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Diagnosing Charlie Baileygates

Charlie Baileygates

Me, Myself, and Irene, the film starring Jim Carrey and Renee Zellwegger. Where Jim Carrey is diagnosed with “Split Personality Disorder with extreme anger” or in a more scientific term, Advanced Delusionary Schizophrenia with Narcissistic Rage.  The film was quite funny, it showed a gentle none confronting Charlie Baileygates (Jim Carrey) who turns into a violent/extremely confrontational Hank Evans (also played by Jim Carrey) every time he is under a lot of stress or if he hasn’t taken his medication.

A background on Charlie and Hank

Charlie was abandoned by his wife for another man, leaving him with only a house and their three kids. As the movie progresses you will see Charlie becoming the town’s fool. He was continuously pushed around by his neighbors and friends because he doesn’t know how to stand up for himself.  However, when he finally had enough of this treatment… Hank came out.

The plot was entertaining and makes a person think if having two very different people in one mind and body is possible.

Is Advanced Delusionary Schizophrenia with Narcissistic Rage real?

Advanced Delusionary Schizophrenia with Narcissistic Rage does not exist.

The movie caused a misleading diagnosis between two different mental disorders. The real diagnosis for such mental illnesses that Jim Carrey’s character played, are Schizophrenia and Dissociative Identity Disorder both classified in the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-V) published by the American Psychiatric Association.

What is schizophrenia?

Schizophrenia is described by the American Psychiatric Association as a chronic brain disorder with symptoms of delusions, hallucinations, inability to concentrate and think, and lack of motivation. The subtypes (paranoid, disorganized, catatonic, residual, and undifferentiated) that were originally used for diagnostic purposes of schizophrenia on the DSM-IV but have been eliminated due to its unreliability in distinguishing different types of delusions. This change also brought great impact to the catatonic subtype that was most influential in determining Schizophrenia.

Elimination of Catatonic Specifier as a subtype

Catatonia is probably the most renowned symptom of schizophrenia used for diagnosis. However, this is not being used in DSM-V anymore. The reason for the elimination of catatonic symptoms is because of its very broad spectrum of usability as a specifier for depressive, bipolar disorder, and other psychotic disorders. But, even with the existence of catatonic tendencies on other mental disorders (depressive, bipolar disorder, and other psychotic disorders) it does not automatically mean the person affected is schizophrenic. Thus, the development of criterions for catatonia: Catatonic Disorder from Another Medical Condition and Other Specified Catatonic Disorder. 

Catatonic Medical Disorder from Another Medical Condition and Other Specified Catatonic Disorder

Catatonic Disorder from Another Medical Condition is the occurrence of catatonia rising from several medical conditions such as Neuroleptic Malignant Syndrome (NMS), Encephalitis, Nonconvulsive Status Epilepticus, and Acute Psychosis. Diagnostic blood tests to rule out this form of catatonia includes Complete Blood Count (CBC), Electrolyte Concentration Studies, Blood Chemical Analyses, Fibrin D-dimer, Serum Creatine Kinase level, Liver function  tests, Serum Ceruloplasmin level. And imaging tests to rule out treatable diseases are Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Single-photon Emission CT (SPECT), Positron emission tomography (PET) with fluorodeoxyglucose (FDG) and Electroencephalography (EEG). Early diagnosis and treatment can prevent catatonic symptoms if its cause is due to another illness. While, Other Specified Catatonic Disorder is used by the physician if s/he is still uncertain of the cause of catatonia. It might be due to depression, bipolar disorder, and psychotic, and medical conditions.

In the Diagnostic and Statistical Manual for Mental Disorders:Fifth edition. It requires at least three to twelve catatonic symptoms of all four possible causes of catatonia in depression, bipolar disorder, psychotic disorder, and medical condition to be diagnosed as schizophrenia.

Diagnosis of Schizophrenia without Catatonia

Under DSM-V at least two of the five symptoms are required for diagnosing schizophrenia.

Five symptoms:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized behavior
  5. Signs of negative symptoms
  • Flat affect
  • Lack of pleasure in everyday life
  • Lack of ability to begin and maintain activities planned for the day
  • Decreased ability to respond to conversations even when forced to do so.

Treatment of Schizophrenia

There is no known cure for schizophrenia, but preventive treatments are available to lessen its intensity and frequency.  Anti-psychotic medications, psychotherapy, cognitive therapy, and family therapy may help the patient function normally in everyday life.

Then again, schizophrenia might also arise from abusing drugs and other substances that can alter the biochemical components of the brain; which can mimic symptoms of schizophrenia. Therefore, it is important that this possibility might be ruled out by the attending physician before referring the individual to a psychiatrist or psychologist.

Hank Evans: The Sort of Bad Guy

Who really is Hank?

Now that we have established the criteria for diagnosing Schizophrenia, we shall now proceed to the infamous Hank Evans. The narcissistic, arrogant, and very angry personality of Charlie Baileygates.

Hank was the suppressed side of Charlie. The one who took the blow when his gentle counterpart did not show any emotion when his wife left him, when the neighbor’s dog used his lawn as its new toilet, or when the guys in the barbershop used him as a valet. After seeing how Charlie was being taken advantage of…Hank finally decided to come out, refuse to stay in the corner and stand up for the both of them,

Does Charlie know Hank?

This is the most intriguing part of the film – the part where Charlie suddenly becomes Hank without him knowing about it.

The medical diagnosis for this condition is Dissociative Identity Disorder or commonly called as Multiple Personality Disorder. Where a person’s own psyche separates himself from his own memories, thoughts, emotions, actions, and even his own identity.

Why is there a separation of our own personality?

We normally experience mild forms of dissociation in our everyday life. Daydreaming or even being too engrossed and hyper-focused in projects we need to submit the next morning can be both considered as a mild form of D.I.D. However, in Charlie’s case – Hank came out because of the emotional trauma he experienced from his wife leaving, the abuse he took from the people around him, and his own inability to cope and express his emotions. Resulting to Charlie unknowingly creating Hank

Dissociative Identity Disorder is brought about by the brain’s ability to protect itself from any traumatic or violent experiences the individual is incapable of handling.

Can someone have two or more personalities?

Yes, a person may have two or more personalities based on how the his/her conscious mind interprets the trauma s/he experienced.

According to an article on the Cleveland Clinic website, a person who experienced repeated trauma can create multiple personalities that is commonly referred to as “alters.” The personalities developed create their own personal history, own distinct traits, and their own reaction to things surrounding them.

The one affected by this disorder usually does not have any awareness of what an alter has done every time it becomes dominant. Creating a chaotic lifestyle with a possibility of putting themselves in danger due to the dominance of one or more personalities.

What are the symptoms of Dissociative Identity Disorder?

Physical symptoms experienced:

  • Severe headaches
  • Pain experienced in other areas of the body
  • Sexual dysfunction
  • Functioning level changes: from high effectivity to almost disabled
  • Unexplained changes in eating
  • Changes in sleeping patterns

Mental symptoms experienced:

  • Anxiety, nervousness, or panic attacks
  • Auditory and visual hallucinations
  • The feeling of not knowing what has happened (Episodes of amnesia)
  • Depression
  • Mood swings

Abuse and addiction

  • Self – injury
  • Suicide attempts
  • Drug abuse
  • Other types of substance abuse

Diagnosing Dissociative Identity Disorder

The most common symptom that encourages a person affected by D.I.D to seek help are the times where he does not remember “what happened.”

However, before it may be considered as Dissociative Identity Disorder a complete evaluation of the person’s medical history and physical assessment is needed. Even though there are no specific laboratory tests for this mental disorder – ruling out bacterial or viral infections of the brain, malignant or benign brain tumor, drug or alcohol intoxication, sleep deprivation, and the possibility of a head trauma can help determine if what the individual is experiencing is either a physical or mental disorder.

If physical illness is ruled out, a referral to a psychiatrist or psychologist who are trained to assess, diagnose, and treat different types of mental disorders can be done.

Treatment of Dissociative Identity Disorder

  1. Cognitive Therapy – Defusing extremely negative and stressful thoughts before they may become distorted and exaggerated can help prevent triggering an alter to become more dominant than the conscious mind.
  1. Psychotherapy – Encouraging the affected individual to “talk it out.” Giving him the ability to express himself without judgment about the way the traumatic experience makes him feel.
  1.  Family Therapy – Educating the family of the person with Dissociative Identity Disorder and the impact of this condition to his individual self and his behavior in societal situations and how it may change the family dynamics. This kind of therapy will also assist families in determining recurrence of symptoms every time an alter becomes dominant.
  1. Art and Music Therapy – The creative expression of the patient’s thoughts and feelings.
  1. Clinical Hypnosis – A unique way of relaxation and exploration of the person’s subconscious and conscious mind to provide more awareness on what his feelings and memories are about the trauma he experienced.

So was it Schizophrenia or DID?

At the end of Me, Myself, and Irene – Charlie declared that Hank can no longer stay in his conscious mind. Which was a symbolic way of confronting any types of fear and emotional stress Charlie might experience in the future.

Jim Carrey’s character had Dissociative Identity Disorder, often mistaken by majority of the population as Schizophrenia. There were no indications that he ever did suffer from the wrong diagnosis especially when if it is based it on the symptoms he was exhibiting in the movie.

 

References:

“Schizophrenia.” Schizophrenia. American Psychiatric Association. Web. 23 Mar. 2015. <http://www.psychiatry.org/mental-health/schizophrenia>.

Zupanick, C.E. “The New DSM-5: Schizophrenia Spectrum and Other Psychotic Disorders – DSM-5.” The New DSM-5: Schizophrenia Spectrum and Other Psychotic Disorders – DSM-5. Aroostook Mental Health Center. Web. 23 Mar. 2015. <http://www.amhc.org/1418-dsm-5/article/51960-the-new-dsm-5-schizophrenia-spectrum-and-other-psychotic-disorders>.

Brassic, James Robert. “Catatonia .” Catatonia. Medscape, 27 July 2014. Web. 23 Mar. 2015. <http://emedicine.medscape.com/article/1154851-overview>.

“Schizophrenia.” NIMH RSS. National Institute of Mental Health. Web. 23 Mar. 2015. <http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml>.

“Dissociative Identity Disorder (Multiple Personality Disorder): Signs, Symptoms, Treatment.” WebMD. WebMD. Web. 23 Mar. 2015. <http://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder>.

“Dissociative Identity Disorder (Multiple Personality Disorder).” Cleveland Clinic. Cleveland Clinic. Web. 23 Mar. 2015. <https://my.clevelandclinic.org/services/neurological_institute/center-for-behavorial-health/disease-conditions/hic-dissociative-identity-disorder>.

 

 

 

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