I heard the statement, “crazy is contagious” from a colleague of mine when I told him about an experience I had recently had with a patient. It got me thinking. “Crazy” is not by any means a part of my vocabulary, nor are other typical terms when we think of the challenges that people have like, “issues,” “problems,” and even “diagnoses.” If you have followed me in my blogging, you have noticed that I do the very best I can to avoid diagnosing someone and finding the diagnosis of much benefit. People use the terms depressed, nervous, bipolar disorder, ADHD, and PTSD way too easily and very often without much knowledge of these conditions. There are, for instance very few people, who suffer from a true bipolar disorder, perhaps one in 1000, maybe less. Bipolar disorder, by the way, is a delusional disorder when someone truly experiences such a severe depression as to truly not want to live for one more day, and that followed by times when the person feels like s/he could fly off a building successfully with arms as wings. I was bemused by a person reported that her husband was “very bipolar.” She actually meant that he swung from happy to sad. But this is not bipolar disorder. Nor is being sad depression, being worried anxiety, being distracted ADHD, or having bad memories PTSD. PTSD and the like are all real disorders, but they are not as common as people think. Enough of my grandstanding on the theme that psychiatric terms are used excessively. Let me get to the point.
The point is this: some kind of “crazy” is contagious. This means that if you around a person who feels delusional, speaks her delusions with firm conviction, and is fully convinced of these delusions, you will absorb some of the “crazy” thinking. This happened to me the other day with a patient who, indeed, espoused a series of delusional-like statements. This was a young man, a man of good integrity as well as high intelligence, but someone who has been suffering from some time with a significant amount of anxiety. I have written about anxiety before noting that it is clearly the most difficult phenomenon to overcome because it is caused by the brain (not the mind, mind you) believes that there is lethal danger just around the corner and keeps you in a state of perpetual hypervigilance in preparation for the danger that the brain believes to exist. I will not restate what I have previously written about this mind-brain interaction except to say that you mind knows everything but your brain knows only safety and pleasure, or lack thereof. You brain doesn’t know that when you are “worried” about passing an exam tomorrow that this is, actually tomorrow, because the brain (not the mind) does not have a sense of time. For the brain everything is in the present. So when your mind thinks about the danger of failing an exam, you brain goes into action to protect you. Unfortunately, you brain does not distinguish some future danger from a present danger. Furthermore, you brain does not distinguish serious danger from minor danger. Hence, anxiety is very difficult to conquer. It is only conquered by sadness. But that is another discussion unless you want to read our books. So, let me tell you about how I “caught” the delusion I heard the other day.
Delusions
I must alter the words and circ*mstances to protect my patient’s identify but the phenomenon is the same: delusion spoken. Jack (I’ll call him Jack) suggested there was a conspiracy operating in Washington having to do with a certain political figure. He expressed how he had concluded that there was some immediate danger to him, to his family, and to America at large due to this individual and his colleagues. At first, he told me that an important senator had been “kidnapped” and another one “arrested” for unknown offenses and by unknown individuals. He told me more and more about what he was quite certain was about to happen in America and advised me that I should prepare myself for some kind of political, cultural, or military storm that was about to happen. When I first heard about the “arrest” of a senator, I was quite distressed because I had not heard about it, but then as Jack continued his story and beliefs in what I should call a conspiracy theory, I became increasingly concerned that I was listening to a person who was either truly delusional or “feeling” delusional for some reason. Jack finalized his statements of concern with a suggestion that there was a true danger of the water in Madison being contaminated with some kind of mind-altering drug. I was advised to keep from drinking tap water.
Now, I know that the water is not contaminated in Madison and I most certainly know that there is no conspiracy to take over the world, but after listening to this long story of conspiracy, I was affected emotionally, and then I was affected cognitively. I actually thought that maybe…just maybe…the water had somehow been contaminated. I knew better, but I found myself actually thinking this “crazy” notion. Why would I do that? I know better. Part of the reason I actually considered that there might be some truth in these stories was because I value Jack, namely his intelligence and his integrity. This is an important factor when you consider what you hear, from whom you hear it, and the content of what you hear. But this is not enough. You have to attend to how you feel because “crazy is contagious.”
Crazy is contagious
There are a lot of things that are contagious. These days, of course, we are all thinking of how Covid is contagious. We hear this all the time with suggestions of social distancing, masking, and all the rest. Then we also hear that social distancing and masking is not enough from some people and that it is harmful from other people. It is hard to know what to believe, but what most people do is trust their feelings: wear a mask, don’t wear a mask, social distance or don’t social distance, have parties or don’t have parties. Watching out for a viral contagion is difficult but you can find your way and do your best. Not so with emotional contagion and intellectual contagion.
Conspiratorial ideas, whether truly delusional or not, create a strong emotion. Witness the recent events in the Capital where people truly believed that it was possible to storm the Capital building and somehow change the course of democracy as it has operated for 250 years. These were not crazy people. They were, in my estimation, “true believers,” namely people who believe so heartily in President Trump, that they could take his words, his suggestion, and then broaden it into action. It is debatable whether Trump really wanted the crows to invade the Capital as it happened, something like the French revolution when outraged Frenchmen stormed to gates of the aristocracy. I doubt that these people were delusional although it is possible that some of them might have been. What happened, at least in my mind, was that there was a crowd effect, largely driven by powerful emotion and belief. The same crowd effect occurred during some Black Lives Matter marches when a few people, obviously overcome with emotion, did physical damage to property, and in some circ*mstances damage to people. Crazy, if we call it that, is contagious because it is profoundly emotional, which then filters into one’s cognition to justify the emotionally-based delusion. There is actually a formal diagnosis, rarely used, but quite real, called “shared psychotic experience.” I have encountered it only a couple times in my career.
It is not only “crazy” that is contagious. All things are contagious. Specifically, both depression and anxiety are contagious. This means that if you are around someone who suffers from depression or anxiety, you will most certainly feel the symptoms of these disorders. We therapists need to be quite aware of the contagion effect as we deal with people who might, indeed, be profoundly depressed or anxious. But this awareness is not limited to therapists. I suggest you be aware of the people around you who are, for instance, depressed, anxious, moody, or even delusional because too much exposure to such things will rub off on you.
Interestingly, you can also “catch” good feeling, like hope, faith, trust, love, and joy. Note how you feel when you are around someone who has one or more of these feelings in their nature or their presentation. Sadly, there are not many people who feel these things with our current deluge of politically motivated statements from all quarters. It behooves us to find people who feel good about life if we are to feel good about life. This can be a challenge especially if you are in some difficult situation, or your family or friend is in some difficult situation, because you would normally want to talk about the situation. Indeed, you need to talk but not with joining in with delusional, depressing, or anxiety-driven conversation, nor with conversation with false hope and simple answers. It is no small task.
Avoid the crazy
You can deal with delusional thoughts by noting how you feel emotionally. You will feel afraid. If you are around depression, you will feel depressed, and when you’re around anxiety, you will feel anxious. Not so bad to feel these things for a few moments, maybe minutes, but not more. Note when you start to absorb the “crazy” and quickly find a way out of the conversation. This may not always be easy. I needed to stay with my patient for a half hour as he talked to me about his delusions. I am not even sure that he really believes these conspiracy theories. Perhaps, he just absorbed them from a good friend. It doesn’t matter where he came to believe such things, nor does it matter how deeply he believes them. It doesn’t even matter whether some of what he says is actually true. What matters is that crazy incites crazy. Likewise, depression incites depression, anxiety incites anxiety, anger incites anger, and so on. You don’t need someone else’s crazy. You have enough of your own. You need to keep your distance.
Keeping you distance means trusting your feelings, namely when you begin to feel things that are not good for you, like anger or fear. If you are with someone and hearing their stories but begin to feel such things, you need to first be aware of your feelings, realize that you have “caught” someone else’s feeling, and then get away as soon as you can. This might take some socially delicate maneuver, but you need not feel what someone else feels if it is bad for you.
Feeling what someone else feels, whether joyful or sad, is not always a bad thing. It can be very good to feel sad with someone who has had a loss or feel truly joyful with someone when they tell you about their success in life. My concern is not to keep your social distance from any and all emotion but to be aware of the emotion that people bring to you because all emotion is contagious. Emotion is wonderful, and there are rare times when it is valuable to be afraid and to be angry. Rare times. There are more times when it is valuable to be joyful or sad because these emotions have to do with love, not defense
