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Families Meeting the Challenge of Mental Illness

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Debunking DDD

By

Angelina Villalva, NAMI Intern

One of my all time favorite movies is The Truman Show. For those unfamiliar (or need a recap), the movie revolves around a guy named Truman, and unbeknownst to him, he’s the star of a TV show about his own life. Neighbors, friends, even his own family, are all actors. Every detail in his life, from his fear of dogs, to the woman he’s married to, was planned and controlled. As viewers progress through the film, we not only discover just how much of his life is being manipulated, but how far people will go to keep him from discovering the truth. 

Aside from the plot, what makes The Truman Show meaningful to so many people, including myself, belongs to its relatability. As Truman slowly discovers the truth about the world around him, he’s faced with weird feelings that something in his environment is not quite right, or that the things around him are not real. As he begins to break down and become more and more suspicious of these things, Truman begins to exhibit symptoms of derealization. 

It is very common for people to experience feelings of derealization. In fact, according to the Merck Manual, almost one half of people will have experienced feelings of detachment from themselves (depersonalization) or their surroundings (derealization) at some point in their life. This can occur after experiencing life-threatening danger, taking certain hallucinogens or drugs, becoming very tired, or being deprived of sleep. 

However, some individuals may be afflicted from symptoms of depersonalization and derealization for long periods of time, which can make it hard to function. This is what’s known as Depersonalization-Derealization Disorder (DDD). 

As mentioned before, individuals with DDD may experience feelings of detachment from their surroundings, but they may also experience detachment from their body. Therefore, symptoms of DDD are split between derealization experiences, and depersonalization experiences. 

Derealization Symptoms

  • Feeling that people and surroundings are not real (almost like you’re living in a movie/dream) 
  • Feeling emotionally disconnected from people you care about 
  • Surroundings that appear out of their usual shape or are blurry or colorless
  • Thoughts about time that are not real such as recent events feeling like the distant past
  • Unrealistic thoughts about distance and the size and shapes of objects

Depersonalization Symptoms

  • Feelings that you’re seeing thoughts, feelings, or body or parts of body from the outside 
  • Feeling like a robot or that you’re not in control of what you say or how you move 
  • The sense that your body, legs, or arms, appear twisted or like they’re not the right shape 
  • Emotional or physical numbness of your senses or responses to the world around you
  • Sense that memories lack emotion and they may or may not be your own memories

The causes of DDD are still not well understood. Some think that high levels of stress, fear, childhood trauma or generally stressful and traumatic events could lead to bouts of DDD. It is also highly probable that due to genetic and environmental factors some people may be more likely to experience depersonalization and derealization than others, but again there is no definite source. 

What sets DDD apart from a psychotic disorder is awareness. Despite feeling this detachment and separation from bodily or environmental senses, individuals remain in touch with reality and understand that these perceptions aren’t real. This often causes frustration and anxiety, with people commonly reporting feeling that they are going crazy. This awareness can lead to comorbidities such as depression, anxiety, OCD, PTSD, or personality disorders. 

While it is still unsure about the best way to treat DDD, the most current available options are to use various psychotherapies (cognitive behavioral, eye movement desensitization processing) or medication. 

As always, remember you are supported and loved, even if you feel alone. There will always be someone willing to listen, and you deserve to get the resources you need. 

Resources: 

Citations: 

Pride & Prejudice

By

Bella Santulli, NAMI Intern

As we head into June, it is crucial to reconigize the historical significance of this month for the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, plus) community. Without Stonewall (June 1969) or Marsha P. Johnson, a black trans woman who threw the first brick, the LGBTQIA+ community would not have the same rights today. That being said, the lack of rights within the queer community along with confronting discrimination, risks to physical health, and lack of comapssion & care dignifes the high rate in which queer people experience mental health conditions. 

Members of the LGBTQ+ community are more than twice as likely as heterosexual people to experience a mental health condition in their lifetime, according to the American Psychiatric Association. This isn’t because queerness itself is a problem—it’s because of how society often responds to it.
Discrimination, rejection, and social stigma continue to be daily realities for many queer individuals. From family rejection and religious trauma to school bullying, workplace bias, and underrepresentation in healthcare systems, LGBTQIA+ people are often left feeling unseen, unsafe, and unsupported. These stressors can contribute to higher rates of:

  • Anxiety and Depression
  • PTSD
  • Substance use disorders
  • Suicidal ideation and attempts

Mental Health of America studies convey that forty-eight percent of transgender adults report that they have considered suicide in the last year, compared to 4 percent of the overall US population. Additionally, in a survey of LGBTQ+ people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness. Fear of discrimination may lead some people to conceal their sexual orientation or gender identity from providers or avoid seeking care altogether.
When we talk about queer mental health, we can’t ignore intersectionality—the way systems of power overlap and intensify for those who are both queer and BIPOC. It’s not just one layer of identity; it’s a web of lived experience that shapes how people move through the world. For queer BIPOC individuals, the mental health toll isn’t just about sexuality or race in isolation—it’s about how they collide. That’s why affirming, accessible, and culturally aware mental health care isn’t optional. It’s needed. But seeking support isn’t always easy. Many LGBTQIA+ individuals report:

  • Lack of culturally competent providers
  • Fear of discrimination or being outed in clinical settings
  • Limited access to affordable care, especially for trans and nonbinary people
  • Mistrust of medical systems, often rooted in past harm

These barriers leave many feeling that their identities are misunderstood or pathologized, rather than affirmed and supported. Nonetheless, mental health care should be a space for healing, not another site of erasure. Whether through affirming therapy, queer support groups, chosen family, creative expression, or simply existing authentically, visibility in the queer mental health space becomes an act of healing and a reminder that sentiments and experiences deserve to be seen, supported, and celebrated.

How You Can Help

  • Listen without judgment when queer friends and loved ones talk about their mental health.
  • Support LGBTQIA+ mental health organizations, like The Trevor Project, Trans Lifeline, or National Queer & Trans Therapists of Color Network, Mindout, etc. 
  • Educate yourself on how systems of oppression affect mental health. 
  • For more educational resources, check out the toolkit, “Mental Health and the LGBTQIA+ Community,” sourced by another intern, which includes definitions, explanations of various topics within the community, and outreach resources. 

Book of the Week: Disappoint Me by Nicola Dinan

This tender, layered novel follows two timelines: Max, a transgender woman navigating a new relationship in the present, and Vincent, the man she’s begun seeing, whose story unfolds a decade earlier. I was especially moved by the way the novel explores romantic dynamics between men and trans women, intergenerational family trauma, forgiveness, and shared cultural identity, as both Max and Vincent are of Chinese heritage. 

But what stayed with me most was the profound affirmation that while Max’s transness is central to who she is, her experience of womanhood carries a universal resonance. Nicola Dinan captures the quiet strength of queer storytelling–how identity and mental health are deeply intertwined, echoing the heart of this week’s blog. Happy Pride! 

Resources 

  • NAMI Mercer Helpline Phone Number: 609-799-8994 x17
  • NAMI Mercer Helpline Email: helpline@namimercer.org
  • LGBT National Help Center: https://lgbthotline.org/
  • The Trevor Project: https://www.thetrevorproject.org/resources/

References 

  • “LGBTQ+ Communities and Mental Health .” Mental Health America, mhanational.org/resources/lgbtq-communities-and-mental-health/. Accessed 9 June 2025.
  • American Psychiatric Association. “Psychiatry.org – Lesbian, Gay, Bisexual, Transgender and Queer/Questioning.” Psychiatry.org, 2024, www.psychiatry.org/psychiatrists/diversity/education/lgbtq-patients.
  • Intersect. “Intersectionality | LBGTIQ Intersect.” Lgbtiqintersect.org.au, 2019, www.lgbtiqintersect.org.au/learning-modules/intersectionality/.


Bearing BPD

By

Angelina Villalva, NAMI Intern

Have you ever been told by a parent, “Where’s the you I used to know?” In some ways, you feel that you have not changed at all. Yet, from the eyes of someone who’s watched you grow and go from a small infant to a teenager and then adult, you’ve become someone entirely different. 

It’s not unheard of for us to experience changes in our personality and self-image as we develop and grow into ourselves. It’s common that we often look back and see phases of our lives where we behaved or dressed a way that is so far removed from what we act and look like presently. 

Although everyone experiences shifts and changes in personality as we age, some are afflicted with personality disorders (PD), something more severe than just meager shifts in typical mood and behavior changes exhibited in teenagers. 

So what is a personality disorder? According to Mayo Clinic, personality disorders are defined as a condition where people have a lifelong pattern of seeing themselves and reacting to others in ways that cause problems. 

Personality disorders often begin in adolescence but are not diagnosed until much later due to the rapidly changing personality and self-image of adolescents and teenagers with development. As categorized in the DSM-5, personality disorders can fall under 3 clusters: 

  • Cluster A: Odd or eccentric disorders
  • Cluster B: Dramatic, emotional, or erratic disorders
  • Cluster C: Anxious or fearful disorders

You may already be familiar with some of the personality disorders found amongst Cluster B, those being antisocial PD, borderline PD, histrionic PD, and narcissistic PD. (In fact, if you haven’t already, check out more information on histrionic personality disorder in fellow intern, Bella Santulli’s, post Histrionic Minds). 

Today, we’ll mainly be covering the symptoms and treatments available for borderline personality disorder (BPD). 

BPD is the most widely studied personality disorder. Those afflicted are characterized with high impulsivity and high emotional instability. Provided from Cleveland Clinic are the following common symptoms: 

  • Fear of abandonment
  • Unstable, intense relationships
  • Unstable self-image or sense of self
  • Rapid mood changes
  • Impulsive and dangerous behavior
  • Repeated self-harm or suicidal behavior
  • Persistent feelings of emptiness
  • Anger management issues
  • Temporary paranoid thoughts

Up to 75% of people diagnosed with BPD are female, although males may be equally affected but misdiagnosed with PTSD or depression. Causes of BPD may vary, but unfortunately there is a correlation between childhood abuse and trauma, with 70% of people who have reported experiencing sexual, emotional, or physical abuse as a child developing BPD. Similarly, those with family members who experience BPD are more likely to develop BPD as well. 

Historically, BPD has been difficult to treat. While medication may help, there is not a definite correlation created as of recent. However, current treatment which has been showing promise pertains to psychotherapy treatment such as dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), or group therapy. 

Individuals with BPD are more likely to partake in self-harm or suicidal tendencies than the average person. If you or someone you know is afflicted with BPD or similar thoughts/actions, please reach out for help. As always, no one is alone and there are resources available to you for support. 

Despite how you change, you will always be important and loved. 

Resources: 

Citations: 

Catharsis & Chaos

By

Bella Santulli, NAMI Intern

A fiction of fun that is well-known throughout the world, introduced in the early 20th century, is horror–my personal favorite. Is it so wrong that one of my favorite movies is Terrifier 3? Yes, a movie comprised of heavy gore, the annihilation of others, and psychological torture of the main characters is one of my favorite movies. Well, I am not the only one. Terrifier 3 well exceeded its quota, accumulating more than 73 million at the box office, dethroning larger productions such as Joker 2 in 2024. Still, the real question is, what is the psychology behind deriving pleasure from horrifying fiction?

Several factors must be considered when discussing the appeal of the genre, including underlying biological elements, cultural influences, and connections to fear, among others. Awareness of personal safety is a colossal contributor to enjoying horror movies. As sociologist Margee Kerr told The Atlantic, it is partially due to a biological phenomenon known as excitation transfer. After the physical reactions to fear, such as an accelerated heart rate and heavy breathing, wear off, viewers experience intense relief. Positive feelings intensify and, in short, “fear floods our brains with feel-good chemicals.” This cascade of ‘feel good’ neurotransmitters and hormones, such as endorphins, dopamine, serotonin, and adrenaline, that influence our brains and our bodies gives us a moment of relief or excitement. This, in turn, can serve as a break from an overly routinized and even mundane everyday life, or it can make us want to experience the “high” (adrenaline rush) again.

Here is a breakdown of the unconscious, wonderful ways of the human brain: 

  • The thalamus determines where incoming sensory data should be sent in the body.
  • The sensory cortex interprets this sensory data.
  • The hippocampus can store and retrieve memories and process stimuli to give context.
  • The amygdala determines possible threats and “decodes emotions” while storing fear memories.
  • The hypothalamus activates the fight-or-flight response.

Psychologically, we love to scare ourselves silly because when we make it through a terrifying yet safe activity, it results in feelings of confidence, competence, accomplishment, and success–a real self-esteem boost. Overall, horror offers a cathartic experience, allowing people to confront and release their fears in a safe and controlled environment. This can be therapeutic and help individuals process their anxieties, while also functioning as a controlled exploration of fear without genuine risk. Additionally, the horror genre is more than just a source of entertainment; it’s a powerful cultural tool that allows us to confront our fears, engage with social issues, and explore the depths of the human psyche. The individual traits/interests are also dependent on the enjoyment of the adapting genre. First spanning folklore and religious beliefs, it has evolved into numerous subgenres, as well as the modern slasher.

In the upcoming months of summer, various new horror movies are being brought to theaters, such as A24’s Bring Her Back, I Know What You Did Last Summer, 28 Years Later, The Conjuring: Last Rites, Saw XI, etc. Enjoy the adrenaline rush! 

Book of the Week: Hungerstone by Kat Dunn

A bite-sized masterpiece of gothic horror and sapphic romance that will leave you hungry for more. This story revolves around Lenore, trapped in a loveless marriage to steel magnate Henry, whose ambitions drag them from London to the shadowy Nethershaw manor. After a mysterious carriage accident near the manor, Carmilla enters Lenore’s life: vibrant at night, pale by day, and irresistible. As Carmilla awakens a deep hunger within Lenore, young girls in nearby villages begin to fall ill, consumed by a bloody thirst that hints at a much darker truth. Every page drips with gothic allure, every chapter pulses with tension, and by the end, you will be left starving for another taste!

Resources

  • NAMI Mercer Helpline Phone Number: 609-799-8994 x17
  • NAMI Mercer Helpline Email: helpline@namimercer.org

References

  • “The Psychology of Fear | CSP Global.” Concordia University, St. Paul, 13 July 2020, online.csp.edu/resources/article/pyschology-of-fear/. 
  • Carollo, Laura. “Horror Movies – Statistics & Facts.” Statista, 29 Oct. 2024, www.statista.com/topics/12896/horror-movies/#topicOverview. 
  • Cooper-White, Macrina. “This Is Why We Love to Scare Ourselves Silly.” HuffPost, HuffPost, 16 Oct. 2014, www.huffpost.com/entry/science-of-fear-why-we-love-to-scare-ourselves_n_5976266.
  • Hoffner, Cynthia A., and Kenneth J. Levine. “Enjoyment of mediated fright and violence: A meta-analysis.” Media Psychology, vol. 7, no. 2, May 2005, pp. 207–237, https://doi.org/10.1207/s1532785xmep0702_5.

Advocating for ASD

By

Angelina Villalva, NAMI Intern

As humans, we have an innate drive for social connection with others. It is foundational to not just being emotionally stable, but as a basic need as essential as food and water. When that gets taken away, we tend to struggle quite a bit. 

At some point in your life, you probably have felt a moment of feeling ostracized. Left outside of the group. In other words, the odd-one-out. Can you remember what it felt like to be in that moment? For a lucky group, they’ve might’ve had the occasional buffer but for the most part live unafflicted from this fear. Unfortunately, the same can’t be said for adolescents and young adults who live with ASD. 

ASD stands for autism spectrum disorder. This is a neurological and developmental disorder that affects the way that people interact with others, communicate, learn, and behave. Due to this, people with ASD commonly experience feelings of social isolation and problems in forming relationships. 

The word spectrum in ASD refers to the wide range of symptoms and severity that can be present in various individuals. Some autistic people have intellectual disabilities, while others do not. Some require significant support in their daily lives while some need little to no support and can live independently. However, getting early treatment for ASD can make a big difference in how severe autism presents later in life. 

Signs of autism are usually seen around 2–3 years old. These can include(but are not limited to): 

  • Having poor eye contact and little to no expression on their face
  • Doesn’t speak, have delayed speech, or lose the ability to say words/sentences as they could before
  • Make the same movement over and over again (rocking, spinning, hand-flapping, etc.) 
  • Become withdrawn or aggressive
  • Doesn’t respond to their name 
  • Have unusual, stiff, or exaggerated body language
  • Sensitive to light, sound or touch but may not be affected by pain or temperature

Today, there is no single known cause of autism. A common misconception is that ASD is caused by vaccines, but this has been disproven as untrue. In fact, the original study in which this claim originated was retracted due to poor design and questionable research methods. Others suggest genetic and environmental factors have a correlation, but this does not apply for all ASD cases.  

As social beings, struggling to make connections can be very distressing and affect us in all parts of our life. For people living with autism, facing this struggle is part of their reality. It can feel overwhelming, and incredibly lonely at times. However, it is important to note that no one is ever alone. Not only are there resources available for those who struggle with autism, but also for those who live without it and can support those who do.

I highly encourage you to check out the resources below to find more information and support. 

Resources: 

Citations: 

Histrionic Minds

By

Bella Santulli, NAMI Intern

This May, as we recognize Mental Health Awareness Month, it is essential to emphasize less-discussed disorders such as Histrionic Personality Disorder (HPD) to encourage understanding, challenge stigma, and promote connection for those who feel overlooked or misrepresented.

So, What is HPD? HPD is a mental health condition that involves an unstable center of emotions as well as a distorted self-image. For people with this condition, their self-esteem depends on the approval of others, not themselves. Additionally, they desire to be noticed by others, often exhibiting erratic or impulsive behavior. Researchers estimate that approximately 1% of people have this condition, predominantly women, although more research is being conducted for undiagnosed men. 

The criteria for diagnosing this condition include five or more of the following behaviors.

  • Uncomfortable when not the center of attention.
  • Seductive or provocative behavior.
  • Shifting and shallow emotions.
  • Uses appearance to draw attention.
  • Impressionistic and vague speech.
  • Dramatic or exaggerated emotions.
  • Suggestible (easily influenced by others).
  • Considers relationships more intimate than they are.

It is important for those who have HPD to seek outside support, such as talk therapy or different support groups. Cleveland Clinic recommends these steps because gaining insight into their condition tends to have better outcomes and increased functionality in social relationships. 

Shedding light on Histrionic Personality Disorder, this Mental Health Awareness Month helps bring attention to often less-known or ignored conditions. By understanding HPD, we can build empathy and create space for people to seek help without shame or judgment.

Book of the Week: Boy Parts by Eliza Clark

This novel follows Irina in Newcastle, UK. She is a troubled photographer with a twisted view of herself and others. Her mind is chaotic—full of obsession, control, and confusion between what’s real and what’s not. It is a raw look at a woman unraveling and a powerful match for this week’s focus on Histrionic Personality Disorder. 

Resources

References

  • Lovering, Nancy. “Treating Histrionic Personality Disorder.” Edited by Jeffery Ditzell, Psych Central, 14 Oct. 2014, psychcentral.com/disorders/histrionic-personality-disorder/treatment. 
  • “Histrionic Personality Disorder: Causes, Symptoms & Treatment.” Cleveland Clinic, 19 Mar. 2025, my.clevelandclinic.org/health/diseases/9743-histrionic-personality-disorder. 
  • Torrico, Tyler J. “Histrionic Personality Disorder.” National Institutes of Health, U.S. National Library of Medicine, 20 June 2024, www.ncbi.nlm.nih.gov/books/NBK542325/#:~:text=Introduction-,Histrionic%20personality%20disorder%20(HPD)%20is%20a%20chronic%2C%20enduring%20psychiatric,late%20adolescence%20or%20early%20adulthood.