psychotherapy

Cognitive Behavioural Therapy (CBT) helps the patient acquire the skills to manage:

  • coping strategies for dealing with the hearing of voices and other hallucinations and delusions
  • the psychological side of dealing with the side effects of medication
  • stress to dampen symptoms of schizophrenia
  • social anxiety
  • depression

Family Intervention Therapy can assist a patient’s family to cope with the illness.  The family members learn how to support a person with schizophrenia and how to deal with some problems that may crop up on a daily basis.  The aim of this therapy is to assist the family to communicate and problem solve effectively so as to provide the understanding and loving support the patient critically needs.

mental illness

Schizophrenia is a complicated mental illness.  Medical and psychiatric interventions are vital for equipping the patient and his family with the coping skills necessary to live with this mental affliction on a daily basis.