How does psychosis affect daily life. What are the symptoms of psychosis. How is psychosis diagnosed and treated. Can people with psychosis lead normal lives. What support is available for those experiencing psychosis.

What is Psychosis and How Does it Manifest?

Psychosis is a mental health condition characterized by a disconnection from reality. People experiencing psychosis may have difficulty distinguishing between what is real and what is not. The term “psychosis” literally means “out of touch with reality,” and it can manifest in various ways, profoundly impacting an individual’s perception of the world around them.

Some common manifestations of psychosis include:

• Delusions: Fixed false beliefs that persist despite contrary evidence
• Hallucinations: Seeing, hearing, or feeling things that aren’t there
• Disorganized thinking and speech
• Altered sense of self
• Changes in behavior and emotions

The Experience of Psychosis: A Personal Perspective

For those living with psychosis, the experience can be overwhelming and disorienting. One individual describes their experience with psychosis as follows:

“For two decades, I have lived with psychosis. During acute episodes, often triggered by stress, I become convinced that I am or will soon be Britain’s most wanted criminal. These beliefs are unshakeable at the time, leading me to isolate myself at home, believing it’s where wanted criminals belong. Even in the safety of my own bed, the psychosis affects me – a helicopter flying overhead becomes, in my mind, the police closing in on me.”

This personal account highlights the intense and often distressing nature of psychotic experiences, which can significantly impact daily life and well-being.

The Spectrum of Psychotic Disorders: Beyond Schizophrenia

While psychosis is often associated with schizophrenia, it’s important to understand that it can be a component of various mental health conditions. Psychotic symptoms may appear in:

• Schizophrenia
• Schizoaffective disorder
• Bipolar disorder with psychotic features
• Psychotic depression
• Brief psychotic disorder
• Substance-induced psychotic disorder

The diagnosis of specific psychotic disorders often requires careful evaluation over time. For instance, it may take years before a psychiatrist concludes that a person has schizophrenia, as the condition’s development and manifestation can be complex and varied.

Schizoaffective Disorder: A Complex Diagnosis

Schizoaffective disorder is a condition that combines symptoms of schizophrenia with mood disorders like depression or bipolar disorder. This diagnosis highlights the complexity of psychotic disorders and the importance of considering multiple factors in assessment and treatment.

A patient shares their experience: “For me, it took the best part of a decade for schizophrenia to be diagnosed, and with support, my diagnosis has changed to schizoaffective disorder. Depression, anxiety, and mood swings are all put together to determine my diagnosis today.”

The Challenge of Diagnosing Psychotic Disorders

Diagnosing psychotic disorders can be a complex and time-consuming process. It requires careful observation, multiple assessments, and consideration of various factors. Why is diagnosing psychotic disorders so challenging?

• Symptoms may overlap with other mental health conditions
• Individuals may be reluctant to disclose all their symptoms
• The onset and progression of symptoms can vary greatly between individuals
• Cultural and environmental factors may influence symptom presentation
• Substance use can mimic or exacerbate psychotic symptoms

Dr. Vijayakumar Motappashastry, a Locum Consultant Psychiatrist, explains: “We cannot diagnose schizophrenia immediately – rather, it takes several assessments, plenty of time, we need to take into account the patient’s family history, and collateral using a structured assessment. Only after all of these steps can schizophrenia be diagnosed. I must stress the time it will take clinicians like me to make a diagnosis.”

The Role of Insight in Diagnosis and Treatment

One crucial aspect of psychotic disorders is the concept of “insight” – the awareness that one’s experiences are symptoms of an illness rather than reality. Professor Stephen Lawrie, Head of Psychiatry at The University of Edinburgh, notes:

“A diagnosis of a psychotic disorder is usually only made if the symptoms are distressing or interfering with everyday life, but it often also means that the person does not realize that they are ill – in other words, in psychiatric jargon, they ‘lack insight’ that their experiences are products of their mind rather than real.”

This lack of insight can complicate both diagnosis and treatment, as individuals may not seek help or may resist interventions that they don’t believe they need.

The Impact of Psychosis on Daily Life

Living with psychosis can profoundly affect various aspects of a person’s life. How does psychosis impact daily functioning?

• Social relationships may become strained or difficult to maintain
• Work or academic performance can suffer
• Self-care and daily routines may be disrupted
• Increased risk of social isolation and loneliness
• Higher vulnerability to stress and environmental triggers
• Potential legal or financial complications due to impaired judgment

For many individuals with psychosis, fear and paranoia can lead to self-imposed isolation. As one person describes: “During acute psychotic episodes, I have locked myself away at home as I’ve felt that this is where wanted criminals belong. Even from a place as safe as under the duvet, psychosis still affects me.”

The Emotional Toll of Psychosis

Beyond the direct symptoms of psychosis, individuals often grapple with intense emotional experiences. These may include:

• Fear and anxiety related to delusional beliefs or hallucinations
• Depression and feelings of hopelessness
• Frustration and anger at the impact of the condition on their lives
• Shame and self-stigma due to societal misunderstandings about psychosis
• Grief over lost opportunities or changes in life trajectory

Addressing these emotional aspects is a crucial part of comprehensive treatment for psychotic disorders.

Treatment Approaches for Psychotic Disorders

While psychotic disorders can be challenging, various treatment options are available to help manage symptoms and improve quality of life. What are the primary treatment approaches for psychosis?

• Antipsychotic medications
• Psychotherapy (e.g., Cognitive Behavioral Therapy for Psychosis)
• Family support and education
• Social skills training
• Vocational rehabilitation
• Complementary therapies (e.g., art therapy, mindfulness)

Treatment is typically tailored to the individual’s specific needs and may involve a combination of these approaches. As one individual shares their experience: “I have lived with this condition for almost two decades and manage it with a combination of anti-psychotic medication, talking therapies, and lifestyle choices such as regular exercise and eating well.”

The Importance of Early Intervention

Research has shown that early intervention in psychosis can lead to better outcomes. Early intervention programs typically focus on:

• Rapid assessment and diagnosis
• Prompt initiation of appropriate treatment
• Support for families and caregivers
• Education about psychosis and its management
• Efforts to maintain social and occupational functioning

By addressing psychotic symptoms early, these programs aim to reduce the duration of untreated psychosis and minimize the condition’s impact on an individual’s life trajectory.

Living Well with Psychosis: Strategies for Recovery and Management

While psychotic disorders can be challenging, many individuals learn to manage their symptoms effectively and lead fulfilling lives. What strategies can help in living well with psychosis?

• Adhering to prescribed medication regimens
• Engaging in regular therapy or counseling
• Developing a strong support network
• Practicing stress management techniques
• Maintaining a healthy lifestyle (diet, exercise, sleep)
• Setting realistic goals and celebrating achievements
• Engaging in meaningful activities and hobbies

It’s important to remember that recovery is a personal journey, and what works for one person may not work for another. As one individual with lived experience notes: “While it has been a hard illness to cope with, not least because of stigma from others, it is not a life sentence.”

The Role of Peer Support in Recovery

Peer support, where individuals with lived experience of psychosis provide support to others, can be a valuable component of the recovery journey. Peer support can offer:

• A sense of hope and possibility
• Practical coping strategies based on personal experience
• Reduction of isolation and stigma
• Empowerment and self-advocacy skills
• A bridge between clinical services and community integration

Many mental health services now incorporate peer support workers as part of their multidisciplinary teams, recognizing the unique value of lived experience in supporting recovery.

Challenging Stigma and Promoting Understanding of Psychosis

Despite increased awareness of mental health issues, psychotic disorders continue to be misunderstood and stigmatized. How can we challenge stigma and promote better understanding of psychosis?

• Education and awareness campaigns
• Sharing personal stories of recovery
• Promoting accurate media portrayals of psychosis
• Advocating for equitable access to mental health services
• Encouraging open conversations about mental health in communities
• Supporting research into the causes and treatment of psychotic disorders

By fostering a more informed and compassionate society, we can create an environment where individuals with psychosis feel supported and empowered in their recovery journeys.

The Importance of Language in Discussing Psychosis

The language we use to discuss psychosis and other mental health conditions can significantly impact perceptions and attitudes. Some guidelines for respectful and accurate language include:

• Using person-first language (e.g., “person with schizophrenia” rather than “schizophrenic”)
• Avoiding sensationalist terms like “crazy” or “psycho”
• Describing behaviors and experiences rather than labeling individuals
• Emphasizing that psychosis is a treatable condition, not a character flaw
• Highlighting stories of recovery and hope alongside discussions of challenges

By being mindful of our language, we can contribute to a more nuanced and compassionate understanding of psychotic disorders.

Understanding and managing psychosis is a complex journey, but with appropriate support and treatment, individuals can learn to navigate life even when their perception of reality is altered. By fostering greater awareness and compassion, we can create a society that better supports those experiencing psychosis and celebrates their resilience and recovery.

When being ‘out of touch with reality’ is your reality

In psychiatry I suffer from what is known as ‘false beliefs’ or ‘delusions’ – I hold a fixed belief that I am or will soon be Britain’s most wanted criminal.

Unshakeable beliefs

Psychosis literally means ‘out of touch with reality’ and for two decades I have lived with it. For me, psychosis means losing touch with reality and this has been near fatal at times as my paranoia can leave me feeling suicidal.

During acute psychotic episodes I have locked myself away at home as I’ve felt that this is where wanted criminals belong. Even from a place as safe as under the duvet, psychosis still affects me. During an episode, often brought on by stress, if I hear a helicopter outside I think it is the police closing in on me. I also believe the police have fitted spy equipment into my bedroom to watch me suffer. At the time of the episode these beliefs are unshakeable.

Developing psychosis

Psychosis isn’t a diagnosis in itself but it can be the tip of the iceberg for many conditions including schizophrenia, bipolar disorder, and psychotic depression – all diagnoses I’ve had at some point. For me, it took the best part of a decade for schizophrenia to be diagnosed, and with support my diagnosis has changed to schizoaffective disorder.

Often people will develop psychosis in their teens from either a family history or sometimes through taking illicit substances. But even at this stage of acute psychosis not all of this group will develop schizophrenia. This can take years before a psychiatrist may conclude that a person has schizophrenia.

There are also many other different factors to all the ‘schizophrenias’. Depression, anxiety, and mood swings are all put together to determine my diagnosis today of schizoaffective disorder.

Professor Stephen Lawrie, Head of Psychiatry at The Univeristy of Edinburgh, says:

“When mental health workers use the word psychosis, it is usually because the person they are seeing has one or more  psychotic symptoms. These are usually delusions (‘bizarre beliefs’) and/or auditory hallucinations (‘hearing voices’).

“A diagnosis of a psychotic disorder (or condition) is usually only made if the symptoms are distressing or interfering with everyday life, but it often also means that the person does not realise that they are ill – in other words, in psychiatric jargon, they ‘lack insight’ that their experiences are products of their mind rather than real”.

The difficulty of disclosure

A psychiatric assessment is given before diagnosis and this will be clinical. Psychiatrists will assess the mental state in which the patient is presenting. Sometimes patients are scared to express the full extent of their experiences, making a schizophrenia diagnosis less likely.

For example, a lady with bipolar disorder with psychotic features might not tell her psychiatrist about all her symptoms for fear of the outcome or even being locked away. She may confide in a professional other than a psychiatrist such as a Support Worker or Occupational Therapist who can then refer her back to her psychiatrist who will likely commence anti-psychotic medication.

Dr Vijayakumar Motappashastry, Locum Consultant Psychiatrist, Midlands Partnership NHS Foundation Trust, UK, tells me: “I have treated patients with schizophrenia for 25 years as a psychiatrist. It’s a very complex condition and not at all straightforward to diagnose.

“We cannot diagnose schizophrenia immediately – rather, it takes several assessments, plenty of time, we need to take into account the patient’s family history, and collateral using a structured assessment. Only after all of these steps can schizophrenia be diagnosed. I must stress the time it will take clinicians like me to make a diagnosis”.

Being psychotic, or ‘out of touch with reality’ can thankfully be managed. I have lived with this condition for almost two decades and manage it with a combination of anti-psychotic medication, talking therapies, and lifestyle choices such as regular exercise and eating well. While it has been a hard illness to cope with, not least because of stigma from others, it is not a life sentence.

Erica Crompton is the co-author of The Beginner’s Guide to Sanity: A Self-Help Book for People with Psychosis – written with Professor Stephen Lawrie (published by Hammersmith Health Books)

Definition, Symptoms, Causes, Diagnosis, Treatment

Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isn’t as common as other major mental illnesses, it can be the most chronic and disabling.

People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn, and could appear to have lost touch with reality. This lifelong disease can’t be cured but can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia involves a psychosis, a type of mental illness in which a person can’t tell what’s real from what’s imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.

How severe schizophrenia is varies from person to person. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively normal lives in between. Still others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.

What Are the Early Symptoms of Schizophrenia?

The condition usually shows its first signs in men in their late teens or early 20s. It mostly affects women in their early 20s and 30s. The period when symptoms first start and before full psychosis is called the prodromal period. It can last days, weeks, or even years. It can be hard to spot because there’s usually no specific trigger. You might only notice subtle behavioral changes, especially in teens. This includes:

• A change in grades
• Social withdrawal
• Trouble concentrating
• Temper flares
• Difficulty sleeping

Positive Symptoms of Schizophrenia

In this case, the word positive doesn’t mean good. It refers to added thoughts or actions that aren’t based in reality. They’re sometimes called psychotic symptoms and can include:

• Delusions: These are false, mixed, and sometimes strange beliefs that aren’t based in reality and that the person refuses to give up, even when shown the facts. For example, a person with delusions may believe that people can hear their thoughts, that they are God or the devil, or that people are putting thoughts into their head or plotting against them.
• Hallucinations: These involve sensations that aren’t real. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person’s behavior, insult them, or give commands. Less common types include seeing things that aren’t there, smelling strange odors, having a funny taste in your mouth, and feeling sensations on your skin even though nothing is touching your body.
• Catatonia: In this condition, the person may stop speaking, and their body may be fixed in a single position for a very long time.

Disorganized Symptoms of Schizophrenia

These are positive symptoms that show that the person can’t think clearly or respond as expected. Examples include:

• Talking in sentences that don’t make sense or using nonsense words, making it difficult for the person to communicate or hold a conversation
• Shifting quickly from one thought to the next without obvious or logical connections between them
• Moving slowly
• Being unable to make decisions
• Writing excessively but without meaning
• Forgetting or losing things
• Repeating movements or gestures, like pacing or walking in circles
• Having problems making sense of everyday sights, sounds, and feelings

Cognitive Symptoms of Schizophrenia

The person will have trouble:

• Understanding information and using it to make decisions (a doctor might call this poor executive functioning)
• Focusing or paying attention
• Using their information immediately after learning it (this is called working memory)
• Recognizing that they have any of these problems

Negative Symptoms of Schizophrenia

The word “negative” here doesn’t mean “bad.” It notes the absence of normal behaviors in people with schizophrenia. Negative symptoms of schizophrenia include:

• Lack of emotion or a limited range of emotions
• Withdrawal from family, friends, and social activities
• Less energy
• Speaking less
• Lack of motivation
• Loss of pleasure or interest in life
• Poor hygiene and grooming habits

What Causes Schizophrenia?

The exact cause of schizophrenia isn’t known. But like cancer and diabetes, schizophrenia is a real illness with a biological basis. Researchers have uncovered a number of things that appear to make someone more likely to get schizophrenia, including:

• Genetics (heredity): Schizophrenia can run in families, which means a greater likelihood to have schizophrenia may be passed on from parents to their children.
• Brain chemistry and circuits: People with schizophrenia may not be able to regulate brain chemicals called neurotransmitters that control certain pathways, or “circuits,” of nerve cells that affect thinking and behavior.
• Brain abnormality: Research has found abnormal brain structure in people with schizophrenia. But this doesn’t apply to all people with schizophrenia. It can affect people without the disease.
• Environment: Things like viral infections, exposure to toxins like marijuana, or highly stressful situations may trigger schizophrenia in people whose genes make them more likely to get the disorder. Schizophrenia more often surfaces when the body is having hormonal and physical changes, like those that happen during the teen and young adult years.

Who Gets Schizophrenia?

Anyone can get schizophrenia. It affects people all over the world, from all races and cultures. While it can happen at any age, schizophrenia typically first appears in the teenage years or early 20s. The disorder affects men and women equally, although symptoms generally appear earlier in men. The earlier the symptoms start, the more severe the illness tends to be. Children over the age of 5 can have schizophrenia, but it’s rare before adolescence.

How Is Schizophrenia Diagnosed?

If symptoms of schizophrenia are present, the doctor will perform a complete medical history and sometimes a physical exam. While there are no laboratory tests to specifically diagnose schizophrenia, the doctor may use various tests, and possibly blood tests or brain imaging studies, to rule out another physical illness or intoxication (substance-induced psychosis) as the cause of the symptoms.

If the doctor finds no other physical reason for the schizophrenia symptoms, they may refer the person to a psychiatrist or psychologist, mental health professionals trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a psychotic disorder. The therapist bases their diagnosis on the person’s and family’s report of symptoms and their observation of the person’s attitude and behavior.

A person is diagnosed with schizophrenia if they have at least two of these symptoms for at least 6 months:

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior
• Negative symptoms

One of the symptoms has to be

• Delusions
• Hallucinations
• Disorganized speech

During the 6 months, the person must have a month of active symptoms. (It can be less with successful treatment.) Symptoms should negatively affect them socially or at work, and can’t be caused by any other condition.

How Is Schizophrenia Treated?

The goal of schizophrenia treatment is to ease the symptoms and to cut the chances of a relapse, or return of symptoms. Treatment for schizophrenia may include:

• Medications: The primary medications used to treat schizophrenia are called antipsychotics. These drugs don’t cure schizophrenia but help relieve the most troubling symptoms, including delusions, hallucinations, and thinking problems.
  • Older (commonly referred to as “first-generation”) antipsychotic medications used include:
  • Newer (“atypical” or second-generation) drugs used to treat schizophrenia include:

Note: Clozapine is the only FDA-approved medication for treating schizophrenia that is resistant to other treatments. It’s also used to lessen suicidal behaviors in those with schizophrenia who are at risk.

• Coordinated specialty care (CSC): This is a team approach toward treating schizophrenia when the first symptoms appear. It combines medicine and therapy with social services, employment, and educational interventions. The family is involved as much as possible. Early treatment is key to helping patients lead a normal life.
• Psychosocial therapy: While medication may help relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, social, and occupational problems that go with the illness. Through therapy, patients also can learn to manage their symptoms, identify early warning signs of relapse, and come up with a relapse prevention plan. Psychosocial therapies include:
  • Rehabilitation, which focuses on social skills and job training to help people with schizophrenia function in the community and live as independently as possible
  • Cognitive remediation, which involves learning techniques to make up for problems with information processing. It often uses drills, coaching, and computer-based exercises to strengthen mental skills that involve attention, memory, planning, and organization.
  • Individual psychotherapy, which can help the person better understand their illness, and learn coping and problem-solving skills
  • Family therapy, which can help families deal with a loved one who has schizophrenia, enabling them to better help their loved one
  • Group therapy/support groups, which can provide continuing mutual support
• Hospitalization: Many people with schizophrenia may be treated as outpatients. But hospitalization may be the best option for people:
  • With severe symptoms
  • Who might harm themselves or others
  • Who can’t take care of themselves at home
• Electroconvulsive therapy (ECT): In this procedure, electrodes are attached to the person’s scalp. While they’re asleep under general anesthesia, doctors send a small electric shock to the brain. A course of ECT therapy usually involves 2-3 treatments per week for several weeks. Each shock treatment causes a controlled seizure. A series of treatments over time leads to improvement in mood and thinking. Scientists don’t fully understand exactly how ECT and the controlled seizures it causes help, but some researchers think ECT-induced seizures may affect the release of neurotransmitters in the brain. ECT is less well-proven to help with schizophrenia than depression or bipolar disorder, so it isn’t used very often when mood symptoms are absent. It can help when medications no longer work, or if severe depression or catatonia makes treating the illness difficult.
• Research: Researchers are looking at a procedure called deep brain stimulation (DBS) to treat schizophrenia. Doctors surgically implant electrodes that stimulate certain brain areas believed to control thinking and perception. DBS is an established treatment for severe Parkinson’s disease and essential tremor, but it’s still experimental for the treatment of psychiatric disorders.

Are People With Schizophrenia Dangerous?

Popular books and movies often depict people with schizophrenia and other mental illnesses as dangerous and violent. This usually isn’t true. Most people with schizophrenia are not violent. More typically, they prefer to withdraw and be left alone. When people with mental illness do take part in dangerous or violent behaviors, it’s generally a result of their psychosis and the fear that they’re being threatened in some way by their surroundings. Drug or alcohol use can make it worse.

On the other hand, people with schizophrenia can be a danger to themselves. Suicide is the top cause of premature death among people with schizophrenia.

What Is the Outlook for People With Schizophrenia?

With proper treatment, most people with schizophrenia can lead productive and fulfilling lives. Depending on how severe the condition is and how well they get and stick with treatment, they should be able to live with their families or in community settings rather than in long-term psychiatric hospitals.

Ongoing research on the brain and how brain disorders happen will likely lead to more effective medicines with fewer side effects.

Can Schizophrenia Be Prevented?

There’s no known way to prevent schizophrenia. But early diagnosis and treatment can help avoid or ease frequent relapses and hospitalizations, and help cut the disruption to the person’s life, family, and relationships.

NIMH » Schizophrenia

The causes of schizophrenia are complex and are not fully understood, so current treatments focus on managing symptoms and solving problems related to day to day functioning. Treatments include:

Antipsychotic Medications

Antipsychotic medications can help reduce the intensity and frequency of psychotic symptoms. They are usually taken daily in pill or liquid forms. Some antipsychotic medications are given as injections once or twice a month, which some individuals find to be more convenient than daily oral doses. Patients whose symptoms do not improve with standard antipsychotic medication typically receive clozapine. People treated with clozapine must undergo routine blood testing to detect a potentially dangerous side effect that occurs in 1-2% of patients.

Many people taking antipsychotic medications have side effects such as weight gain, dry mouth, restlessness, and drowsiness when they start taking these medications. Some of these side effects subside over time, but others may persist, which may cause some people to consider stopping their antipsychotic medication. Suddenly stopping medication can be dangerous and it can make schizophrenia symptoms worse. People should not stop taking antipsychotic medication without talking to a health care provider first.

Shared decision making between doctors and patients is the recommended strategy for determining the best type of medication or medication combination and the right dose. You can find the latest information on warnings, patient medication guides, or newly approved medications on the U.S. Food and Drug Administration (FDA) website.

Psychosocial Treatments

Cognitive behavioral therapy, behavioral skills training, supported employment, and cognitive remediation interventions may help address the negative and cognitive symptoms of schizophrenia. A combination of these therapies and antipsychotic medication is common. Psychosocial treatments can be helpful for teaching and improving coping skills to address the everyday challenges of schizophrenia. They can help people pursue their life goals, such as attending school, working, or forming relationships. Individuals who participate in regular psychosocial treatment are less likely to relapse or be hospitalized. For more information on psychosocial treatments, see the Psychotherapies webpage on the NIMH website.

Family Education and Support

Educational programs for family members, significant others, and friends offer instruction about schizophrenia symptoms and treatments, and strategies for assisting the person with the illness. Increasing key supporters’ understanding of psychotic symptoms, treatment options, and the course of recovery can lessen their distress, bolster coping and empowerment, and strengthen their capacity to offer effective assistance. Family-based services may be provided on an individual basis or through multi-family workshops and support groups. For more information about family-based services in your area, you can visit the family education and support groups page on the National Alliance on Mental Illness website.

Coordinated Specialty Care

Coordinated specialty care (CSC) is a general term used to describe recovery-oriented treatment programs for people with first episode psychosis, an early stage of schizophrenia. A team of health professionals and specialists deliver CSC, which includes psychotherapy, medication management, case management, employment and education support, and family education and support. The person with early psychosis and the team work together to make treatment decisions, involving family members as much as possible. Compared to typical care for early psychosis, CSC is more effective at reducing symptoms, improving quality of life, and increasing involvement in work or school. Check here for more information about CSC programs.

Assertive Community Treatment

Assertive Community Treatment (ACT) is designed especially for individuals with schizophrenia who are at risk for repeated hospitalizations or homelessness. The key elements of ACT include a multidisciplinary team, including a medication prescriber, a shared caseload among team members, direct service provision by team members, a high frequency of patient contact, low patient to staff ratios, and outreach to patients in the community. ACT reduces hospitalizations and homelessness among individuals with schizophrenia. Check here for more information about ACT programs.

How can I help someone I know with schizophrenia?

Caring for and supporting a loved one with schizophrenia can be very challenging. It can be difficult to know how to respond to someone who is experiencing psychosis.

Here are some things you can do to help your loved one:

• Help them get treatment and encourage them to stay in treatment
• Remember that their beliefs or hallucinations seem very real to them
• Tell them that you acknowledge that everyone has the right to see things their way
• Be respectful, supportive, and kind without tolerating dangerous or inappropriate behavior
• Check to see if there are any support groups in your area

Some symptoms require immediate emergency care. If your loved one is thinking about harming themselves or others or attempting suicide, seek help right away:

COVID patients losing touch with reality, happening in CLE

CLEVELAND — Psychosis. It’s a word describing conditions that affect the mind so much so that people lose touch with reality. Now it’s something mental health experts are examining as a symptom of some COVID cases.

“I have a whole new appreciation for mental illness,” said Ivan Agerton, 50, from the Seattle area. He’s a photographer and film maker. He was on a two-month, overseas expedition, but by the time he got home, he tested positive for COVID.

“I lost my sense of smell,” said Agerton. The physical symptoms were not that big of a deal.

THE MENTAL EFFECTS

However, at one point he said he got a spam phone call that rang then suddenly stopped. From there, the mental effects of COVID flipped on like a light switch. “I became extremely paranoid and I had these thoughts that people were tracking me and watching me,” Agerton told us.

He didn’t tell his wife about this for two days, but then, he just couldn’t take it anymore.

“I pulled her into our closet in our bedroom and had her leave her cell phone outside of the closet because I also thought my cell phone…they were listening to us,” he said.

He spent a total of 17 days in a mental hospital. “(We) found some information where this was something that was happening in Europe,” said Agerton.

There has been a growing number of patients like Agerton diagnosed with COVID and psychosis all over the world. There are studies going on in the United Kingdom. Patients have similar symptoms to Agerton and there are risks of self-harm. Here in the U.S., the CDC sent out a warning.

“I had no control over this,” said Agerton. He is certainly brave to come forward with his story. He wants you to be aware this can happen. In fact, we tracked down cases of COVID psychosis in our own backyard.

CASES IN CLEVELAND

“She said she completely lost track of time for those 2 or 3 weeks,” said Poorvanshi Alag, who is a resident doctor at MetroHealth Medical Center in Cleveland. She was describing a woman in her 60s that recently came into the hospital.

“We saw the patient kind of grumbling, her speech was disorganized, she kept repeating certain words over and over again,” said Alag.

The woman had COVID-19. She wasn’t sleeping. She was texting people strange things.

“She was seeing old, dead family members and she was reporting to her family that she was pregnant and that she would have to deliver,” said Alag.

“It’s particularly scary, not just for the person, but for the family,” said Dr. Raman Marwaha who is the Residency Training Director of Psychiatry Metro.

“(The husband) said, ‘This is not my wife anymore. I’ve never experienced anything like this,’” said Alag. “He just didn’t know, and he just couldn’t stop crying.”

And, it’s not just happening at Metro.

“They believe that the people in the hospital are trying to hurt them or kill them,” said Dr. Susand Padrino from University Hospitals Cleveland Medical Center. She’s seen it, too. She told us all of this is happening without any prior history or family problems with mental health.

WHY IS THIS HAPPENING?

So, why is this happening? One reason experts said is that COVID binds to a protein in the lungs.

“This specific protein is produced by the brain. So, maybe that’s how it gets into your brain,” said Alag.

Autopsies done on former COVID patients show wherever the virus is found in the brain, there was decreased blood flow in that region.

“You could have a stroke which leads to depression, it could lead to mania, mood disorders, psychosis. It could go any way,” said Alag.

There is some good news. It appears most psychosis subsides when COVID is no longer an issue for a patient. Plus, there are lots of studies are underway.

“Maybe now we have the science to really understand what is causing that in the brain to make people have these experiences,” said Padrino.

Some researchers say mental history and psycho-social stressors can make other patients at higher risk for COVID psychosis.

WHAT SHOULD YOU DO IF THIS HAPPENS TO A LOVED ONE?

So, what should you do if you see such abnormal behavior in a loved one?

Padrino said to reassure the person that they are safe. Tell them there are people ready to help them be safe. And take away any guns and ammo. Put them in a safe place away from the patient.

For patients like Agerton, who said he’s now 100% recovered, he just wants you to be aware that severe mental effects are real. “This isn’t something you can tough out,” said Agerton. “It’s something where you need medical assistance. You need help.”

How Climate Scenarios Lost Touch With Reality

By Roger Pielke Jr., Justin Ritchie

A failure of self-correction in science has compromised climate science’s ability to provide plausible views of our collective future.

The integrity of science depends on its capacity to provide an ever more reliable picture of how the world works. Over the past decade or so, serious threats to this integrity have come to light. The expectation that science is inherently self-correcting, and that it moves cumulatively and progressively away from false beliefs and toward truth, has been challenged in numerous fields—including cancer research, neuroscience, hydrology, cosmology, and economics—as observers discover that many published findings are of poor quality, subject to systemic biases, or irreproducible. 

In a particularly troubling example from the biomedical sciences, a 2015 literature review found that almost 900 peer-reviewed publications reporting studies of a supposed breast cancer cell line were in fact based on a misidentified skin cancer line. Worse still, nearly 250 of these studies were published even after the mistaken cell line was conclusively identified in 2007. Our cursory search of Google Scholar indicates that researchers are still using the skin cancer cell line in breast cancer studies published in 2021. All of these erroneous studies remain in the literature and will continue to be a source of misinformation for scientists working on breast cancer. 

In 2021, climate research finds itself in a situation similar to breast cancer research in 2007. Our research (and that of several colleagues) indicates that the scenarios of greenhouse gas (GHG) emissions through the end of the twenty-first century are grounded in outdated portrayals of the recent past. Because climate models depend on these scenarios to project the future behavior of the climate, the outdated scenarios provide a misleading basis both for developing a scientific evidence base and for informing climate policy discussions. The continuing misuse of scenarios in climate research has become pervasive and consequential—so much so that we view it as one of the most significant failures of scientific integrity in the twenty-first century thus far. We need a course correction. 

In calling for this change, we emphasize explicitly and unequivocally that human-caused climate change is real, that it poses significant risks to society and the environment, and that various policy responses in the form of mitigation and adaptation are necessary and make good sense. However, the reality and importance of climate change does not provide a rationale or excuse for avoiding questions of research integrity any more than does the reality and importance of breast cancer. To the contrary, urgency makes attention to integrity that much more important.

Scenarios and baselines

A policy is a prediction. Committing to a particular course of action reflects expectations for the outcomes of choosing one option over others. Effective policymaking, which leads to desired outcomes, therefore requires some ability to discern and map the future. Not surprisingly, policy in the context of climate change, which will occur over many decades and centuries, requires methods for distinguishing alternative paths into the future.

One fundamental approach to conducting research on the climate is based on scenarios. In the 1960s, Herman Kahn adopted use of the word scenario to characterize a formalized vision of the future. A military strategist for the RAND Corporation, Kahn befriended actors and directors in Southern California and was likely one of the models for the eponymous character in Stanley Kubrick’s Dr. Strangelove. 

Kahn explained that “scenarios are simply a more or less imaginative sequence of events that are put together so that each event forms a context for the other events and so that there is some continuity over time in the ‘narrative.’” The idea of “scenario planning” caught on, and by 1972 Shell Corporation had sought out Kahn as it developed its methods of scenario planning to shape company strategy. 

Scenarios are an important tool for analysis because the world is incredibly complex and humans need tools to envision the contours of this complexity. As the anthropologist James C. Scott observes, “any large social process or event will inevitably be far more complex than the schemata we can devise, prospectively or retrospectively, to map it.” We thus need tools to simplify the world’s complexities to help us invent and evaluate action alternatives, ultimately for purposes of implementation. However, such maps of the world are not simply reflections of an underlying reality. As the geographer Alan MacEachren explains, “When we build these abstract representations (either concrete ones in map form or cognitive ones prompted by maps) we are not revealing knowledge as much as we are creating it.” 

Scenarios are an important tool for analysis because the world is incredibly complex and humans need tools to envision the contours of this complexity.

Climate research was a natural fit for the use of scenarios, given its roots in long-term planning and the energy industry. Early scenarios were highly idealized and focused on exploring what would happen if carbon dioxide concentrations doubled from their preindustrial levels or increased at a steady rate of 1% per year. The Intergovernmental Panel on Climate Change (IPCC) introduced scenarios not just to explore scientific questions, but to project or predict alternative futures. In 1990, the first IPCC report adopted a concept from the scenario literature called “business as usual,” a term to describe where the world is presently headed. A business-as-usual scenario is meant to create a baseline expectation of the future in the absence of unforeseen events or concerted efforts to change that future. This baseline expectation can then structure an evaluation of benefits that might come from taking an alternative path. 

The notion of a baseline (or business-as-usual, or reference) projection in scenario planning was reinforced by the adoption of cost-benefit analysis as a central tool for understanding the potential effects of proposed government regulations. In 1981, for instance, the Reagan administration issued an executive order that required federal regulations to undergo a formal cost-benefit analysis prior to implementation. A key feature of such analysis is a comparison of multiple futures—typically one without regulation (the baseline scenario) and one with various policy interventions (a policy scenario). Under such a methodology, analysts view the baseline as a prediction of the most likely future in the absence of specific policy interventions to avoid that future. As climate science took shape in the following decades, the field inherited this legacy
of baseline scenarios.

The future isn’t what it used to be

Efforts to understand the future of climate change depend on scenarios of future GHG emissions because these emissions are centrally responsible for any excursion of the climate’s behavior beyond its natural variability. Emissions scenarios are thus a key input for the climate models that aim to project the future behavior of the climate. But emissions scenarios are themselves dependent on variables such as population growth, economic growth, technological change, land use change, and so on.

As the world has evolved in incredible and unanticipated ways over the three decades since the first IPCC report in 1990, the future envisioned by the IPCC has remained remarkably static.

One obvious challenge for constructing plausible emissions scenarios then is that these key variables are continually changing, sometimes in quite unexpected directions. And yet, as the world has evolved in incredible and unanticipated ways over the three decades since the first IPCC report in 1990, the future envisioned by the IPCC has remained remarkably static. For instance, the first IPCC report in 1990 adopted a business-as-usual scenario for carbon dioxide emissions that resulted in a projected GHG concentration level for the year 2100 of more than 1,200 parts per million (ppm) carbon dioxide equivalent, a radiative forcing (a measure of the greenhouse effect) of 10 watts per square meter (W/m²), and a global temperature increase of between 2.9 and 6.2 degrees Celsius above preindustrial values. The Sixth Assessment Report of the IPCC, planned for publication this year, will use a baseline scenario with a projected GHG concentration level for 2100 of about 1,200 ppm, a radiative forcing of 8.5 W/m², and a temperature increase of 3.0 to 5.1 degrees Celsius. 

This remarkable continuity of characteristics among different generations of climate scenarios facilitates the comparison of research conducted over many decades using the different scenarios. But it also creates a problem. The emissions scenarios the climate community is now using as baselines for climate models depend on portrayals of the present that are no longer true. And once the scenarios lost touch with reality, so did the climate, impact, and economic models that depend on them for their projections of the future. Yet these projections are a central part of the scientific basis upon which climate policymakers are now developing, debating, and adopting policies.

How emissions scenarios got off track is a long and technical story (which we relate in a 20,000 word article, for those interested). Here is the short version. 

Four futures

Scientists and policymakers have learned over and over that accurate predictions of society’s future are not just difficult but fundamentally impossible. Scenario planning helps to address limited foresight by envisioning a set of alternative possible futures, thus enabling consideration of policies that can be effective despite uncertainties and ignorance. But scenarios of the future need constant updating because the possibilities for the future change as events unfold in the present.

A baseline or business-as-usual scenario is, by definition, an expectation of the most likely future in the absence of actions taken to alter that future. Having adopted one baseline and three policy scenarios (each reflecting a different mix of future climate policies) in its early reports, the leaders of the IPCC recognized by the late 1990s that the organization needed to update its scenarios. The IPCC community actively debated whether new scenarios should adopt the baseline-policy distinction of earlier IPCC assessments or instead present scenarios without any consideration of their likelihood.

The emissions scenarios the climate community is now using as baselines for climate models depend on portrayals of the present that are no longer true.

The late climate expert Stephen Schneider argued for including likelihoods in the scenarios. He explained that “policy analysts needed probability estimates to assess the seriousness of the implied impacts; otherwise they would be left to work out the implicit probability assignments for themselves.” But other scientists involved in creating IPCC scenarios argued that assessing likelihoods of scenarios a century into the future was fundamentally impossible and they should not do it, lest it mislead their users about the foreseeability of the future. Both sides have good arguments.

The latter perspective won out. When the IPCC published its Special Report on Emission Scenarios (SRES) in 2000, it presented the new family of emissions scenarios with no likelihoods. Thus it made no distinction between baseline and policy scenarios. In fact, the report emphasized four scenarios, spanning a wide range of outcomes, so that scenario users such as climate modelers would not be tempted to interpret a middle scenario as representing the most likely baseline future. The IPCC SRES report concluded, “The broad consensus among the SRES writing team is that the current literature analysis suggests the future is inherently unpredictable and so views will differ as to which of the storylines and representative scenarios could be more or less likely. Therefore, the development of a single ‘best guess’ or ‘business-as usual’ scenario is neither desirable nor possible.”

This decision was not without its critics. For instance, in a 2012 review of IPCC assessments, Detlef van Vuuren and his colleagues at the Netherlands Environmental Assessment Agency noted that the failure to assign likelihoods “was strongly criticized by some environmental NGOs [nongovernmental organizations] as it would suggest that autonomous developments could also lead to a (modest) reduction of emissions.” In other words, if one scenario suggested that the world might evolve toward a lower emissions future in the absence of aggressive climate policies, it might reduce motivation to develop policies to actually create such a future. Here is evidence that scenarios are not simply lenses to help envision possible futures, but also fulcrums to motivate action—for turning desired futures into reality. Scenarios are thus never neutral because different futures reflect different choices among policy options.

The sum of all forcings 

To develop emissions scenarios, scientists begin with assumptions about the future of socioeconomic variables such as economic growth, population growth, and energy consumption, as well as a range of other variables, such as changes in land use (farming, grazing, forestry, and so on) and particulate pollution. They plug these variables into models of society and the economy called integrated assessment models to generate plausible pathways of future emissions—these are the emissions scenarios. These scenarios project the future not only of carbon dioxide emissions, but also of other chemicals that affect the climate, such as methane and nitrous oxide. Emissions scenarios, in turn, are necessary to determine another variable, called radiative forcing, a measure of changes in the net transfer of energy (i.e., heat) in the atmosphere. Radiative forcing pathways (changes in forcing over time) are a key input for the climate models that project the future behavior of climate.

The IPCC scenarios serve the needs of the climate modeling community, which has exacting technical requirements for inputs into their climate models. As scientific understanding of the complexity of the climate system has grown, so too has the complexity of the scenarios upon which climate models—and the futures they project—depend. 

By 2005 the IPCC was beginning to produce a new generation of emissions scenarios to replace those of SRES. These new scenarios would require time to develop and that would delay the advance of climate modeling research. To provide the information necessary to continue climate model development without waiting for updated scenarios, the IPCC simply selected a set of four radiative forcing pathways to the year 2100 for use by the research community. Called Representative Concentration Pathways, or RCPs, these were drawn from the many hundreds of existing emissions scenarios to represent one high, one low, and two middle projections. Modelers could then immediately apply the four RCPs to produce a range of updated projections of future climate behavior. In parallel, scenario developers would simultaneously start with this same set of radiative forcing pathways and work backward to develop socioeconomically plausible emissions scenarios that would produce the four RCPs. 

Scenarios are not simply lenses to help envision possible futures, but also fulcrums to motivate action—for turning desired futures into reality.

Although the IPCC selected the four radiative forcing pathways to provide a range of projected futures to 2100, it did not consider the plausibility of the socioeconomic assumptions used to generate them. Indeed, in 2008 the IPCC noted, “It is an open research question as to how wide a range of socioeconomic conditions could be consistent with a given [RCP] pathway of forcing, including its ultimate level, its pathway over time, and its spatial pattern.” The online guidance for the RCP database similarly warned, “The differences between the RCPs can therefore not directly be interpreted as a result of climate policy or particular socioeconomic developments.” 

The IPCC had cut the link between the socioeconomic characteristics underlying the scenarios (population change, economic growth, and so on), the emissions scenarios they provided for climate models, and the climate futures those models would predict. The effect of the separation was to save time while abandoning any commitment to evaluating the scenarios and pathways for plausibility or probability. 

And yet the IPCC ignored its own guidance. It associated the RCP scenarios with not just plausibility but also likelihoods when it labeled the scenario leading to the greatest amount of climate change, called RCP8.5 (indicating a radiative forcing of 8.5 W/m² in 2100), as the single business-as-usual scenario of the set. In so doing, the IPCC identified RCP8.5 as the most likely future in the absence of further policy intervention, which gave it special status among not only the RCPs but among the hundreds of baseline scenarios of the broader IPCC scenario database.

What’s good for science

Why does this matter? Because RCP8.5—the most commonly used RCP scenario and the one said to best represent what the world would look like if no climate policies were enacted—represents not just an implausible future in 2100, but a present that already deviates significantly from reality. We know this because we have studied RCP8.5 (as well as other climate scenarios) for years and have evaluated many of its inputs and assumptions against how the world has actually developed since 2005, where RCP8.5 begins. We have also evaluated hundreds of IPCC scenarios against near-term projections of global energy assessments. Our work (including collaborations with Matthew Burgess and other colleagues), as well as studies by other researchers published in many papers, clearly shows that most IPCC scenarios are already off track and some, like RCP8.5, significantly so. As summarized by two scenario experts in a January 2020 commentary in Nature, “the world imagined in RCP8.5 is one that, in our view, becomes increasingly implausible with every passing year.” 

RCP8.5—the most commonly used RCP scenario and the one said to best represent what the world would look like if no climate policies were enacted—represents not just an implausible future in 2100, but a present that already deviates significantly from reality.

For instance, RCP8.5 projects to 2100 a six-fold growth in global coal consumption per capita, while the International Energy Agency and other energy forecasting groups collectively agree that coal consumption has already or will soon peak. Also, RCP8.5 foresees carbon dioxide emissions growing rapidly to at least the year 2300 when Earth reaches more than 2,000 ppm of atmospheric carbon dioxide concentrations. But again, according to the IEA and other groups, fossil energy emissions have likely plateaued, and it is plausible to achieve net-zero emissions before the end of the century, if not much sooner. Today, projections that carbon dioxide emissions from fossil fuels will increase dramatically for the next 50, 100, or 300 years are simply implausible.

Why, then, did the IPCC choose RCP8.5 as its only business-as-usual baseline? Not because it explicitly judged it the world’s most likely or even plausible future, although the designation implies both. Rather, it selected RCP8.5 in part to facilitate continuity with scenarios of past IPCC reports, both SRES and earlier baseline scenarios, so that results of climate modeling research across decades could be comparable. It also chose RCP8.5 to help climate modelers explore the differences between climate behavior under hypothesized extreme conditions of human-caused climate forcing and natural variability. The difference between the high (8.5 W/m²) and low (2.6 W/m²) RCP forcing pathways created, as scenario developers explained, “a good signal-to-noise ratio for evaluating the climate response in AOGCM [atmospheric-oceanic general circulation model] simulations.” The technical requirements of climate modeling, and not climate policy, drove the design of IPCC scenarios. 

These decisions might be justifiable if climate models were simply scientific tools aimed at exploring a variety of conditions as a way to test hypotheses and researchers’ understanding of the climate system. But scientists, policymakers, the media, environmentalists, and the public now widely justify and interpret climate models as providing predictive information about plausible futures. By choosing RCP8.5 as one of only four forcing scenarios to be used by modelers, and compounding this choice by labeling it as the business-as-usual scenario, the IPCC promoted a scenario useful for scientific exploration but highly misleading when applied to projecting the future to inform decision-making. 

In our research on the plausibility of IPCC scenarios, we have discovered it is not just RCP8.5 that is implausible, but the entire set of baseline scenarios used by the IPCC. In some ways this is unsurprising. As events unfold in a complex world, even the near-term futures anticipated by scenarios will  drift away from reality. As a matter of scientific integrity, however, the reputation of science as a source of uniquely reliable knowledge depends on its internal capacity for self-correction. In the case of the RCPs (as with the example of breast cancer research after 2007), what we are seeing instead amounts to a stubborn commitment to error. This wouldn’t matter if climate scenarios had no implications for the world outside of science. But they lie at the heart of scientific efforts to understand the future of climate change and society’s decisions about how to respond. 

A Rube Goldberg future 

The RCPs are far from the end of this story. Originally, the IPCC intended them to serve as a stopgap, while it developed a more fully integrated set of scenarios that reunited socioeconomics with elements of radiative forcing. It took more than a decade to develop the Shared Socioeconomic Pathway (SSP) scenarios, which in principle would supersede the RCPs. In practice, our research shows that people continue to widely use the RCPs along with the SSPs as input into climate models and as the basis for assessments, projections of climate impacts, and policy evaluation.

We have discovered it is not just RCP8.5 that is implausible, but the entire set of baseline scenarios used by the IPCC.

The SSPs represent a massive effort and are themselves the focus of a growing literature that explores the futures that they envision. But the SSPs have repeated many mistakes of the RCPs, most notably in supporting the designation of two extreme, implausible futures, with future emissions that emulate RCP8.5—again not for reasons of plausibility, but for purposes of continuity and to meet the technical constraints of climate modeling. Indeed, the creators of the SSPs have noted that its most extreme scenario (SSP5-RCP8.5) can only emerge in a limited number of models under a restricted set of assumptions. Even with this indication of implausibility, the IPCC designated it as the highest priority reference scenario for purposes of the climate modeling studies supporting the next IPCC assessment. 

As with the RCPs, the IPCC chose the SSPs to represent a wide range in radiative forcing pathways. Yet all of the RCPs and SSPs share some important assumptions. One of the most significant is the projected growth of coal consumption. The single RCP and two SSP baseline scenarios prioritized in climate modelling studies envision that coal will outcompete virtually all other energy technologies this century. In the latest version of the RCP8.5 scenario (SSP5-8.5), coal would even surpass oil and electric vehicles to become the dominant fuel for the world’s cars. One can trace the vision of a global energy system utterly dependent for the rest of the century on increased burning of coal to the beginning of the IPCC assessment process in the late 1980s and the influence on its early energy-use projections of flawed reports of virtually unlimited, very inexpensive coal in China and Siberia. The IPCC carried the error forward, freezing it into emissions scenarios to support the extreme energy outlooks adopted as baselines for climate science. It’s as if the profound changes in the world’s mix of energy resources and technologies in the past three decades, from the rise of natural gas to the growth of renewable energy, had never happened. 

While RCP8.5 and its progeny SSP5-8.5 represent an obsolete and extreme vision of a coal-dominant future, the specter of coal superabundance introduces error into all other baselines, as well as the policy scenarios that derive from those baselines. For example, even in the lower-emission SSP baseline that depicts a globally coordinated effort to achieve sustainability through green growth (SSP1), the world’s coal use doesn’t fall below current levels until after the year 2080. The common assumption of coal as the most desirable global fuel source—independent of all other social, technological, and economic factors—results in a single point of failure across the scenarios. 

In the latest version of the RCP8.5 scenario, coal would even surpass oil and electric vehicles to become the dominant fuel for the world’s cars.

To compensate for this shared error, IPCC policy scenarios have had to invent a Rube Goldberg kind of future. This is an imagined future where massive amounts of coal that will never be burned necessitate massive amounts of so-called “negative emissions” technologies (dominated by highly speculative bioenergy plus carbon capture and storage) in order to generate policy pathways to a low-carbon future. Yet, even though researchers are now more likely to recognize problems with the RCPs and SSPs, these scenarios continue to be the basis for dozens of climate research papers published every week. According to Google Scholar, from the beginning of 2020 until mid-June 2021, authors published more than 8,500 papers using the implausible baseline scenarios, of which almost 7,200 use RCP8.5 and nearly 1,500 use SSP5-8.5. Neither the IPCC nor the broader climate modeling community has sought to counter or reverse this proliferating source of error in projections of future climate change.

Restoring integrity in climate science

The consequences of pervasive, implausible climate scenarios extend far beyond the IPCC process and the academic literature these scenarios have enabled. A continued focus on implausible emissions scenarios in climate research is a failure of science’s supposed internal quality assurance mechanisms and thus a failure of scientific integrity. The persistent use of implausible scenarios introduces error and bias widely across climate research. They are now woven through the climate science literature in ways that will be very difficult to untangle. 

Many of these thousands of published papers project future impacts of climate change on people, the economy, and the environment that are considerably more extreme than an actual understanding of emissions and forcing pathways would suggest is likely. As scientists’ understanding of climate change continues to improve, perhaps scientists will someday conclude that the most extreme impacts are also plausible under lower emissions trajectories. But that is not the consensus at present. And so, with any attempts at scientific nuance lost in technical language, these implausible projections of apocalyptic impacts decades hence are converted by press releases, media coverage, and advocates—as in an extended game of telephone—into assertions that climate change is now catalyzing dramatic increases in extreme events such as hurricanes, droughts, and floods, events that foreshadow imminent global catastrophe. 

Even though researchers are now more likely to recognize problems with the RCPs and SSPs, these scenarios continue to be the basis for dozens of climate research papers published every week. 

At the same time, and unsurprisingly, some opponents of climate policies are politically exploiting problems with the IPCC emissions scenarios. Groups such as the Global Warming Policy Foundation in London and the Competitiveness Enterprise Institute in Washington, DC, are highlighting the misuse of RCP8.5 to call into question the quality and legitimacy of climate science and assessments as a whole. But unlike many attacks on climate science, in this case these organizations have a good point.

Implausible climate scenarios are also introducing error and bias into actual policy and business decisions today. For example, the US government derives its social cost of carbon estimates, which it uses for cost-benefit analysis of federal regulations, from the IPCC scenarios. The financial sector also customizes IPCC scenarios for its use. The emerging market for climate scenario products has led to a $40 billion “climate intelligence” industry, involving familiar companies such as Swiss Re and McKinsey, and start-ups such as Jupiter Intelligence and Cervest. These companies are using implausible RCP scenarios to develop various predictive products that they sell to governments and industry, who will depend on these products to help guide policy and business decisions in the future. 

Good science works to bring society the best possible images of the real world. The emissions scenarios of today’s climate science are delivering distorted pictures that compromise both understanding and well-informed policymaking. Until the climate science community addresses this fundamental problem of scientific integrity, its potential to contribute to pragmatic solutions for the vexing, extraordinarily difficult challenge of climate change will be unnecessarily compromised. Climate change has been solved countless times in fanciful models, but it is the real world that matters.

Lost touch with reality – SickNotWeak

Disclaimer: SickNotWeak does not provide medical advice, diagnosis or treatment. This content contains explicit and sensitive information that may not be suitable for all ages.

My story with mental illness began in March 2010. I was completing my final year undergraduate research project at a local university. I was preparing my final presentation for my project. I began to not eat properly, not sleep and had increased stress levels. I was spending most of my time at the campus doing long hours and then continuing my work when I got home. As well, I was volunteering with a local organization and I began to have symptoms, but at that point I had lost touch with reality but did not know that I was. 

My undergraduate supervisor called me one day, and I said something concerning and she ended up calling the ambulance which came to my place and took me to the local hospital. I ended up being hospitalized for two months on a psychiatric ward. I underwent many tests as the doctors were unsure what exactly was going on with me. I don’t recall a lot of my exact thoughts while I was in hospitalized, however, I do remember not understanding why I was there. I thought everything was going fine with me. 

at that point I had lost touch with reality

During my stay, I was told that I was going through a psychotic episode. I was started on medication. My health care team, family and supervisor suggested that I go home to my parents to recover. I felt anger and frustration as I had worked so hard during my undergrad and final year to achieve my degree. I was told that due health conditions, and my marks up until the point I got sick, that I had passed my courses prior to writing final exams for that semester which resulted in me having enough credits to receive my degree! I was so excited and proud of myself. However, I was also disappointed how I ended up completing my degree. The psychiatrist agreed that I could attend my convocation and was discharged a week or so after.  I still had thoughts of pursuing my Master of Science, but because of my illness, I put that on hold until January 2011. 

When I was home that summer, I still was not feeling 100 per cent. I had residual symptoms and did not feel quite like myself for some time. Every night I would go to bed questioning myself and my ability to do daily tasks. When I went back to the campus to study again, it didn’t feel the same and I felt ‘out of place’. Eventually, I began to have depressive and anxiety symptoms and was started on an antidepressant and an anti-anxiety medication. I tried to stick with the master’s program for six months however, I just couldn’t get comfortable in my own head and environment. I was working with a social worker at that time and he reframed my thoughts of “quitting the program” to “leaving the program.”

This reframing helped me a lot in making my decision to leave the program less difficult. Although, it was one of the hardest decisions I made thus far in my life.

When I left the master’s program though, I still felt like I did not complete my goal of pursuing further education. I took some time (a couple of years) to look for jobs with my bachelor’s degree, however, nothing was coming up-few interviews and no offers. I was feeling frustrated again. I began to research other two- to three-year programs at the local college which was different from the college I completed my bachelor’s degree at. I applied and was accepted into a program and graduated from the program two years later (2015), after a move to a different city in the middle of the program. I achieved this diploma with a lot of support from health care professionals, family, and friends.

Work-life balance is very important to my routine

I completed my final placement during my diploma in acute care mental health. I chose this because of my own experience in the mental health system. During my final placement, I applied for a job and went through the interview process, and I ended up being one of the successful candidates. I am still currently working with this organization and became a permanent staff in January 2019. 

Some of my coping strategies during my struggles with my mental illness included exercise, social support time with friends and family, and eating nutritious food most of the time. Work-life balance is very important to my routine too. Adhering to my medication regime and following up with my mental health team was useful in preventing relapse during the past 10 years.

Overall, I would say I’m in a good environment and headspace. COVID-19 is taking a toll on my mental health right now but trying to do things that I have control of including previously mentioned exercise, nutrition, and good sleep patterns. 

How did this story make you feel?

Losing Touch With Reality – A GameStop Lesson

The GameStop stock craze highlights the looming impact that bots can potentially make.

NurPhoto via Getty Images

Before long, the saga of the GameStop run of 2021 will be studied in economics and investment classes. If you were off grid for the last month, and are not up to date on this story, there are hundreds of articles out there that describe the circumstance of how small retail investors got together on a little known internet forum called “wallstreetbets” and ultimately drove interest and pricing on GameStop’s public stock to unexpected highs. The GameStop stock (Stock Symbol: GME) ended last year near $18 a share but soared as high as $483 in late January 2021. After falling back and trading below $40, the stock then jumped back up in a “Round 2” ramp—along with other popular stocks targeted on Reddit—to $194.50 as of this writing. 

Many at Wall Street hedge funds were caught in short selling positions, having to cover the differences in prices between the low price they bet on in their “put” options, and the actual price as their options were set to expire. This forced the hand of the hedge funds involved to “cover” their short bets, and purchase the stock at very high prices. One of the hedge funds, Melvin Capital, lost 53% of its value, and had to receive an emergency cash infusion of $2.75 billion. Needless to say, these activities cost these hedge funds billions of dollars as the damage reports and aftermath are still coming in. In a recent article “Warnings For Tech Giants And An Ode To A Simpler Web,” I called out the ongoing threat of bots and lack of authenticity that is pervasive across platforms such as social networks and forums such as Reddit, Twitter, Facebook, etc. This is an identity and integrity problem that has the potential to cause untold damage in addition to posing an experience issue.

David vs. Goliath? 

The GameStop episode has been labeled as a showdown between Wall Street and Main Street. Events played out on the Reddit forum wallstreetbets in a way that corresponded with massive surges of activity, leading many to believe that automated “bots,”  or “pretend users,” helped exacerbate the conditions that ran up the price. The roots of these circumstances within the forum dated back to the middle of 2020, when interest in GameStop investment began to gather momentum. 

Major investment firms followed the track of publicizing the expectations that the stock would soon be worthless, in a story similar to Blockbuster Video. Typically, this is something they can make true through the presence of investment movement and the open positions that occur when this happens. When the short sales options became due and the price did not match expectations, the hedge funds who expected to win lost big.

Before long, “Big Tech” intervened with a heavy hand as it has been doing lately, shutting down forums and conversations in places where they popped up. Trading firms, such RobinHood, E*Trade, and others even stopped and curtailed trading in the stock. This saga rose to such prominence, that culminated with hearings in front of Congress.  However, those hearings were a late damage control response attempt that neglects a major issue affecting the majority of experiences on the web nowadays, which is lack of authenticity. Congress, along with “Big Tech,” still missed that point for whatever reason.

An Inauthentic Web and an Authentic Answer

The openness of the social media platforms to malfeasance is a persistent issue. It is difficult to ascertain safety and authenticity when engagements on many platforms are completely anonymous and unauthenticated. Who is a friend? Who is a foe? Or the equally important question—who is a bot and part of a bot farm in an effort to manipulate results? Bot farms exist, and are sponsored not only by criminal enterprises but also by state-actors.

Bots and bot-based activity are a significant threat to not only the personal privacy and security of the average person, but also the valuation of well-known companies like GameStop, AMC, BlackBerry, etc. The public is engaged in a virtual congregation and exchange of information that could literally be anybody, from anywhere or any automated program. These bots open the door to threats that include:

• State-sponsored economic terror
• Foreign intelligence gathering
• Economic and political influence
• Fraud
• Cybercriminal activity
• Market manipulation
• Narrative shaping

As a population, we have a pretty good handle on malicious email activities, but bot activity must be brought into check now  especially in online forums and social media. There seems to be a lack of will by companies like Facebook, Twitter, and Reddit to do so.  With a lack of measures to assure a genuine base of users, trolls and opportunists will leverage any crack possible to jump into the stream and corrupt conversations to their needs. Every account should be validated and traced to an actual individual and in obvious cases, an actual business or organization. What we are seeing is the product of nothing but purposeful neglect and a gap in the mission of what online interactions were built for. 

It is time to gather around the principles of “who” these platforms are for. Are online forums designed around the experience of having shapeless, anonymous bots consuming online engagements? Can the same be said for social networks? Do you have any idea who is behind the public comments that drop into your Twitter posts? Many people think they do, but the simple fact is that we engage in a virtual world where there is little validation and the experiences we engage in may not be human or genuine in nature. 

Where There is a Will, There is Sanity

The GameStop situation clearly illustrated that major networks and forums should be regarded as potential risk points. Every one of these risk points should be contextualized in terms of impact and the effort required to ensure a genuine experience and open exchange of ideas. Various technologies can help the effort towards a genuine web. For example, multi-factor authentication, account validation, biometrics, preemptive security monitoring, and other leading technologies provide ways to do this on financial websites. It would only take the will of the social media  giants (with the help of technology) to improve the experiences and impact of these public meeting places in a positive manner. Authentication will bring authenticity to our conversation. Authenticity will bring accountability. Accountability will bring sanity.

90,000 Depersonalization: a syndrome that interferes with feeling – BBC News Russian Service

• Adam Eley
• BBC

September 28, 2017

Photo caption,

Sarah says that because of her illness, familiar places seem decorations

For people with depersonalization syndrome, the world seems unreal, two-dimensional, as if in a fog. One in every hundred suffers from this disorder, but despite this, British doctors are not taught to work with such patients, experts say.

“The connections that you consider valuable lose their original meaning. You know that you love your family. -bi-si.

Sarah is an actress, she constantly tries on various images and reproduces other people’s emotions. But in reality, for most of her adult life, she is emotionally paralyzed and unable to experience any feelings.

The reason for this is a poorly understood mental disorder called depersonalization.

Sarah’s syndrome manifested itself three times. This happened for the first time when she was preparing for her final exams.

The main sign of depersonalization is the feeling that a person is losing physical connection with the world around him and his own body.

It is believed that this is how the defense mechanism manifests itself when, during stress or serious shock, the consciousness is disconnected from reality. Some drugs, such as marijuana, can have the same effect.

For people with depersonalization syndrome, the world can change in a second.

“It was an unexpected switch. Everything around seemed alien and even frightening. Suddenly the apartment and other places where you are used to being become a set for you, and all your things are decorations,” says Sarah.

Other patients report the feeling that they are outside their body, that it does not belong to them, and the world around it seems two-dimensional and flat.

This happened to Sarah during the second episode.

“I was reading, there was a book in my hands.And suddenly my hands began to look like a picture with two hands drawn. There was a feeling that the real world and my perception of it did not match. “

The disorder that Sarah suffers from is not uncommon. Three independent studies have shown that it occurs in one person in a hundred.

Experts say that the disorder has long been recognized as a medical It is as common as obsessive-compulsive disorder or schizophrenia

Some untreated patients may suffer from depersonalization symptoms for life.And, nevertheless, not all doctors know what it is.

The doctor, who recently completed his studies and suffers from the disorder himself, stated that depersonalization was not taught either in medical school or in refresher courses for therapists.

He admitted that he himself at least twice misdiagnosed his patients. According to him, he will be very surprised if it turns out that at least one of his colleagues has heard about this syndrome.

Sarah says that in her life she encountered at least 20 professionals who had no idea what she was talking about.These include counselors, therapists, community psychiatrists and doctors.

The Royal College of General Practitioners (RCGP) in London stated that mental health was a key element of advanced physician training.

The institute added that the study of more complex psychological problems is still in development.

The Royal College of Psychiatry emphasized the need to ensure that these disorders are properly studied.

Photo caption,

Dr. Elaine Hunter runs the only specialist center in the UK for depersonalized patients

Poor diagnosis is only part of the problem, access to treatment is another challenge.

There is only one specialist clinic in the UK. Its resources are limited, with only 80 patients a year being admitted there. Given that 650 thousand people can potentially suffer from this disease.

A referral from your GP is required to access this health center free of charge. And even if the patient is diagnosed with depersonalization, treatment will have to wait several months or longer.

After a year of waiting in line, Sarah decided that the only way out was to pay for the treatment herself.

“I had panic attacks all the time. It’s really scary. I knew it was a crisis,” she says.

Adults only

Specialized Center for Patients with Depersonalization Syndrome operates at Maudsley Hospital in south London. However, for patients under 18 years of age there are restrictions; the center only deals with the treatment of adults.

It is often during adolescence that the disease occurs. Dr. Elaine Hunter, who runs the center, is concerned that she has to refuse to help children and adolescents.

“Sometimes deeply depressed and frightened 15-year-old patients come to us, but we have nothing to offer them,” she says.

One of the adult patients of the center developed the syndrome at the age of 13. For two years she could not leave the house, she experienced ten panic attacks a day due to the disorder.

At the beginning of treatment, she did not even recognize her own parents.

Dr. Hunter hopes that over time, the right treatment will be available to underage patients as well.

She believes that treatment needs to be organized in every district. Doctors at local psychological care centers should undergo special training, then disseminate information to other professionals.

Photo caption,

Sarah Ashley was unable to eat or sleep until she was treated by Dr. Hunter

Hunter developed cognitive behavioral therapy (CBT) specifically for patients with depersonalization. She believes that she can easily be mastered by doctors who already have experience in conversational psychotherapy.

Sarah Ashley, a patient of Dr. Hunter, says she was skeptical at first about this technique, but after a while she felt a huge difference.

“[Before CBT] I looked at my own hands or other parts of my body and it seemed to me that they were not mine. I looked at myself in the mirror and did not realize that it was me,” explains Sarah.

“I could not eat and sleep, due to stress I lost up to 42 kg. Now I still have some symptoms, but I can quickly deal with them,” she continues.

There is treatment, but it is difficult to get it.

According to Dr. Hunter, it is necessary to correct the situation in which patients are forced to look for information about their disorder on the Internet, and then explain to the doctor what it is about. Instead of, on the contrary, the doctor told the patient about his illness.

What is depersonalization and how to live with it

Impaired self-perception, feeling unreality of what is happening, anxiety attacks, panic attacks and loss of emotions – these are the symptoms of depersonalization disorder, which is often confused with schizophrenia.Afisha Daily publishes three stories of people with this terrible diagnosis.

Tatiana, 28 years old: “For the first time I came across a feeling of unreality of what was happening when I was 22 years old. Once I just stopped feeling any emotions; my relatives suddenly became strangers, I did not want to communicate with anyone, go anywhere. I did not feel myself – the personality was erased, and I became a different person: the feeling that the soul is no longer there, only one shell.This was accompanied by constant anxiety, self-examination, headaches, and a feeling of hopelessness. This is a terrible state where suicide seems like the only way to end everything.

I was very scared and urgently called my mother, since I myself could not even go to the doctor. A neurologist at the hospital said I was depressed and prescribed a cocktail of antidepressants and antipsychotics. Surprisingly, almost from the first days of taking the pills, I returned to life: the symptoms disappeared, my mood improved, my ability to work increased, I became sociable and open.A month later, I stopped taking these drugs and did not go to the doctor again (although I was warned not to give up drugs). For four years, I forgot about the problems.

Symptoms returned when a relative offered me a new job. There were quite high requirements for employees – the obligatory presence of a driver’s license, specialized education in the field of shipping and fluent English. I was given six months to prepare. A relative paid for all the courses, the university – and then the stress began.I felt that I was covering, so I voluntarily returned to the pills. It got a little easier for a while. I tried with the last bit of strength not to hit my face in the mud, to get this job, not to let down the person who believed in me and also spent money. But I got worse and worse, and I failed the job interview. It was a very difficult period.

After that, I began to sit on forums, google articles about mental disorders with similar symptoms. There were thoughts that I had schizophrenia and that I was completely derailed.I started to run on psychiatrists, but all polls denied my suspicions. Depression was re-diagnosed, antidepressants were prescribed – anxiety receded a little, but emotions and feelings never returned.

Once on a website I saw a description of a diagnosis that exactly matched my symptoms. Then my acquaintance with the disorder of depersonalization-derealization began. I went to the doctors, but they basically did not know what it was and how to treat it. Sometimes they just didn’t want to listen to me – they immediately prescribed medication and sent me home.One professor said that it was me “who read a lot on the Internet.” I found my salvation in online consultations with a doctor who dealt with dereal: according to his scheme, I began to take antidepressants and antiepileptic drugs.

The reason for my depersonalization is neurosis, which is accompanied by anxiety: during stress, the body defends itself and the brain seems to shut down, isolation from the outside world occurs. This happens to impressionable people who are worried about any reason, take everything to heart.I’m one of those.

Topic details

How to live with bipolar disorder

How to live with bipolar disorder

My experience is 2.5 years. I know that there may be deterioration, but there is a way out. Now I have entered the stage when a new job is a joy, I again feel myself, mental abilities, emotions and feelings as before the illness. And even though I’m still on pills, it’s better than suffering again. Hopefully someday it will be possible to cancel them.It sounds strange, but this disease changed me for the better. Thanks to her, I really began to appreciate the life and loved ones. I became more patient. I am glad that I can live a normal life again, feel, love, enjoy communicating with people and my favorite activities.

Our society is very contemptuous of those in need of psychological help. If they find out that a person has been to a psychiatrist, they are immediately branded a psycho and shunned. Nevertheless, you should not be afraid to seek qualified help, the main thing in this matter is to find a really good doctor.And there are very few of them. ”

Nikolay, 27 years old: “I have been neurotic since childhood: stuttering, obsessive-compulsive disorder (obsessive-compulsive disorder). In August 2014, I went to a psychiatrist with depression and impaired perception of reality, I was then 25 years old. It all started with rare panic attacks, which were followed by attacks of severe derealization. The world turned upside down, and I had to lie down on the floor and close my eyes, it helped to come to my senses. After another such attack, I became anxious.

Exactly 6 months I kicked in search of and inventing physical ailments to justify my condition. It is difficult to admit to yourself that you are a little “peek”, and this is how hypochondria appears. The catalyst for hypochondria is such an unpleasant reality as unqualified medicine. The inertia coming from the USSR still persists – doctors make a diagnosis of “VSD” (which has not been in the world classification of diseases for a long time), say that everything is in order, prescribe vitamins and send home.Therefore, I had to engage in self-diagnostics and be terribly afraid of what was really wrong with me. Unfortunately, I made the diagnosis of “depersonalization disorder” myself, once again surfing the Internet. Through my acquaintances, I managed to go to a neuropsychiatric dispensary. There I was pumped with the same Soviet drugs, put on droppers, there was even a massage and a circular shower. At discharge, there were no significant results: it became easier to sleep, but the condition remained the same painful.

Depersonalization is, in the usual sense of the word, the loss of oneself; when you can’t understand what kind of person you are

Finally, miraculously, I managed to get to a good psychiatrist. Well-chosen drugs have built a solid foundation for my recovery. Now pharmacology has reached such a level that drugs work reliably with a minimum of side effects and consequences for the body.Of course, they do not eliminate psychological problems, but they provide a runway to climb to a height where these problems could be eliminated. The antidepressant began to take effect approximately 3-4 weeks after the start of the drug. The mood improved, strength appeared, life began to bring pleasure. Then little by little: communication with friends began to be restored, I began to go out, my libido and a desire to do something woke up. I have recovered at work: when reaching the toilet is a huge challenge, work becomes something unbearable.

Depersonalization is, in the usual sense, the loss of oneself; when you can’t understand what kind of person you are. Recovery after this leads to a rethinking of life attitudes. For example, in the past I limited myself, tried to conform to the ideas dictated by society. He lived according to the principle “as it should”, and not “as I want”. During this period, understanding of your person is lost: who are you? why are you who are you supposed to be? You are depersonalizing. At the turning point of frustration, you understand that you need to live for yourself, and not for others, you stop constantly looking for flaws and fix them in order to become someone.I accepted myself. ”

Anastasia, 20 years old: “At school I was often bullied because of my excess weight, no one took me seriously at home, there were constant screams and scandals due to my father’s alcohol addiction. At the age of 15, I decided to try drugs and, not knowing the “correct dosages”, I took too much at one time. After that, my health sharply worsened: short-term panic attacks began, heart palpitations, unsteadiness of gait, dizziness appeared. At first I thought I had something with my heart or blood vessels; over time, this grew into a fear of a heart attack, stroke or sudden death.Then there was an examination of the whole organism, but nothing concrete was found out: the doctors either did not find anything, or diagnosed vegetative-vascular dystonia. One doctor advised me to get tested for cancer.

Over time, the situation has progressed. There was an eerie feeling inside like anxiety: I could not sleep normally, it seemed that I would die any minute. One day I realized that I do not feel my body. A feeling of lightness and weightlessness appeared at the same time, and then I began to catch myself thinking that I was as if not.The sensations in my hands were not mine, the reflection in the mirror was not right. Then I realized that I was not facing a heart attack, but schizophrenia. I completely surrendered to this fear: the physical symptoms disappeared, there was an indescribable horror that now I would lose touch with reality and control over myself. I began to hide the handle from the balcony, so that in a fit of unconsciousness I would not suddenly throw out the window. The world as I knew it was blown to smithereens. Going out into the street, I realized that there was a big barrier between me and reality. The world behind the glass seemed flat, colorless, dead.I could not understand if it was a dream or reality, or maybe I died altogether. Time just stopped, it was not there, it was not for me. And in the soul there is emptiness, silence and no emotions.

Topic details

What are panic attacks and how to get rid of them

What are panic attacks and how to get rid of them

The fact that this is not schizophrenia at all, I learned on the site about dissociative disorder. So a new stage began.On VKontakte, I found a group about dereal, where there were hundreds of people like me. For about a week I sat in the community, reading information, personal stories and recommendations, until I fully realized that this is it – depersonalization-derealization disorder.

In the 11th grade, everything got to the point that I was picked up from the exam by ambulance. When I went to the doctor, he started asking something, and I was silent: I was so tired of this shit that I could not say a word. My parents learned that I have serious mental problems.It seemed to me that my mother did not understand me. I was again taken to the doctors, but we failed to find a sensible specialist. In Soviet-era hospitals, doctors with depersonalization are not at all familiar: in one of these they prescribed me 12 dubious pills a day, and also glycine – it is completely useless for my symptoms. There were doctors who were more interested in my outlook on life than my health.

As a result, I found my psychiatrist, with whom we keep in touch now, through my mother’s acquaintance.If we talk about treatment, then you cannot do without antidepressants. They help to return to the previous regime and significantly improve the condition. Now I am 20, and I am still on pills: I decided that it is better to feel good with them than to think about suicide every day. ”

Expert opinion

Artem Kostyuzhev

“At the heart of the depersonalization-derealization syndrome lies the attempt of the psyche to adapt to stress in conditions of its high intensity, for example, during fear or panic.This syndrome, as a separate disorder, is included in the International Classification of Diseases (ICD-10), but it often occurs as a secondary syndrome in severe anxiety, depression and other acute conditions. Depersonalization and derealization, although they are combined into one term due to their similarity and common nature, represent two independent symptoms that can manifest themselves separately from each other. With depersonalization, the patient seems to be unfamiliar with his own face, figure, smile, speech, as if observing yourself as a stranger.Derealization concerns the perception of the environment: place, time, circumstances, etc. Sometimes the feeling of “drunkenness”, “unreality” and “floating picture” is added.

The main reason for DP / DR lies in the activation of opiate receptors – there is an assumption that in this way the human body is trying to reduce severe anxiety. Stress can be a reason if it was intense and caused a vegetative crisis (like a panic attack).

Feelings during depersonalization-derealization are frightening in their unusualness.It seems to the patient that he has lost control of his own body, and this in itself provokes an even stronger fear. This differs from schizophrenia primarily in the absence of symptoms of psychosis (hallucinations, delirium, catatonia, etc.). Also, DP / DR syndrome can be observed in acute psychotic episodes, but then there must be corresponding mandatory symptoms of severe mental illness.

With all its prevalence, this diagnosis is not fully understood in terms of mechanisms and origin, which leads to difficulties in therapy.In the United States, the disorder is treated primarily with antidepressants and lamotrigine. In Russia, there is no clear standard and recommendations: with DP / DR, they often look for the “main disorder”, hoping that the syndrome will recede on its own. Often, depersonalization or derealization quickly resolves if it occurs in the structure of panic or other anxiety disorder, but it can take years to treat these disorders in depression and bipolar disorder. ”

90,000 “I’m not sure if Putin has kept in touch with reality.”10 quotes from Merkel about Russia

Decision of the Federal Service for Supervision of Communications, Information Technology and Mass Media (Roskomnadzor) of November 27, 2020 EL No. FS 77-79546

Founder: JSC “Business News Media”

And about. Editor-in-Chief: Kazmina Irina Sergeevna

Advertising and information supplement to the Vedomosti newspaper. Registered by the Federal Service for Supervision of Communications, Information Technology and Mass Media (Roskomnadzor) under number PI No. FS 77 – 77720 dated January 17, 2020.

Any use of materials is allowed only if

the rules of reprinting and in the presence of a hyperlink to vedomosti.ru

News, analytics, forecasts and other materials presented on this site do not constitute an offer or recommendation to buy or sell any assets.

The site uses IP addresses, cookies and geolocation data of Site Users, the terms of use are contained in

Personal data protection policy

All rights reserved © Business News Media JSC, 1999—2021

Any use of materials is allowed only if the

the rules of reprinting and in the presence of a hyperlink to vedomosti.ru

News, analytics, forecasts and other materials presented on this site do not constitute an offer or recommendation to buy or sell any assets.

All rights reserved © Business News Media JSC, 1999—2021

Decision of the Federal Service for Supervision of Communications, Information Technology and Mass Media (Roskomnadzor) of November 27, 2020 EL No. FS 77-79546

Founder: JSC “Business News Media”

AND.O. Editor-in-Chief: Kazmina Irina Sergeevna

Advertising and information supplement to the Vedomosti newspaper. Registered by the Federal Service for Supervision of Communications, Information Technology and Mass Media (Roskomnadzor) under number PI No. FS 77 – 77720 dated January 17, 2020.

The site uses IP addresses, cookies and geolocation data of Site Users, the terms of use are contained in

Personal data protection policy

Russia tries to pretend to be a victim

It looks like a parody: Russia every time speaks about itself and the West in the terms in which Ukraine speaks about itself and Russia.But the peculiarity is that Kiev has the right to speak like that, while Moscow does not.

On the topic “The Kremlin’s hand” as a universal indulgence: what threatens the constant search for the culprit

What the Russian media tell about Ukraine

“Hybrid war against our country”, “attempts to destroy our sovereignty”, “a neighboring country that is slipping into terror “- it seems to us that all this is from the lexicon of the Ukrainian media, but no. These are words from the lexicon of Russian media. They talk to their readers as if 7 years ago the Ukrainian army annexed Taganrog, surrounded Rostov and is trying to seize the Kuban.

An incident in Crimea, where Russian security officials detained a Ukrainian pensioner, accusing him of spying on Ukrainian intelligence – after all, he was also from there, from the battle for the right to be considered a victim.

In the interpretation of the Russian media, it is Ukraine that is the tip of the Western spear, which is looking for holes in the Russian defense over and over again. And this all once again proves how different pictures of reality have formed on both sides of the border.

There is no Russian army in Donbas on the Russian agenda.There were no captured GRU special forces, Aleksandrov and Erofeev. There was no Russian ammunition that Ukrainian soldiers find on the territory liberated from the militants. There was no Russian citizenship of Motorola and Buryat tankers.

Yevgeny Erofeev and Alexander Alexandrov / Collage 24 channel

But there are Ukrainian pensioners who collect intelligence about the Black Sea Fleet in Crimea. If you look at it, this is nothing new. Any authoritarian regime at all times tries to pretend to be weak – no matter how strong in reality it may be.

Pay attention The effect of the theft of Crimea has disappeared, or When to expect a new annexation from Putin

And that is why Mao Zedong in China addressed the red guards with a message that the power was seized by bureaucrats and only on them – young people with a warm heart and clean hands – all hope. And the Soviet Union, expelling Brodsky, felt itself not as a Leviathan devouring the poet, but as an uncompromising island of truth opposing the world of cash and profit. And the Union of Writers of the USSR in this scheme was a kind of brave minority opposing the world hydra, whose heads bore the names of Akhmatova and Mandelstam.

Putin has lost touch with reality

At times it seems that the Russian vertical has become a hostage to the reality it has constructed. That she not only broadcasts it, but also sincerely believes.

• Believes in an anti-Russian conspiracy along the borders.
• The voluntary nature of the emergence of “quasi-republics” in the Ukrainian Donbass.
• The fact that the doping scandal with the Russian Olympians was the result of a conspiracy between Washington and Brussels, and not the result of manipulations by their own special services, replacing urine tubes.

A kind of effect of a sagittered agitator. Nothing new. And now Russia is spinning a story about the aggression of Ukraine , which recruits pensioners in Crimea for espionage. The same Ukraine, which for the last 7 years has only been trying to defend itself from the empire so that the terrorist hole does not spread to the borders of Kharkov and Zaporozhye.

In 2014, Angela Merkel said that Vladimir Putin had lost touch with reality.

90,000 Trapped in luxury: how the stars lost touch with reality

The self-isolation regime has put many show business stars in jeopardy: they are increasingly accused of not understanding people’s real problems.By encouraging them to stay home by example, celebrities demonstrate wealth, and their complaints about life are perceived as infatility. Gazeta.Ru is about how the stars are losing popularity due to the coronavirus.

The famous American TV presenter Ellen DeGeneres, who is usually praised for her great sense of humor, offended subscribers of social networks with an inappropriate joke about self-isolation. On Tuesday, April 7, she posted on Instagram a recording of her talk show, created at home – her wife Portia de Rossi acted as a cameraman and director of the program.

In a recording made in a mansion in Montecito, California, Ellen DeGeneres compared self-isolation to imprisonment. “It’s like being in jail, that’s what. Mainly because I have been wearing the same clothes for ten days now and there are only gays here, ”said the TV presenter.

The gay joke could be regarded as simply tasteless, but the problem was exacerbated by the fact that the TV presenter and her life companion are self-isolating in a $ 27 million mansion on a hill – with ten bathrooms and five bedrooms, a gym, an overgrown courtyard with greenery. pool, huge veranda and stunning views.Therefore, Ellen DeGeneres’ subscribers did not appreciate the comparison with the prison. “I am signing up to send her to a real prison when the quarantine is lifted,” said one of the comments. “Only for a month or so, maybe then she will understand something.” After that, Ellen DeGeneres silently deleted her post.

Since the number of people infected with COVID-19 in the United States skyrocketed in mid-March and the authorities began to urge people to isolate themselves, show business stars have repeatedly outraged their behavior on social networks – they demonstrate their privileged position by doing tests for coronavirus, without having symptoms, and filming videos in their mansions, which now everyone can compare with their own living conditions.By recording videos in the bathrooms, showing themselves shaggy and in home clothes, demonstrating their simple entertainment and trying to console the audience with the performance of John Lennon’s song Imagine, like Gal Gadot and others, they, like never before, give the public access to their homes and introduce them to their way of life, unwittingly emphasizing their wealth.

The stars are trying to prove that they are in the same situation as everyone else – but people are drawing the opposite conclusions.

On Wednesday, April 8, subscribers of social networks accused Jennifer Lopez and her fiancé, baseball player Alex Rodriguez, of hypocrisy.They posted a video calling for self-isolation and support for the authorities in the fight against the coronavirus epidemic – but people did not forget that a week earlier, the Page Six portal published a photo of paparazzi, capturing a couple leaving a fitness center in Miami, which opened for the two of them. “The gym is closed,” reads the sign on the photo. “Stay home, stay safe.”

After posting a video urging Americans to stay home, the couple took part in the #IStayHomeFor flash mob launched by New York Governor Andrew Cuomo.“We stay at home to protect those on the front lines,” said the caption to the video for J. Lo and Alex Rod. “This comes from people who still have a gym open so they can work out alone,” they replied on social networks. “Like you do it.”

Tension is growing in social networks – people are annoyed with Madonna’s strange videos from the bathroom or Justin Bieber’s attempt to have fun playing the children’s game “Floor is lava” and jumping on sofas, chairs and ottomans in the living room.Not every American has a bathtub – and the room that Bieber is galloping through will fit several living rooms of ordinary people.

“I’m not interested in what the stars are doing in their mansions”, “It’s funny how the stars are out of work when we have real problems,” such voices are heard in social networks more and more often.

“Big Hollywood people will be cut to pieces, especially if they keep posting on Instagram“ Oh my God, I’m so bored. I drink martinis in my own pool, ”predicts Akshaya Srinivasan, an SMM strategy expert at A&M University Business School in Texas, in an interview with The Associated Press.In her opinion, stars who do not treat the problems of ordinary people inattentively risk losing subscribers, which will further affect their income due to the loss of popularity with the public. “They need to do something to protect their brand,” the specialist explains.

90,000 9 films questioning our reality – What to see

Several pictures, each of which has its own interesting concepts of our reality. Overly impressionable and suggestible viewing should be careful not to take everything too personally.

Mandela effect

The Mandela Effect, 2019

In the lives of Brendan and Claire, the worst possible tragedy happened – they lost their only daughter, drowned in the sea. A few months later, while sorting through his daughter’s belongings, he noticed a little oddity: the book of fairy tales about bears, read many times, is called quite differently from what he had previously believed. Then new and new inconsistencies between reality and memory of it began to come across his eyes.

Draft

2018

The hero of “Draft”, the designer of computer games Kirill, suddenly discovers that he has been deleted from life. His friends and family do not recognize him, he has no passport, and his personality, respectively. As it turns out, his vocation is not to live a boring philistine fate, but to be a customs officer between parallel worlds.

In this honorary post, he learns a lot of things that mere mortals are not supposed to know.

Matrix

The Matrix, 1999

If Neo was not so curious, we would not even know what is really going on in the world. It looks good, people are decently dressed, but in reality they are all naked with pipes in the inlets and outlets. And reality is a dream.

Extremely dangerous

Wanted, 2008

The story that one simple loser somewhere deep inside is the coolest killer, you just need to reveal his abilities with grueling training and Angelina Jolie, well, and show him a little of the truth that allows him to manage the laws of physics as he pleases.

Start

Inception, 2010

The boundaries between sleep and reality are blurred, you can do everything, but does it matter if you don’t understand which of the worlds you are in? However, it all starts with a rather elegant robbery, carried out in the subconscious of one influential person.

Brazil

Brazil, 1985

Sam Lowry lives in a society of total bureaucracy, and in general he is satisfied with everything.But one day he meets the girl from his dreams. Unfortunately, Jill is doomed, as she had the carelessness to write a letter about a mistake made by the bureaucratic system. And the system prefers to correct mistakes by removing people.

Thirteenth floor

The Thirteenth Floor, 1999

The development team has created a perfect model of virtual reality, in which you can go for walks and not feel the slightest trick.However, this amazing achievement entails the mysterious assassination of the head of the company, and all the answers are hidden there – in unreality.

Doctor Strange

Doctor Strange, 2016

Successful neurosurgeon Stefan Vincent, having got into a car accident, loses what he valued more than anything else – his favorite job. Having lost the meaning of life, the hero embarks on an incredible journey in order to fix everything.As a result, he discovers amazing abilities in himself, and in the world around him – amazing plasticity.

Eternal Sunshine of the Spotless Mind

Eternal Sunshine of the Spotless Mind, 2004

The real world is created primarily in our brain, and what we see and are aware of depends on how neurons interpret external signals. But what if you remove a loved one from your memory, as if he never existed? It’s like hiding from danger by covering your face with your palms.However, this is exactly what the protagonist tries to do when he erases his ex-girlfriend from his memory.

November 9, 2020

Found a mistake? Select the fragment and press Ctrl + Enter.

Sovereign. End – Newspaper Kommersant No. 241 (6962) dated 12/30/2020

In 2020, Alexander Lukashenko turned into a visual aid about what happens to a leader who has lost touch with reality. His decision to rule for another five years blew up Belarus, and now numerous dissenters are forcefully convinced that he is president.Mr. Lukashenko has created problems not only for himself, but also for Russia.

His lovely

“Don’t give your beloved!” – this is how Alexander Lukashenko finished his address to the Belarusian people on August 4, five days before the presidential elections. “Favorite” is Belarus, which Mr. Lukashenko has ruled since the end of the last century. He spared no compliments for her: “Pure and bright, honest and beautiful, hardworking, a little naive and a little vulnerable.” He does not know any other such country, and the country has not known another president since 1994.

The authorities tried to ensure that even after the vote, the “beloved” did not go to any of those who sought her favor. Two prominent opponents of Mr. Lukashenko – the rebel blogger Sergei Tikhanovsky and the increasingly popular ex-banker Viktor Babariko – were taken into custody in advance. Valery Tsepkalo, who also criticized the president, was not allowed to go to the elections.

The violent reaction of the Belarusians to the arrests showed that many people were tired of the irremovability of Alyaksandr Lukashenka. It is difficult to say exactly how many: there is no independent sociology in Belarus, and rating research not controlled by the state is, in fact, banned.The latter played against the authorities.

There was nothing to oppose to the myth that Mr. Lukashenko is supported by no more than three percent of the population. The humiliating meme “Sasha 3%” went to the people, in the form of graffiti decorating fences, bus stops, walls of houses and asphalt on Minsk roads. Professional sociologists, like Andrei Vardomatsky, who had to move from Belarus to Poland, told Kommersant that the president’s rating was higher. But it didn’t matter.

The society that quietly tolerated Alexander Lukashenko woke up and began to move not only because of fatigue from the long-lived president.The authorities, which ignored the coronavirus, first frightened citizens with the lack of a policy regarding COVID-19 and support for the people, and then began, in principle, to enrage.

Of all the representatives of the non-systemic opposition, Svetlana, the spouse of the blogger Tikhanovsky, was admitted condescendingly, as if in mockery, to the elections. The then unknown housewife looked faded, shunned publicity and did not hide the fact that she was busy with her own business. In case of victory, Svetlana Tikhanovskaya promised to release the arrested politicians from the pre-trial detention center and hold new elections with their participation.Her entire electoral program consisted of this proposal. Apparently, it was decided that experienced Alexander Lukashenko would easily swallow an opponent with such data.

But it turned out that not in 2020 in Belarus.

Winner gets riot

Svetlana Tikhanovskaya, supported by the coordinator of Victor Babariko’s headquarters Maria Kolesnikova and Valery Tsepkalo’s wife Veronika, became a star of Belarusian politics in less than a month. The women’s opposition trio toured the country, gathering tens of thousands of fans and turning into a tangible danger.There was nothing to be done with them. Attacks on the three smiling women did not work or turned against the attacker.

But Alexander Lukashenko promised not to give up his beloved Belarus to anyone and kept his word. After the elections on August 9, the scoreboard of the Central Election Commission showed the result: the current president defeated his rival with a devastating score of 80.10% against 10.12%. The dissenters filled the streets of Minsk, where riot police met them with shots and flashbangs.

Diplomats from Russia and the embassies of Western countries working in Belarus told Kommersant that Mr. Lukashenko’s entourage allegedly expressed the idea of ​​organizing elections with a different result – also in his favor, but not 80% and not so far from Svetlana Tikhanovskaya.But the thought did not find support. Speaker of the upper house of the Belarusian parliament Natalya Kochanova insisted on 80%. There were also those surrounded who assured Alexander Lukashenko that there were almost no protest moods in the country, and the situation was under control.

The very first week after the elections showed that Mr. Lukashenko lived in his own world. Neither mass detentions, nor torture of detainees in isolation wards, nor even the killing of protesters, as happened to Aleksandr Taraikovsky on August 10 near the Pushkinskaya metro station, did not bring down the wave of protests.

On August 16, Alyaksandr Lukashenka’s team made another mistake, opposing the pro-government rally to the processions of dissent. The winner himself came to him. “With all the difficulties, with all the shortcomings, we have built a beautiful country with you,” he again praised his beloved Belarus. “To whom did you decide to give it? If someone wants to give up the country, then even when I am dead, I will not allow you to do that! ”

It sounded menacing. But Mr. Lukashenko looked insecure and lost. The rally of supporters, called the seventy thousandth by the press service, hardly exceeded 15-20 thousand.Alyaksandr Lukashenka, speaking from the dais, could see this: only the rostrum was crowded.

A march of dissent that took place on the same day showed that the authorities had lost the street duel. A white-red-white sea of ​​protesters flooded Minsk – the wave almost reached the presidential residence. And then the enterprises went on strike, the preservation of which the president always took credit for. The workers said they did not believe in the victory of the incumbent president and were outraged by the violence.

When on August 17 Alexander Lukashenko left the bunker and, having decided to plunge into the atmosphere of the street again, came to the Minsk Wheel Tractor Plant, the workers whom he considered 100% “his own” began to chant “Go away!”.It seems that he first encountered reality and realized how serious everything is. After that, Mr. Lukashenko himself took a submachine gun and armed his 16-year-old son Kolya, demonstrating that he was ready for anything.

Hit the Bottom

Belarus was covered with violence. Alyaksandr Lukashenka staked on the security forces. The machine of suppressing protests, perfected over the years, rolled across the country. The Belarusian riot police became known for their ruthlessness long before last summer. But in 2020, the security forces reached a new level.Anyone can end up in a paddy wagon or morgue. Among the employees of the internal troops, militia, special forces, riot police and strong people in civilian clothes, it is as if there are competitions in cruelty. The number of videos showing the “work” of the security forces against civilians is incalculable, and the number of those detained since the beginning of the actions has exceeded 30 thousand.

The power machine allowed Mr. Lukashenko to sit in the presidential palace. But the protests continue, despite the cold, and with the onset of spring, their summer scale may return.Those who disagree have no leaders – they are either abroad, like Svetlana Tikhanovskaya, or in an isolation ward, like Maria Kolesnikova and others. The question “to beat or not to be” Alexander Lukashenko decided in favor of “hitting”. And how long “to be” will last, no one knows. He talks about constitutional reform, the redistribution of presidential powers, and possibly new elections for the head of state. Only it is not clear how to leave after this year’s punitive operations.

Beloved Belarus, meanwhile, is looking around in search of something else: sociologists who are forced to study public opinion from abroad say the level of support for the president is around 20%.So many respondents, according to one of Kommersant’s interlocutors, who insisted on anonymity, when asked “who would you vote for,” now name Lukashenka.

In September Alyaksandr Lukashenka admitted that he “may have stayed for a while” in the presidential chair. If he followed the example of his Kazakh colleague Nursultan Nazarbayev, who launched a quiet transit of power in his country, you see, there would be no current storm. On the other hand, thanks to Mr. Lukashenko, there are now two cases for authoritarian post-Soviet long-lived presidents: Kazakhstani and Belarusian.

Meanwhile, the problems of the Belarusian president concern not only him. Sociology has recorded that after the Kremlin offered a shoulder to Mr. Lukashenko, Moscow began to lose an important resource – the disposition of the inhabitants of Belarus. Ukraine, still smoking, is a reminder of what this leads to.

And one more thing. It is impossible to deal with Alexander Lukashenko, who has never been a convenient partner for Russia and who is not particularly trusted in Russia. After August 9, his word or signature is worthless: the next Belarusian leader can refuse any agreement, nodding at the illegitimacy of his predecessor.

The Kremlin understands this. Kommersant’s interlocutors in Russian government agencies talk about Moscow’s interest in an early transit of power in Belarus. While this process, according to them, can still be controlled, and the threat that the West will interfere with the transit is small. It is no coincidence that President Vladimir Putin and Foreign Minister Sergei Lavrov regularly remind Alexander Lukashenko of his promise to carry out constitutional reform and new presidential elections.

But there are people in the Russian government who advocate a different approach.They believe that no reform is needed, since the strengthening of the role of, for example, parliament will lead to the fact that at some point there will be EU-oriented parties there. Therefore, there should be one boss, the powers of the president should remain the same, just Alexander Lukashenko should step aside. However, no matter what idea about Mr. Lukashenko prevails in Russia, he himself, as has happened more than once, can confuse any cards. You can be sure of one thing – in 2021 Belarus will not disappear from the news.

Vladimir Soloviev

.