"Mental" Illness: The Future of Treatment

If by “a compromised sense of reality,” you mean a reality ‘outside the norm,’ what’s the norm and who establishes it? Is that your question in what I’ve underlined?

I think the only answer can be, if a person’s ‘reality’ conflicts with the ‘realities’ of the people within his milieu to the extent that it’s extremely troublesome/worrisome to both, then the first person’s reality might be compromised and s/he should find out if it is. Both psychology and psychiatry (which seem to be merging) can help in those circumstances. But I think the danger in relying only on psy and psy is that both fields can hit on an explanation that gives irrational behavior(?) a cause, and turn it into an all-encompassing cause–even when that ‘cause’ can only be ‘proven’ through comparison of general symptoms, lumped together and given a label.

Neuroscience can, possibly, isolate physical ‘abnormalities’ and use drugs to reverse the effects of those ‘abnormalities’ in some instances–but not all. Psy and psy can lead to behavior modification and the patient’s understanding and agreement/acceptance of the diagnosis–but not all.

Neuroscience is more than the study of brain abnormalities, as far as mental behavior goes, however. Perhaps, to get away from the overuse and over-reliance on drugs that seems rampant in our society, there should be a blending of the three fields, devoted to ‘irrational behaviors.’–Psychology to test and evaluate, Neurology to eliminate abnormalities within the brain, and Psychiatry to treat what’s left after the first two have ‘cured’ through behavior modification and/or drugs depending on the cause. Have I made any sense?

Stat and Liz,
Your posts make sense to me. Let me give an example of a person I dearly love who has been diagnosed as paranoid schizophrenic. Using the net to get information about this, I found a decent site. I think it was from the Mayo(SIC) Clinic. The advice was that one should not try to judge or counter the sufferer’s hallucinations and delusions. These are the person’s current reality.
Lacan finds these “disorders” exemplified in how one uses language. I don’t know enough about that to comment. What I do know is that when I comfort my friend with hugs and attention, she often gets back to the type of reality I’m used to. IMHO, a caring psychotherapy, not that from a doctor watching his clock, can affect the disorder in positive ways.
As to a norm for the sense of reality, I don’t think any such animal exists. But there does exist states of mind from which harm to self or others becomes possible. These must be addressed.

Notice: hugs and attention… not drugs and pseudo-science claptrap invented by industries for profit. My own healing modality of choice is called “Breathwork.” It’s fantastic, and of course involves lots of love and physical closeness as the vibes move up the chakras and the feelings start moving. It’s the best method for accessing birth and very early memories that I know of, btw.

In the meantime, be very, very careful. I’m not a doctor, but, as a person, I’d say the personality, and person, you hold is extremely delicate. If you’re not trained in any of the fields mentioned so far, keep on hugging and holding, but rely on the docs. In paranoid schizophrenia, from what I’ve read, therapy will include drugs, simply to reach a state wherein the patient can accept other therapies. From what I’ve read, the disease is the result of a combination of factors, from genetic through environmental–which would suggest the triumvirate of specialists I’ve mentioned. I’m trying to be very careful with what I say because I’m not qualified to give medical advice–nor is this site.

Paranoid schizophrenia may be manageable. I’m not sure it’s totally curable. Drug therapy may dampen the delusions, but that diminishes the person’s idea of reality, doesn’t it? Would that contribute to the disease? You’ve already distanced yourself from your loved one by ‘intellectualizing’ the illness. People prone to philosophy do that–I know I do.

But I’ve found that there comes a time when ‘intellectualizing’ is, oftentimes, no more than a defense mechanism, which we all need.

We live in a society in which profit outweighs its collaterlal damage–physical, mental harm or even death. The latest statistics are that the the gulf of wealth between haves and have nots has never been greater, at least not for half a century. No remedies for the harm or considerations of deaths are possible under this type of blind obsession.

Thanks for the good advice. I do research on my friend’s condition and listen to ideas given here not to intellectualize, but to find out how to help her without being invasive. I would ask nothing of her that would compromise her integrity. The meds do stabilize, but I cannot believe that she is doomed to a lifetime of delusions and hallucinations that have to be kept at bay by drugs. I would not advise her to get off this regimen; but, I’ve found that honest affection can heal. We’re an elderly, pot-bellied couple, finding comfort in mutual caring.

It’s true that you have to be thoughtful when it comes to drugs. My brother is a psychologist who doesn’t believe in drugging people; but when he gets a client on drugs, he never just has them quit cold turkey. They work together and the client slowly weans off. It’s also important to have a support system in place while getting off the drugs.

You’re welcome. You’re a caring person, obviously, so it might be difficult for you to accept–there are some mental conditions that can’t be meliorated by anything other than drugs as part of a treatment package. I believe this is true with manic-depressive disorder (Bi-polar disorder) as well as paranoid schizophrenia. Think of it like this, a child with diabetes faces the rest of her/his life dependent of insulin because of a defect in the pituitary gland. Is there onus to being a diabetic?

Honest affection can help but there are some things it can’t heal.

Last piece of advice and then I’ll put up my shingle. You found the Mayo Clinic web site which is a good one for a lot of different things. Go back to the site and see if it lists any support groups in your area for care-givers of people with paranoid schizophrenia. It should; but, if not, Google "support groups for care-givers in (your area.) You need to learn what other people in your circumstances have learned.

There’s no reason why your friend can’t lead a ‘normal’ life, if she stays with her docs, her meds and you.

Bless you!!!

Excellent, excellent response Liz. I had a whole reply to Irrellus formulated in my head until I came across this post of yours. I can’t possibly say it any better.

Irrellus,

Your friend’s condition seems very similar to that of my sister. I was in elementary school when her symptoms began to develop as such that she became a danger to herself. My family fell apart, she was transferred around to at least half a dozen hospitals and “care” facilities, and I was essentially left in the dark all the while. My dad refused to believe her problem was beyond her control, mom was lost, and a few doctors told them, quite frankly, they couldn’t [or didn’t know how to] treat her. Anyway, to keep things short, my sister was in desperate need of both love and medication. Love saved her life, but medication gave it back to her. I can’t put it any clearer than that. She is the reason I come chime in on these threads suggesting drugs are the devil. Some drugs are over prescribed, some are abused, some probably shouldn’t exist at all – I can agree with all of that. However, for some people a reliance on medication is not a prison sentence. It is just another consequence of living their lives, like eating and sleeping. I don’t know why, but that fact seems much more difficult to accept for people on the outside looking in, than the people who actually experience the difference. The trade-off can be difficult sometimes because certain medications, specifically anti-psychotics, have a very sedating effect that disagrees with some people. I just believe that some drugs, for certain cases, can come as nothing short of a blessing. My sister lives on her own with a husband and kid now, and is probably happier than I am. She still takes her meds, too. My only advice to you, as you seem to have a good head about you already, is to find and stick with a doctor you can dare to trust. There are good and bad doctors, like anything else, but there are some who actually care. If you ask me, a pill is a small price to pay for a drastically improved quality of life. It just doesn’t seem right to regard the drugs as a crutch in every circumstance. Nobody should ever feel guilty or less-than-‘normal’ for wanting to experience life as their loved ones do.

good stuff…the part about finding a doctor that you can trust is so important…and i would extend that to people that you can trust…you have to be very careful about a doctor–they can make you a lot sicker…

Good support, Stat. And thanks for the real, personal example about your sister. Your post is helpful and caring. The problems with my friend do have to with how her family and friends accept what she experiences daily. It seems they are frustrated about the stigma of diagnosis and the inability of doctors to “cure” her. She is on suicide watch.

i am not up-to-date on causes of schizophrenia…
what is the latest thinking…how is research going…

The latest seems to be that the condition is not split personality; it is experiencing hallucinations and delusions and seeing these as reality. It is considered a lifetime condition. Meds keep the condition at bay, but cannot compensate for the ignorance and prejudices of "friends"and family. It’s not always the Docs who are at fault here–the fault being lack of compassion and understanding.

why are they having hallucinations…is it something neurological.

This is all sounding eerily familiar. At first it was bipolar disorder, then it was possible [paranoid] schizophrenia, then possible split personality, then maybe just depression, until finally people start throwing their hands up in frustration. That’s when my sis got transferred to a live-in care facility where they essentially grouped her with peers and counselors that actually understood her condition. They taught her to live and cope as an individual there. I remember visiting and always wondering why her school was so much cooler than mine. Of course, I didn’t find out the real story until years later when I started asking questions. That was the place that really did wonders for her because it was like 24/7 behavioral therapy where the counselors could also monitor her progress on her meds. The emphasis was taken off of the drugs and they were simply treated as a part of a healthy life, like a balanced diet. I am convinced the success there was due largely to her acceptance – people cared and related to her. She wasn’t just a patient who everyone looked at and scratched their heads like they were dealing with a damned alien.

In other words, I couldn’t agree with you more Irrellus. Compassion, understanding, and support were paramount to her healing. The drugs only help with biological ‘abnormalities’, but enabling her to establish healthy relationships with others, and eventually herself, was the real breakthrough. If the care and support begins with friends and family it is more likely to show in her professional treatment because she [your friend, like my sister] will grow accustomed to that level of comfort and understanding.

Thanks, Stat.
My friend seems to have been dumped here in these apartments with no one to monitor her meds, eating, sleeping, exercizing, etc. I go on walks with her and listen, but the situation is getting beyond my understanding. I need support group help as much as she does. But I don’t give up hoping that I can provide her with a caring companionship that may make her life easier to bear.
Turtle,
It’s a combo of apparently fixed neuron routes, genetics and environment. More than I can understand, but, hopefully, not more than I can compassionately address. I suffer from major depression. Maybe the two of us can find comfort in being with each other that benefits us both. No one should have to face these things alone.

Irrellus,

Just curious, who did the ‘dumping’? Family? If so, my heart really goes out to both of you. Her for essentially being abandoned to care for herself, and you for your compassion. You are an admirable individual in my book, man. Not because you’ve made friends with this person, but because you’ve made a personal investment. you are the type of ‘anomaly’ in society that nihilists have no witty retort for. Your actions obviously mean something, and, even without any innate purpose, you seem to have purposed yourself. I respected you before, but now in an entirely new light.

I suppose what I’m trying to say is that I wouldn’t mind being more like you.

My last piece of advice is just to agree with something that has already been said: There is support out there that can help her, and even you. I think an introduction to a group of peers that not only recognize, but understand and relate, to her condition can do wonders for someone [perhaps like your friend] who has been ostracized due to circumstances beyond her control. That was the main point of my last post about my sister being transferred to a sort of care community [in case the point got lost in all the extra details] where she began to thrive again.

As do I. And I have since elementary school, back when I didn’t even understand enough to really be “depressed” about. But I was, and still struggle daily. Maybe it’s genetics considering how my sister’s situation evolved, but who’s to say. You must admit, though: Seeing someone in a far more compromising situation kind of lends a new perspective to your own ailments, no?

I’m a full grown man and not embarrassed to say I wish I could give you both a hug.

I’m no saint, my friend, and often am not someone to serve as an example for others. Floundering is what I do best. My life includes many “dirty deeds done dirt cheap”, paranoia, judgmentalism, etc., etc. Intersubjective communication sometimes sets me straight in daily attempts to get outside the locked-box of self-closed mind wherein disturbances ruminate and fester. I’ve been advised that the local chapter of NAMI may be my and my friend’s only resource for identifying with others who suffer in the ways we do.
If I’m not getting too personal, how do you handle your depression? Most times I just have to wait mine out and hope I didn’t do anything stupid or unloving in the interim. Humor helps. Music helps. Hugs do the best help. Thank you. And ditto.
My friend’s family seems not to know what to do with her, which has more to do with ignorance than lack of caring.

Of my friend–I have to be totally honest with her, which prompts thorough examination of my motives. When I hugged her she thanked me for touching her. That humbled me. Such gratitude, IMHO, is unwarranted. She should be touched by anyone who claims to love her or even care for her. I thank her back for touching me. I’m afraid that in her reliance on her negative self-image she will come to resent me for tresspassing in her familiar mindset. Change in a sense of reality is often emotionally painful, even if the change is for the better.
I think we can agree here that current therapy suffers from lack of empathy and compassion, that the more skilled therapists have little time for such concerns or consider them obstacles to objectivity and that the general public is still remarkably ignorant of, or biased toward, mental illnesses. In this situation I think we can agree that group therapy, with its sharing of experience, may offer what is missing from one-on-one talk with doctors and drug stabilizers.