A user named observationist made a response to this post, but they responded to a troll, whose comment was nuked which removed their very valuable comment (I was responding to them at the time so I happened to have both in cache).
observationist https://news.ycombinator.com/user?id=observationist original comment:
Around 1% of people have schizophrenia. This holds over a lifetime - there's a structural, unavoidable component to the person's neural wiring or physiology that will result in a schizophrenic break. Prior to the break, they may seem more or less normal, but after, they will experience deficits in cognition and perception, and may have significant barriers to living a normal life.
Schizophrenics, as a rule, will have a psychotic break before they turn 45. Psychoactive substances, and high doses of psychedelics, will trigger breaks from reality earlier than they might otherwise happen. Stress, caffeine, trauma, or significant excitement can also be triggers, but psychedelic drug trips are a reliable trigger, and in conjunction with other effects, can spiral a "bad trip" into a much worse trauma.
Another 3 to 4% of the population have significant mental disorders, ranging from those we know, to those we can observe but don't have a good diagnostic criteria for. In these cases, it can be very detrimental to use psychoactive substances generally, and psychedelics in particular.
It's crucial to visit with a doctor to rule out the likelihood that you're in the roughly one in twenty people that might have a significant negative reaction to psychedelics. Some of the people in that camp might be safe from harm later in life. I know a person with significant family history of schizophrenia and earlier life indicators he was at risk, who then started using mushrooms in his 50s and seems very stable. He talked things over with his doctors before deciding to take the risk - apparently after you turn 45 it's incredibly rare, even with significant trauma and stressors, for schizophrenic breaks to occur, so if that's your main threat, it might be safe to engage in psychedelics when you're older.
If you're not in the high risk camp, you should still have at least one frank discussion with your doctor about pitfalls, and do a metric ton of personal research about any substance you intend to use. It can be a profound and wonderful departure from the norm, or a mildly unpleasant experience, or a stressful confrontation with your inner demons, depending on the dose and preparation.
my response:
Thank you for this. I thought this was a very informative comment; I am worried about schizophrenia as a disease that might impact my kids. I wanted to ask you for more information, but that is a burden, so I asked ChatGPT instead so at least you wouldn't have to go find links. If you have Other reading besides what is below I would be happy to hear about it.
Here is it's response from ChatGPT (Claude couldn't provide links). My contribution is that I checked the links and skimmed them to see if they supported the statement. They are repetitive (there are only 7 articles linked actually), but they generally support your comment. Of note the PLOS article does not support your comment, and it seems that it doesn't support what ChatGPT says (maybe I misunderstood when skimming it). The stuff in parens below (Looks Like This), was a link in ChatGPT, but the links didn't copy-paste, so I'm going to put all the articles at the top here:
https://www.nature.com/articles/s41380-023-02138-4
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12...
https://www.who.int/news-room/fact-sheets/detail/schizophren...
https://www.nimh.nih.gov/health/statistics/schizophrenia
https://www.psychiatrictimes.com/view/drug-psychosis-may-pul...
https://psychedelics.berkeley.edu/qa/understanding-your-risk...
https://journals.plos.org/plosone/article?id=10.1371/journal...
The comment you saw online contains some accurate points but also could benefit from additional context and nuance based on available research.
1. Prevalence and Risk Factors of Schizophrenia:
- The lifetime prevalence of schizophrenia is approximately 0.3% to 0.7% globally, which supports the 1% figure as an upper bound (Nature) (BioMed Central) (World Health Organization (WHO)) .
- Schizophrenia typically emerges in late adolescence to early thirties, with men often experiencing onset earlier than women (National Institute of Mental Health) (World Health Organization (WHO)) .
- Factors such as genetic predisposition, prenatal exposures, and psychosocial stressors contribute to the risk of developing schizophrenia (National Institute of Mental Health) (World Health Organization (WHO)) .
2. Triggers for Psychotic Breaks:
- The statement that high doses of psychedelics can trigger psychotic breaks in predisposed individuals is supported by evidence. Drug-induced psychosis, particularly from hallucinogens and cannabis, can lead to schizophrenia in some cases (Psychiatric Times) .
- Other triggers include stress, trauma, and significant life changes, which can exacerbate underlying vulnerabilities (Berkeley Psychedelics) .
3. Impact of Psychedelics on Mental Health:
- Psychedelics can pose significant risks for individuals with a family history of schizophrenia or other major mental health disorders. It is crucial for these individuals to consult healthcare professionals before considering psychedelic use (Berkeley Psychedelics) .
- Research has shown that about 25% of those with substance-induced psychosis may transition to schizophrenia, with the type of substance being a significant predictor of this transition (Psychiatric Times) .
4. General Mental Health Considerations:
- Around 3-4% of the population may experience significant mental disorders other than schizophrenia. For these individuals, the use of psychoactive substances, including psychedelics, can be particularly detrimental (PLOS) . [NOTE: This seems to be an error from ChatGPT, this PLOS article doesn't seem to support this conclusion. As I haven't done personal work on this yet, I don't know whether the statement is supported by other research.]
- Mental health evaluation and professional consultation are recommended before the use of psychedelics to identify potential risks and ensure safety (Berkeley Psychedelics) .
5. Later-Life Considerations:
- The risk of new-onset schizophrenia after the age of 45 is indeed rare, which suggests that older individuals may have a lower risk of experiencing a first psychotic episode triggered by psychedelics (Berkeley Psychedelics) .
For further reading and to deepen your understanding, you may refer to sources like the National Institute of Mental Health (NIMH), the World Health Organization (WHO), and recent research studies on the global burden and risk factors of schizophrenia (National Institute of Mental Health) (World Health Organization (WHO)) (Nature) . Additionally, the Berkeley Center for the Science of Psychedelics (BCSP) provides detailed information on the safety and risks associated with psychedelic use (Berkeley Psychedelics) .