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Why what we think we know about schizophrenia is wrong

theguardian.com

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Re: Why what we think we know about schizophrenia is wrong

#61

Post by Mirioron »

coleifer wrote: post #42
asveikau wrote: post #12

Earlier quoted context omitted.

It might be he doesn't want to associate with people, groups, events that revolve around the diagnosis. Perhaps that labels him an "other" and it feels little much. Why not similar activities with the general population? That is not meant to belittle the point that delusional people will strongly deny their symptoms, of course. Being close to somebody like that gets tough, especially when the delusions have led to ha…

Extreme agoraphobia, social anxiety, very little to talk about... Most 31 year olds are working, raising children, etc., and don't live in their parents house. Don't underestimate the shame he feels when around others. Outside his family, I think it is overwhelming for him.

I think this is a very important point. He doesn't fit in and humans love to ask one another about their lives. If you give non-standard answers, then you're seen as weird or a failure in life.

Re: Why what we think we know about schizophrenia is wrong

#62

Post by isnetea »

JamesBarney wrote: post #50
isnetea wrote: post #36

I’ve often wondered if it’s possible to induce psychosis and symptoms of schizophrenia in a subject via environmental conditioning. This seems practical to test these days, given the expanse of information possessed by large tech companies, and their lack of regulation. Perhaps this would be related research for a larger automated behavior control initiative. Does anyone have any pertinent references or info?

Mind elaborating on the connection between psychosis and automated behavior control.

Restated, is it possible to develop (eventually automated) ways to “drive people crazy”. Is it possible to use data and algorithms to manipulate someone into losing contact with reality, for instance, or trick them into manifesting schizophrenic symptoms

Re: Why what we think we know about schizophrenia is wrong

#63

Post by hindsightbias »

Well, this article didn’t lead to any answers or any insight for me. The whole unexplained opening of poisoning is cryptic and unhelpful. Does this nurse see the nuclear options as poison or was this doctor trying to give Amit cyanide? Who knows.

I’ve spent a month of evenings at Langley-Porter and then again at Zuckerberg, and the staff there didn’t strike me psychzombies. The last thing they wanted to do was to commit to a diagnosis of schizophrenia for my relative. I sat for an hour with the Attending on his outtake and she did everything to assure us that in her expert opinion it wasn’t black and white - drugs were part of the toolset and not The One Answer.

What’s wrong isn’t that people are ignorant. They always have been and always will be. Until you’ve been there, you won’t get it.

What’s wrong is we have brilliant people who are hamstrung by process. At SFGH it’s “If you aren’t a threat, you’re out” 7 days after the 72 hour lockdown. It’s a factory, because that’s all the runway WE give them.

We’re lucky. We’re wealthy enough and there’s enough of us that we can probably make this work.

But the other 90% in those wards? They don’t have anybody. So unless WE want to fund that level of intervention/compassion, the factory and pharmacology is the solution.

Re: Why what we think we know about schizophrenia is wrong

#64

Post by cvshepherd »

stephenamills wrote: post #53
coleifer wrote: post #8

My youngest brother has schizophrenia, which started when he was 19. He just turned 31, and were it not for his family supporting and caring for him, I'm sure he would be homeless or worse. He's one of the most sensitive, gentle people I have ever known. My wife and others who have gotten to know him would agree. Although he's "stable", thanks to an injection every 3 weeks, he's not going to ever get better. In fact…

Thank you so much for sharing this. My fraternal twin has schizophrenia and was diagnosed at 23. We're 25. I don't have schizophrenia. But his problem is that he refuses to take medication, so not sure where things will end up in the future with him. It's very up and down. One day like yesterday he's hearing voices and talking to himself, then the next day he's sort of normal. Hearing that someone else also has a fam…

you could maybe try getting him to take some CBD, if it's available and legal where you're located. looks very promising.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099166/

https://www.ncbi.nlm.nih.gov/pubmed/29241357

Re: Why what we think we know about schizophrenia is wrong

#65

Post by HeadsUpHigh »

DSM and other such systems(icd for example) are for CLINICAL use. I.e. they are not academic. If 2 different mechanisms create the same symptoms and are treated by the same drugs then from a clinical aide of view separating them is pointless. Academic research on the mechanics of diseases is much more nuanced than what an article on a news site can cover. Once something is clearly separated as 2 different entities in a clinically meaningful way via research then the classification system will be updated. What this means is that if e.g. we find a way to differentiate between 2 different mechanisms for schizophrenia with each of the responding better to a different drug( even if those are already existing drugs, it gives us a shortcut to choosing the right medication without trial and error) then DSM will split schizophrenia to schizo due to x and schizo due to y with further guidelines for medication. Or split them into 2 different things entirely.

Re: Why what we think we know about schizophrenia is wrong

#66

Post by lupire »

thatoneuser wrote: post #38
pygy_ wrote: post #15

Treating DSM categories as if they were a single disease is completely misguided. The DSM describes syndromes, and ignores pathophysiology because we still have little to no idea of what happens in the brain (at least not enough to properly understand the relevant functional aspects). Genome-wide association studies have recently shown that schizophrenia was in fact several distinct diseases [0]. Their symptoms turn…

This is why I think very highly of the transition in DSM V to diagnosing on spectrums. It's not perfect but it really helps get away from putting people into buckets they don't really belong in.

At the expense of putting people on spectrums where two people with the same diagnose have wildly different symptoms and effective treatments, rendering the diagnosis moot.

This is a crisis in "autism", where Asperger's and autism are different on such an extreme scale, yet the language, medical literature, and treatment plans and funding are muddling it up to the detriment of all involved, creating a culture war between people who say their mild Asperger's is a personality type not a disorder, and caregivers of people who cannot speak or provide basic self-care for themselves -- because DSM dumps them in the same diagnosis and society loses the language to disambiguate the scenarios.

Re: Why what we think we know about schizophrenia is wrong

#67

Post by tomohawk »

Schizophrenia can run in families. A family we knew was killed in the middle of the night by their step son with a hammer. Apparently, the disease can have a sudden onset. The mother and step father were teachers, and the whole community was affected. The son (teenager at the time) was diagnosed and has been held in a facility now for many years. The biological father has been in and out of institutions and homeless.

Such a terrible disease.

Re: Why what we think we know about schizophrenia is wrong

#68

Post by jquery »

scardine wrote: post #33
jquery wrote: post #6

Earlier quoted context omitted.

I mostly agree, but I think the movie romanticized the end of institutionalization, making us believe we've progressed "beyond" it, when we merely have people screaming on street corners and sleeping in the gutter. Institutionalization should've been reformed, not all but eliminated (I know it still exists, but only for the most extreme cases).

Well, the support network is far from perfect - having a 5yo son in the autistic spectrum I experience this first hand. Not too long ago my kid would be segregated to a "special" school and I'm glad he is able to attend a regular school although he still needs a dedicated tutor. Do you think weird people that do not endanger their own life or the life of others should be locked away?

There’s a sizeable gap between “weird people” and defecating/shooting heroin on community sidewalks and public transit. I’m referring mostly to the latter.

Re: Why what we think we know about schizophrenia is wrong

#69

Post by Gibbon1 »

scardine wrote: post #4
PaulHoule wrote: post #2

The diagnostic words that start with "schizo-" are a train wreck. Schizophrenia is characterized by hallucinations, delusions, thought disorder, catatonia, etc. You don't hear much about catatonia these days because it is cleared up by benzodiazepines reliably. Schizoid people have reduced emotional reactions compared to other people but they are in touch with reality. Schizoaffective disorder seems to pick a few sym…

I don't think "one flew over the cuckoo's nest" romanticizes mental illness, for me it is about demonizing institutionalization. It pictures the time when mental illness diagnostic was an easy method to put away anyone annoying or inconvenient (the subject really having a mental illness or not made little difference). It talks about institutional cruelty like torture and lobotomy. But then I didn't read the book, jus…

> It pictures the time when mental illness diagnostic was an easy method to put away anyone annoying or inconvenient

One of my friends was sent to Napa State Hospital by his step dad because he had epilepsy. When he was seven. It took six years for his dad to win custody, because his dad was a Mexican.

That was the world of One Flew Over the Cuckoo's Nest.

Re: Why what we think we know about schizophrenia is wrong

#70

Post by Gibbon1 »

thatoneuser wrote: post #35
DanBC wrote: post #10

> It was during my own nursing training that the currently favoured term of “service user” gained traction, as it was deemed more neutral. Patients overwhelmingly prefer the term patient, and this holds true every time we ask them what they want to be called. Service user is a term imposed upon them by well-intentioned mental health professionals and academics who don't recognise their own power dynamic and who do a…

Academics can be the dumbest smart people.

Academia teaches you there are simple solutions to common problems. And that non-academics are stupid.

Most real world solutions are shitty and incomplete.

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