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« Ozodi Osuji Weekly Lectures on African Countries #8 of 54: Cape Verde | Main | Ozodi Osuji Weekly Series on Psychology 2006, #16 of 52: Sexual Disorders »

March 26, 2006

Ozodi Osuji Weekly Series on Psychology 2006, #15 of 52: Organic and Geriatric Mental Disorders

by Ozodi Thomas Osuji, Ph.D. (Seatle, Washington) --- There are mental health issues that are directly correlated with injuries to the brain. These are called organic mental disorders. Another class of mental health issues is called functional mental disorders; these have not been correlated with injuries to the brain, although some folks believe that they are also a product of disturbances of the human nervous system.

Schizophrenia, mania depression, anxiety etc are considered functional mental health issues, for although they seem rooted in biochemical and biophysical disorders there is, at present, no conclusive evidence that they are caused by biological factors.

In organic mental disorders there is apparent correlation between perceived injury to the brain and psychological disturbances. For example, if a person was involved in an automobile accident that damaged his brain and as a result began to see things that other people do not see his hallucinations can be directly related to the injury he suffered; or if he experiences radical change in his personality and becomes prone to anger when he was not given to anger before the accident his anger can be traced to changes induced by his accident (organic personality disorder).

Some mental health issues affect older persons. Whereas not all old persons have mental health issues, a substantial number of them seem to have them, thus we might say that age has something to do with mental health issues. Many persons in their eighties tend to have issues with depression, delusion, senility and Alzheimer’s disease.

In this essay I will briefly discuss organic and geriatric mental health issues. My goal is to provide basic information so that where folks see the issues they can go to mental health professionals for help.


ORGANIC MENTAL DISORDERS

In organic mental disorders the observer can see a direct correlation between an injury to the brain or any part of the nervous system and perceived mental disorder. There are many sources of injuries to the brain, including virus, bacteria, accidents, chemicals and aging.

Some viral and or bacterial infections of the spinal column and or the brain do produce changes in individuals’ psychological behaviors. An infected brain may result in delirium, delusion, hallucination, anxiety etc.

There are many germs that specifically attack the nervous system, such as meningococcal. I will not focus on the specifics of these germs and or how they affect the brain, such inquiry is for those interested in human physiology. What I want to note is that some germs produce changes in human behavior. How this is done is beyond the scope of this essay.

Most parents have witnessed their children infected by some germs and suddenly go into delirium where they are confused and are unable to remember the past etc. When the infection is healed the child returns to his or her normal mental functioning. Unfortunately, some germs do produce permanent injuries to the brain and permanent psychological disturbances.

Have you been in a prolonged operation where you were put under anesthesia? Anesthesia is produced with chemical agents. Some of those chemical agents, such as chloroform, do produce temporary changes in brain chemistry and for our present purposes produce psychological effects. It is not unusual for those recovering from operation, post operation, to experience some hallucination (mainly visual). Momentarily, such persons see what is not there or distort the perception of what is there: people, for example, may look extremely small and take on different colors than their real colors.

All sorts of chemical agents produce changes in brain chemistry, some momentary, others lasting. Where a psychological state is directly attributable to the effects of chemicals it is considered an organic mental disorder. If you remove the causal agent you change the perceived psychological effect.

Suppose that you are in a newly painted house and or in the presence of heavily perfumed women and feel dizzy, faintly and disoriented; it is apparent that the smell from the paint and or the fragrance from the perfume is the cause of your temporary discomfort. There are people with chemical and physical allergies; they cannot stand the smell of fresh paint, fragrances and heat or cold. These people’s behaviors literal change when they are exposed to those agents that negatively affect their nervous system.

Persons who were involved in accidents that injured their brains sometimes suffer profound changes in their psychological make ups. A person who was hitherto quiet and friendly may become very angry and hostile towards other people. In other words, he undergoes profound changes in his personality and behavior. He is no longer the person that he was before the trauma to his brain. Soldiers who were hit in their heads often suffer organic mental and or personality disorders.

Chemical substances like alcohol and drugs do affect the chemistry of the brain. Heavy alcoholics often loose short term memory as well as experience myriad other psychological issues.

Even when heavy drug users finally quit, some of them retain psychological changes due to their drug usage. (As they say on the streets, folks fry their brains with drugs.)

Folks who overdose on street drugs often experience organic mental disorders such as delirium, delusion, hallucination etc.

The aging process seems to produce some changes in the physical and biochemical make up of the brain. Whereas there is no conclusive evidence yet as to how this works some observers attribute some of the changes in behavior in some geriatric patients to changes in their brain chemistry and physics. Alzheimer, senility, delusions etc are said to be due to changes in the old person’s brain.

Organic mental disorders are many and varied. For our present purposes, all we need to emphasize is that they are due to changes in the nervous system and that they were probably brought on by many agents. Some of these organic mental disorders are temporary, while others are long lasting.


GERIATRIC MENTAL DISORDERS

Have you worked in nursing homes and or assisted homes for the elderly? If you have, you probably have noticed some changes in the behaviors of the elderly persons therein, changes that are probably due to the aging processes. It would seem that in old age minor character issues that were always present in the individual become exacerbated.

Some of the main issues seen in the elderly are depression, delusion, senility, Alzheimer etc. Let me briefly explain these.

Most people know what depression is. It is loss of interests in the activities of daily living. The depressed person loses interests in activities that he or she used to enjoy, such as sports, work, social activities, making friends, food, sex, personal grooming; he has a feeling of tiredness and fatigue and a desire not to get up from bed in the morning, to just stay in bed, and in severe stages, to just be left alone and die. Some depressed persons, in fact, attempt suicide and some do manage to kill themselves. Depression is, therefore, a serious mental health issue.

At the moment the various serotonin reuptake blockers seem to alleviate clinical depression. Prozac, Zoloft, Paxil etc seem to have done wonders for depressed persons. Unfortunately, these medications do not seem to work for all patients. Moreover, they seem to have terrible side effects so that some persons do not want to use them. For example, some men become impotent upon using these drugs and to have a sex life may stop taking them.

Old people tend to have lost many persons in their lives. By the time a fellow is in his eighties he has probably lost many of the persons he grew up with and may have even lost some of his significant others (wife/husband, children etc). These losses probably contribute to depression in older people.

It is the rare ninety year old person who does not have some depression. For one thing, the fear of death, which in young persons tend to be well masked, hidden from consciousness, cannot be hidden from older persons’ consciousness.

Any ninety year old person who does not appreciate that his journey on earth is coming near to end is probably in serious denial (delusion). It is safe to say that older persons tend to have some depression and that like in every thing else some of them have it more than others.

Those older persons with severe depression probably need to see mental health professionals for help. But if it is minor, perhaps, a philosophical awareness that this is the human condition is enough to handle such melancholia. We are born. In our youth we are full of vigor. In middle age we begin to lose our vigor. In old age we are weak and then life becomes one continuous pain.

Life is pain and then you die. What can I say, such is life, cest la vie. Man needs some philosophy and or religion to help him cope with the painful realities of this life of ours on planet earth.

I have articulated what seems to me a useful metaphysics elsewhere and we do not need to repeat it here.
In old age, folks do become weak and fragile. Some folks find this reality very difficult to accept.

I am sitting here typing. I ran five miles this morning. It just occurred to me that when I am old that I would not be able to run, indeed, that I may not even be able to walk. That would be a bummer, wouldn’t it? For a chap that struggled all his life to be physically fit, old age must be terrible. As a child, I felt inordinately weak and inferior. In Adlerian categories, I struggled to seem strong, hence I exercise addictively. But in old age my weaknesses and organic inferiorities would return to hunt me. What a bummer.

Some older persons resent their weak bodies and encroaching death. Death, they say, eventually wins over all our efforts. Death makes us feel inferior, powerless and like we are nothing. Just thinking about death makes one depressed. In death my handsome body (forgive that narcissism) would rot and smell to high heaven and become food for worms. My God, my body is nothing; my body is worthless and is valueless.

I am deliberately using myself as an example in these essays; I do so to bring the issues home to you; so that you apply the concepts to you and not see them as abstractions to be played with and ignored. In time, you will get old and die.

In old age I realize my imminent death and more importantly I feel weak. So what would I do? What did I do in childhood when I felt inferior? I tried to compensate with false strength. I pursued the fiction of superiority. I tried to seem powerful when, in fact, I am weak.

In old age some persons try to seem powerful, vigorous and youthful despite their apparent physical weaknesses. I recall my grandfather at 90. He was weak. But he refused to accept his weakness. He pretended to be strong. In his youth he was reputed to be the best wrestler and sports person in his world. So now in his old age he would like to think that he is still strong. He would challenge young men to wrestling matches. He would look at the most athletic chap in our world and invite him to wrestle with him.

No kidding, the old man wanted to prove to himself that he is still young and vigorous. Of course, the young man could dispose him in a few seconds. So he laughed and said: Na anyi Osuji, you are the best wrestler in this world. He gratified the old man’s ego, pride and vanity. Narcissism must be satisfied, you know, or else human beings feel like they are nothing important. Their make belief importance must be affirmed lest they acknowledge their existential nothingness and despair, feel depressed. Delusional disorder is a mask over underlying depression, William Meissner said in The Paranoid Process.

I was a very keen observer of the human condition even as a ten year old kid. I watched our folk’s humor grand father by telling him that he is a strong man when clearly he was a weak old man.


For our present purposes, old people feel weak and some deny their weakness and pretend to be strong. This wish to be strong and pretense that one is strong, when one is not strong, is akin to delusional disorder.

Delusional disorder or something like it tends to be seen in some older folks. As it were, they are in denial of their weakness; they deny their obvious weakness and approaching death; they affirm their strength and life; they affirm an illusion.

What can I say, I have seen it all. In a psychiatric hospital, geriatric word, I saw ninety something year old men talking tough as if they could whip twenty something year old nurses. Move your little finger and the old fella falls and breaks whatever bone is in his fragile body, but he talks tough like he were Hitler.

Talking of Hitler, what was he but a little man who felt very weak and talked tough, and pretended that he was god himself? That is the nature of delusional disorder, being a nothing while pretending to be a something very important.

I believe that old men who tend to pretend to be tough, who are delusional, probably had some of that disease all along in their personality structure, perhaps, in a masked form. Men and women who felt weak all their lives and acted as if they were tough and competed in sports and work in an effort to seem tough are probably more likely to pretend that they are tough in their old age. In other words, old age delusional disorder is an exaggeration of paranoid personality already present in such persons? This is heuristic and ought to be researched, proved or refuted and discarded.

Some old people have senility. That is, they forget things very easily. I lived with my grandparents for a while. My ninety year old grandfather would get lost and would not know how to get home. Some one would rescue him and either bring him home or send for me to come get him. I would go get him. Along the line, while guiding him home, I would pretend that he knows his way home or that he is guiding me home. I dared not tell him that his memory was not good or that he was lost.

My God, this man used to send to jail those who dared talk back to him when he was in his prime. He was into power and in old age could not handle his powerlessness too well, so we all, even ten year old me, knew how to make him seem powerful.

Oh what games we human beings play with each other. Life is nothing but games, games of make belief that we are important. A man sees a woman. He knows exactly what she is, what her body is: eventual food for worms. He tells her that she is such a beautiful woman. That admiration wins her over and both of them dance the dance of courtship and ego love on earth. When she is gone he asks himself, what is that all about, any way?

I remember when finally during my third year at the university I had sex. It felt ridiculous and filthy. What is this, I asked myself. Give it up and go become a Catholic reverend father. Celibacy seemed the right choice for me. (I have the mystic’s temperament; that is, I am inclined to escape from the temporal, empirical world and negate all sensual pleasures and focus on the permanent, spiritual world; but I force myself to endure the world.) In the meantime I had to pretend to the girl friend that the whole experience was interesting. Human beings are dishonest with themselves, let us move on.

Some old persons experience Alzheimer disease. Here, memory, both long and short term, is gone. Some of these folks do not even remember who they are, when they were born, where they are, who their children are etc. I have seen this drama unfold before my very eyes. The children and grandchildren of a man come to visit and he does not know who they are. Sad, very sad. Indeed, some would wander off the grounds and are found in a different state, not knowing where they are.

Alzheimer is due to problems with certain parts of the brain. But what is the existential implication of this disease?

Essentially these people behave like animals; some are even fed by other people, thus not performing the animal function of self feeding. So what are they, and by implication what are we? What am I?

I am an animal, yes? You are an animal, ya, ya, (as my German friends would say? May be, may be not.

What exactly is man? Somewhere, I speculated that we are spirit having physical experience.


Some older folks take an assortment of medications. My God some of them are on so many medications that you loose count. Some of these medications produce all sorts of side effects. Some of the side effects are hallucinations; hence one can say that some old folks have drug induced psychosis?

CONCLUSION

Some mental disorders are produced by injuries to the brain. Some older folks exhibit psychiatric mental disorders. I have mentioned some of the common disorders due to organic injury and old age.

If you have imagination you would know that since older people are afraid of dying that they may have existential anxiety, are stressed, are prone to fear and anger and other mental and emotional upsets.

Old folk’s homes are sometimes the house of mental disorders. In fact, sometimes there is no difference between a nursing home and a nuts home.

Ozodi@africainstituteseattle.org

Posted by Administrator at March 26, 2006 10:27 PM

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