Advice on a mental disorder

Tanydwr · May 6, 2011

Hi,

I'm looking for anyone with knowledge of an appropriate mental disorder that could cause someone to go into violent rages, usually provoked, but not always, where they lose all sense of feeling and skill, and have no memory of what they did during the episode. I haven't written too much of the story yet, but something as closer as possible would be appreciated. Ideally, I'd like it to be the result of a genetic abnormality. Currently I'm claiming it's a serotonin deficiency inherited from her mother, but I know it's complete twaddle.

Any advice would be most appreciated.

Thank you!

jacket · May 6, 2011

Psychosis?
I don't know--are you wanting this to be something like a mood or personality disorder or more of a physical abnormality in the brain type of thing?

veinglory · May 6, 2011

Sudden rage is not a terribly unusual symptom in a range of syndromes. But the loss of memory is much more unusual and would have me thinking of a seizure type disorder.

jacket · May 6, 2011

veinglory said:
Sudden rage is not a terribly unusual symptom in a range of syndromes. But the loss of memory is much more unusual and would have me thinking of a seizure type disorder.

yesyes! A seizure disorder could work well to explain something like this. I've been doing a bit of seizure research myself for my current novel. There are many many different types of seizures and I'm sure I've read about something similar to this. I've found this site useful: http://www.epilepsy.com/

veinglory · May 6, 2011

A seizure type rage attack/storm will tend to be very sudden and severe, relatively unprovoked and afterwards there will be confusion and disorientation.

strictlytopsecret · May 6, 2011

The disorder you're looking for is likely Intermittent Explosive Disorder. It is an impulse control disorder (others include trichotilomania, kleptomania, pathological gambling). The DSM-IV number is 312.34.

~STS~

PinkAmy · May 6, 2011

strictlytopsecret said:
The disorder you're looking for is likely Intermittent Explosive Disorder. The DSM-IV number is 312.34.

~STS~

You beat me too it.
But, you would have to rule out medical conditions causing the behavior and assess for brain damage because brain injuries can cause violent behavior.

Anyone can repress traumatic incidents, so your MC could literally not remember, because the memory is stored in his subconscious or unconscious.

There are many things that can contribute to serotonin levels. The interaction between serotonin, dopamine and norepinephrine also helps determine mood.

I'd go with frontal lobe damage, because it's responsible for impulse control and it's not fixable. Certainly your MC could be medicated and learn coping skills, but he'll always have the tendency toward violence and lack of impulse control.

veinglory · May 6, 2011

I agree with the above, there really is a whole range of conditions that may cause this specific symptom. Some of them will not be in the DSM-IV because they are not considered psychiatric in etiology.

backslashbaby · May 6, 2011

eta: crosspost! Sorry

veinglory said:
Sudden rage is not a terribly unusual symptom in a range of syndromes. But the loss of memory is much more unusual and would have me thinking of a seizure type disorder.

**cough*cough**

The memory loss really is the hard part. A brain route like seizures sounds like the best, too, imho.

You could go totally psychological, though. It would just be an odd and rare thing. The character's background would have to be mentioned a lot, I think; It would almost have to be extremely dramatic.

stormie · May 6, 2011

Not all seizures are considered epileptic. So when you're on the epilepsy site, you might not see this mentioned. Web MD has a good description.

HistoryLvr · May 6, 2011

You might already have decided on one of the disorders above, but thought I'd add one. Someone I know is schizophrenic, which usually becomes prevalent in late teens/early adulthood (so wouldn't really work for YA). He had a psychotic break (at least I think that's what it's called) because he didn't take his meds and he blacked out and everything. He went on a rage, attacked people, though not with guns or swords or anything, and didn't remember anything afterward. Just another possibility for you.

Carmy · May 6, 2011

It depends how much you want to tie the behaviour into a certain "named" psychosis.

Recent research came up with a surprising link between the liver and emotional behaviour. Someone with a toxic liver could display the symptoms you describe. If you Google 'toxic liver and emotions' you'll come up with several mentions of such a thing.

I hope this helps. God luck!

BunnyMaz · May 6, 2011

Hmmm... mood swings of a sort are occassional features of my anxiety problems. But violent and severe mood swings were sadly a common side effect of the last type of meds I let my doctor trial me on, so if your character is medicated that could be a trigger. Especially since forgetting or choosing not to take a med on one day when you normally do have it can cause the side effects and/or withdrawal symptoms of the meds to occur in far more powerful bursts than they ordinarily would.

I don't know what would cause severe memory loss of the sort you need though, but if you check out more side effects of non-SSRI medications you may find something.

kborsden · May 6, 2011

jacket said:
Psychosis?
I don't know--are you wanting this to be something like a mood or personality disorder or more of a physical abnormality in the brain type of thing?

Most psychotic disorders are the result of physical abnormalities in the brain - in fact physical abnormalities of the brain can even come from mental health issues.

Many people compare the brain with a computer - so let's follow that rationale and say that when an error occurs in windows you get a boop and a pop-up - this doesn't happen in the brain - it ignores it for a time. The brain is in constant evolution during your entire lifetime, constantly laying down new pathways and creating links between receptors etc. This is why practice really does make perfect - because the more you do something, the more pathways your brain dedicates to that act. So back to windows - the boop and message stop everything, as good as and offer you the chance to stop, reset or fix an issue. So the fact that the brain gives no boop, it carries on laying those pathways, the more the error occurs, the more pathways -- until -- yup. This is also why it is incredibly hard to undo the shit created by a psychotic syndrome, disorder etc especially as most of those wrong pathways were being laid long before the symptoms became noticeable.

Stoneghost · May 6, 2011

PinkAmy said:
There are many things that can contribute to serotonin levels.

Serotonin levels do not cause, nor are they a direct symptom of, neurological disorders. Serotonin levels are correlates of neural activity of neurons that happen to use serotonin. Depression relates to cortical activity, not to chemical concentrations.

Tanydwr · May 7, 2011

Wow, thanks for all the suggestions. I have been doing a bit of research, and I'd seen a seizure condition or Intermittent Explosive Disorder as possibilities. However, as I have next to no background knowledge in any of these, I figured I'd ask!

Ideally, I'd prefer my character, Laura, not to be on medication, as she gets thrown into another universe where the medication - unless it's derived from easily-accessed plant or animal matter of a generally European/north European/British origin (e.g. the way willow-bark tea might be used for headaches, which aspirin is derived from). At this point, I have it where she hasn't had an 'attack' for about four years - and the last time, her friend Crisiant had to knock her out with a 'bloody good right hook' (in fairness, both Laura and Crisiant have taken martial arts lessons). I'd like it to have started in childhood, ideally by the time she was about seven or eight. Currently, she's blaming the condition on her mother, since she inherited the 'wonky genes' from her. However, that can be changed, and I'd prefer to have a good idea of a condition and the symptoms before I write any more, in case it affects the action of the novel.

Your help is very much appreciated, so thanks for taking the time to do so!

PinkAmy · May 7, 2011

If you don't want her on meds, brain damage would be ideal. It's not a mental disorder but it can cause her to have poor impulse control. Medication would not be necessary (though it might be helpful in slowing her down some.) She doesn't have to have severe brain damage, she could have been in a car accident, a severe concussion that never completely healed. It could have happened at or before birth. You wouldn't have to define how, but you could. Therapists are slow to diagnose teens with major mental disorders, in order to rule out other causes and not to stigmatize. The teen would probably be diagnosed with some type of Adjustment Disorder while medical, substance abuse, and situational issues.

Wiskel · May 8, 2011

Tanydwr said:
Hi,

I'm looking for anyone with knowledge of an appropriate mental disorder that could cause someone to go into violent rages, usually provoked, but not always, where they lose all sense of feeling and skill, and have no memory of what they did during the episode. I haven't written too much of the story yet, but something as closer as possible would be appreciated. Ideally, I'd like it to be the result of a genetic abnormality. Currently I'm claiming it's a serotonin deficiency inherited from her mother, but I know it's complete twaddle.

QUOTE]

A lot here is going to depend on the genre and age you're writing for, whether you want people to take your character seriously or not, and whether the rages are a comedic plot device or not.

The problem is that you're not just looking for an albino elephant, you're looking for an albino elephant with pink stripes....or the hulk. It's fine to populate your story with these fantastical creatures if you're writing that sort of story, but if not, then you might be making problems for yourself.

The idea that someone with mental illness is so "dangerous" that out of nowhere they'll expode in a rage so severe that they'll assault people for no reason and then not even remember it afterwards is one that is a few decades out of date, and one that every mental health advocate has been trying to undo.

You can certainly have parts of what you want. There are disorders of impulse control (including those related to some brain injuries), there are conditions (mainly seizure related) where people have no memory and may act oddly, there are psychological reasons why people repress memories and there are chemicals (like alcohol) that cause disinibition and memory loss, but putting them all together under the banner of mental illness is using cliches that are as outdated as some of the gender or race related stereotypes we could name.

I think there are a couple of questions to consider

1. Why the memory loss?
Are you trying to write a nice character that people will like but need an excuse for someone "nice" to be violent?
Is it a reason that your character never has to apologise or deal with the consequences of her actions?....if there's nothing she can do then she doesn't have to spend time or energy trying?
Is it to make it easier for people to forgive her?

2. Why does the rage not need to be provoked?
Is it a plot device to have your character hit people she didn't mean to?...is that for comedic effect?

If you want to go the mental illness route then I think you'd have a more rounded character if she did have to deal with consequences and had to take responsibility for her actions.

If you're writing a more fantastic story then i'd be tempted to avoid mental illness and go with a fantastic explanation.......something like a curse, or a spell, or that she's one of 0.00001% of the population with a particular brain structure that gets mistaken for mental illnes on earth, but that's actually a reaction to a portal to the other world opening, or interference from alien radio signals that causes disinibition, or something like that.

Sorry if my reply is a little more serious than you'd expected, but as a portrayal of mental illness it's one that would make me sigh and put the book down, and a poorly executed portrayal of mental illness in anything but a fantastic/tongue in cheek story is likely to cause you problems with publication.

Craig

Wiskel · May 8, 2011

Tanydwr said:
Hi,

I'm looking for anyone with knowledge of an appropriate mental disorder that could cause someone to go into violent rages, usually provoked, but not always, where they lose all sense of feeling and skill, and have no memory of what they did during the episode. I haven't written too much of the story yet, but something as closer as possible would be appreciated. Ideally, I'd like it to be the result of a genetic abnormality. Currently I'm claiming it's a serotonin deficiency inherited from her mother, but I know it's complete twaddle.

QUOTE]

A lot here is going to depend on the genre and age you're writing for, whether you want people to take your character seriously or not, and whether the rages are a comedic plot device or not.

The problem is that your not just looking for an albino elephant, you're looking for an albino elephant with pink stripes....or the hulk. It's fine to populate your story with these fantastical creatures if you're writing that sort of story, but if not then you might be making problems for yourself.

The idea that someone with mental illness is so "dangerous" that out of nowhere they'll expode in a rage so severe that they'll assault people for no reason and then not even remember it afterwards is one that is a few decades out of date, and one that every mental health advocate has been trying to undo.

You can certainly have parts of what you want. There are disorders of impulse control (including those related to some brain injuries), there are conditions (mainly seizure related) where people have no memory and may act oddly, there are psychological reasons why people repress memories and there are chemicals (like alcohol) that cause disinibition and memory loss, but putting them all together under the banner of mental illness is using cliches that are as outdated as some of the gender or race related stereotypes we could name.

I think there are a couple of questions to consider?

1. Why the memory loss?
Are you trying to write a nice character that people will like but need an excuse for someone "nice" to be violent?
Is it a reason that your character never has to apologise or deal with the consequences of her actions?....if there's nothing she can do then she doesn't have to spend time or energy trying?
Is it to make it easier for people to forgive her?

2. Why does the rage not need to be provoked?
Is it a plot device to have your character hit people she didn't mean to?...is that for comedic effect?

If you want to go the mental illness route then I think you'd have a more rounded character if she did have to deal with consequences and had to take responsibility for her actions.

If you're writing a more fantastic story then i'd be tempted to avoid mental illness and go with a fantastic explanation.......something like a curse, or a spell, or that she's one of 0.00001% of the population with a particular brain structure that gets mistaken for mental illnes on earth, but that's actually a reaction to a portal to the other world opening, or interference from alien radio signals that causes disinibition, or something like that.

Sorry if this is a little more serious reply than you'd expected, but as a portrayal of mental illness it's one that would make me sigh and put the book down, and a poorly executed portrayal of mental illness in anything but a fantastic/tongue in cheek story is likely to cause you problems with publication.

Craig

PinkAmy · May 8, 2011

Wiskel said:
Tanydwr said:

If you want to go the mental illness route then I think you'd have a more rounded character if she did have to deal with consequences and had to take responsibility for her actions.

If you're writing a more fantastic story then i'd be tempted to avoid mental illness and go with a fantastic explanation.......something like a curse, or a spell, or that she's one of 0.00001% of the population with a particular brain structure that gets mistaken for mental illnes on earth, but that's actually a reaction to a portal to the other world opening, or interference from alien radio signals that causes disinibition, or something like that.

Click to expand...

He makes an excellent point, because as whole the mentally ill are no more violent than the rest of society, even though many people have a misconception that they are.

veinglory · May 8, 2011

As I read it, OP was leaning towards making this not a mental illness at all, but an organic/congenital illness with behavioural symptoms.

Wiskel · May 9, 2011

veinglory said:
As I read it, OP was leaning towards making this not a mental illness at all, but an organic/congenital illness with behavioural symptoms.

Interesting idea, but what is a mental illness if it isn't something that effects either your emotions or thoughts, and behaviour is only those things that we do in response to our thoughts and feelings.

With the exception of epilepsy or brain injury, I'd be hard pressed to name an "organic" illness that fitted the bill at all.

I've got something wrong with my spleen that makes me punch people
I've got something wrong with my shoulder that makes me punch people.
I've got something wrong with my immune system that makes me punch people.
........none of the above would make anyone with a little medical knowledge suspend disbelief. The terms organic and congenital simply decribe how an illness might come about. Neither exclude mental illness.

If we go into conditions of the endocrine system that might flood the body with adrenaline then we can't explain the memory loss. If we go into conditions of the muscles or nervous system (with the exception of epilepsy or brain injury) then we can't explain the rage.

If it's presenting with memory loss and explosive rage then it's in the ballpark of either mental illness, epilepsy, brain injury or an emotional reaction to something, although a disorder of the endocrine system might make you a little more vulnerable to the above.

Craig

Wayne K · May 9, 2011

OCD. I can say from experience that untreated the thoughts can get a person frustrated enough that you lash out. And, yes, in the past, before I knew I had it, they were quite violent

veinglory · May 9, 2011

Wiskel said:
Interesting idea, but what is a mental illness if it isn't something that effects either your emotions or thoughts, and behaviour is only those things that we do in response to our thoughts and feelings.

With the exception of epilepsy or brain injury, I'd be hard pressed to name an "organic" illness that fitted the bill at all.

It is a dull and commonplace idea. And we were specifically discussing seizure disorders which are organic in etiology. One with a direct effect on behavior without an intervening motivational state.

Having something wrong with your brain/genome/body can cause you to be violent. And will probably not be considered psychiatric in etiology (as witness it is not listed in the DSMIV).

IMHO responders are projecting a prejudice onto the original query that I think simply isn't there. OP wants suggestions for a congenital/directly-inherited condition with a behavioral symptom.

If anything I think assuming all abnormal behavior reflects a motivational state and/or psychological etiology is in itself a prejudice that needs to be overcome.

Wiskel · May 9, 2011

veinglory said:
Having something wrong with your brain/genome/body can cause you to be violent. And will probably not be considered psychiatric in etiology (as witness it is not listed in the DSMIV).

You're mixing up different systems of classification. I think you may be mixing up the terms functional and psychiatric.

The different terms are used as layers to try to understand the aetiology.

The first layer is very broad. Essentially organic versus functional illness, organic meaning caused by a problem with the body, functional meaning not caused by an identifiable problem with the body. Bad behaviour, factitious disorder, conversion disorder would all likely fall into functional. The major mental illness such as psychosis fall into organic.

The second layer is a little more precise. An organic illness may be structural, infectious....etc in origin.

Then a condition may be congenital or acquired.

Schizophrenia is a condition that is organic, related to neurotransmitters in the brain, and can be congenital or acquired.
Heart wall defects are organic, related to a structural problem in development, and congenital.
The fact that something is organic and congenital in no way excludes it from being a mental illness.

"Psychiatric" is a very poorly defined term that may be precise in naming some conditions such as depression, may mean "listed in DSM or ICD", or may be nothing more than a social judgement. Survey enough people in the street and they'll tell you that people with violent behavioural problems, alcoholism and even deviant sexual behaviour need to see a psychiatrist and "must have some sort of mental illness". Ask them a few decades ago and being gay would have been included on the list.

I totally agree that assuming a behavioural problem is "psychiatric" is something that society will probably be ashamed of in a few decades time like we're ashamed of the history of locking up single mothers and homosexuals now. These inclusions based on society's judgement are things that greatly add to the stigma of having a mental illness.

My advice to the OP is in two simple parts.

1. There is no illness of any organ or system I can name that presents with unprovoked rage in more or less clear consciousness that is followed by complete memory loss. The clear consciousness part is the bit that takes epilepsy into account as seizure activity typically happens in an altered state of consciousness and is typically semi purposeful. Someone in the midst of a seizure may trash their room, or hit someone for example, but no-one has ever tidied up their room or done someone a favour during a seizure. Seizure activity typically leads to very simple, instinctive behaviour.

2. If the OP subverts an existing "mental illness" label to make it match the factors they need to progress their story ,then they risk adding to the stigma of having a mental illness by propagating the idea that people with a mental illness may be dangerous in ways that they're typically not.

Craig

Advice on a mental disorder

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