"Mental" Illness: The Future of Treatment

Get rest, lady!!! And thanks for caring to stick with this scattered approach to MI.

Sorry I didn’t make it yesterday–I slept late and what was left of my day was squandered on trying to convince LT he was being foolish in another thread.

Yes, there is a ‘scattered approach’ to MI and it isn’t just in this thread. No matter how many advances have been make by neuroscience, they can only be generalized theories. Despite what the computer generation feels, the human mind is not–I repeat–not a computer; it never has been, and it’s silly to think of it that way. The human mind is unique and individual. Neuroscience cannot be.

I read about a woman in Oregon who had oral surgery consisting of removing all of her upper teeth and half of her lower teeth due to gingivitis. They were replaced with dentures, either implants or the take out kind. When she woke from the anesthetic, her accent had changed. The oral surgeon told her she just needed to get used to her new teeth, but the accent change persisted. She finally went on line and learned there was a condition–a very rare one–called, I think, Accent Change Syndrome–that usually occurs after some kind of brain injury. And who’s to say whether or not either the anesthetic or the procedure altered her brain, in some way.

Anyway, the last I heard, she hadn’t had a brain scan because her insurance doesn’t cover it. Is she an example of the individual brain’s uniqueness? I don’t know.

J. must have lucid moments when she’s on her meds, even Alzheimer’s patients have lucid moments and are able to function normally. Why don’t you ask her some of the questions yourself? If you want to, tell her you’re asking the questions because you’re concerned about her welfare and would really like to help her any way you can, but that you’re not a doctor and don’t really know how to help her unless you can get to know her better. If she doesn’t know what a brain scan is, describe the procedure to her.

Television has done a lot to propagate the myths surrounding MI which only adds to misunderstanding by the general public. If you were to mention a fear of heights or PTSD, the public would probably have a better understanding because the first is a very mild phobia and the latter has been given an excuse. People need to label and they need to give the labels reasons. PTSD in a combat vet is ‘understandable,’ but there are other causes of PTSD.

I have two nephews, one is an Afghan war vet who was sitting behind a buddy when their vehicle hit an ied. The buddy was killed; C. was wounded. That’s the understandable PTSD. My other nephew responded to his sister being attacked and stabbed in her bedroom by a former boyfriend who’d gained access into the house and assaulted her after she was asleep. M. responded rationally by calling 911 and then directing the police to the proper house. He, too, has PTSD, but that’s the kind of PTSD that isn’t understood and accepted under the label–and usually goes untreated.

Once again, we’ve gone far afield from your op.

To anyone reading this thread, please remember–the human brain is individual and unique. Any ‘modeling’ of the brain can only be generalized modeling, because it isn’t a computer.

Your insights are much appreciated. About J. On Sunday she decided to get drunk (self-medication). When I was able to get to her she was well on her descent into the maelstrom.
She did not know me. She talked of suicide. I stayed with her until she could sleep. On Monday she knew my name and was apologetic for Sunday’s confusions. I am able on her lucid days to hear her descriptions of her illness.
Abour the brain/computer analogy–this is commonly used by AI advocates who forget that brains are organic, dynamic and complex. Brains invented computers. There are more neuronal connections in a brain than there are memory units in a computer. One author noted that if a computer could be built that had all the capacities of the human brain, it would be ten stories high and the size of Texas!

Digging deeper in hopes that personal experience and objective opinion will yield ideas better than each alone, I’d like to present first the case for and against cultural or societal causes of schizophrenia. It will be in two parts. First, the idea; then its refutations. All quotes are from Torrey.

  1. “Christopher Lash. . . in his 1979 “The Culture of Narcissism”, claimed that psychoses are in some sense the characteristic of a given culture. He also quoted Jules Henry who wrote ‘psychosis is the final outcome of all that is wrong with culture.’”
  2. R. C. Lewontin, et. al., “. . .in the 1984 book 'Not in our Genes”. . .write “An adequate theory of schizophrenia must understand what it is about the social and cultural environment that pushes some categories of people toward manifesting schizophrenic symptoms.'”
  3. Dr Szasz–“According to Szasz, schizophrena and other mental diseases are simply semantic artifacts and do not really exist. . . . People with schizophrenia, says Szasz, have a “false disease”, which is the sacred symbol of psychiatry.” To be a true disease, Szasz claims, it must be capable of being approached, measured, or tested in a scientific fasion."
  4. R. Laing–“He promoted the idea that schizophrenia was a sane response to an insane world and may even be a growth experience. . .”

One of the problems with books on any dynamic subject is that they’re often obsolete before they’re even published. Another ‘problem’ with what you’ve quoted is that 1, 2, and 4 all involve a ‘cultural’ basis for psychoses. #3 implies that psychoses aren’t ‘real’ diseases because they can’t be shown to be real in a ‘scientific’ fashion.

Let’s take ‘culture’ on, shall we? According to Lash, by his title, he seems to feel that ‘narcissism’ is a predominate within a culture that causes psychoses. Lewontin, according to your quote, feels we have to understand the “social and cultural environment” that leads some people into schizophrenic symptoms. So what is that environment? Is it a narcissistic society or is the psychotic narcissistic? You haven’t given us enough on which to base a decision.

Is Szasz correct in calling psychoses false diseases? He could be, but I don’t think so. It depends, doesn’t it, on how one -defines the environment in which psychoses develop and present?

In the meantime, have you asked J, what her docs have told her? What drugs she’s taking? Whether or not she’s ever had a brain scan? What she feels about what the Docs have said. What her family thinks? What her life was like before she became ill? Aren’t her answers more relevant than what books say?

Liz,
I’ve made a list of antipsychotic meds and will see if J. recognizes any of them. I’m going slowly with her so as not to be invasive or appear meddling. Perhaps the following will address some of the good questions you raise.
Part 2.
“If the brain was so simple we could understand it, we would be so simple that we couldn’t.”–Colin McGinn
Dr. Torrey cites several 19th century physicians who recognized MI as brain diseases, not as some “semantic artifact”. In the past three decades EEGs, describing brain waves, and PET and MRI brain imaging techniques have detected radical differences in brains of schizophrenics as compared with brains of persons who do not have schizophrenia. Differences of electrical potential in neurons, of functions of known neurotransmitters and even of the physical structures of the brains are clearly evident. Scientific study of MI is well underway and has been for decades.
According to Torrey, after Laing’s daughter contracted scizophrenia and Laing’s Kingsley Hall experiment “in which people with schizophrenia were allowed to experience their psychosis amidst friends and family who were loving” and meds were given only to those patients who asked for them failed, "Laing became increasingly disillusioned and alcoholic. . . .In 1982 he commented to an interviewer: “I was looked on as one who had the answers but I never had them.'”
continued–

I still have met persons in 12 step programs who claim all this “chemical imbalance” stuff is BS. And I have family who still believe MI is demon posession.
I’m familiar with Dr. Szasz from reading his famous statement: “Mind is a verb!” and Lewontin"s valuable work on genetics and environment in “The Triple Helix”. I’ve heard about Laing, but am not familiar with Henry or Lash. The brevity of their takes on social or cultural causes of MI is Torrey’s lumping them all under “obsolete theories”.
I’d like to see someone describe how an “insane” society or culture produces “insane indiviuals” backed by research into which societies do this and which do not. Reinforcing such a description would be studies of how cultures can cause radical alterations in brain structure and function. All else seems to me to be anthropological or philosophical wishful thinking. What is a sane society?

One of the things I worry about with regards to any intake-chemicals, is if we continue to take them, that is in effect an alteration of our habitat, is it not possible that as time passes as we evolve that we will come to relly on the various chemicals we have been takeing in order to function “normally”?

Dear Friend, If you have family who believe in ‘demon possession’, that’s a pretty insane culture, imm. Are there 12 step programs for people other than alcoholics? I suppose there are–like for people ‘addicted’ to gambling, shopping, and so on. I don’t think there’s any way for AA to treat people who are ‘true’ alcoholics. My younger brother (adopted as an infant), was a true alcoholic–he had a mental illness that ultimately, but indirectly, killed him two years ago, five months before his 48th birthday. Alcoholism is as much an MI as is PS, but it’s not treated as such.

Anyway,people don’t ‘contract’ an MI the way people contract a cold or the flu. That’s, to me, a gross fallacy. If a peer group considers Laing–and I include him because of what you’ve said about him,-- Henry and Lash to be positing ‘obsolete theories,’ I’d go along with that. I’ll try to do some on-line research into Szasz and Lewontin, and their work later tonight and tomorrow.

I don’t believe society and/or culture–insane or not–can alter brain structure or function. The world and it’s various cultures could, however, play ping-pong with brain chemistry and thought–I just think that would take a long time–like generations. But we see generations of tribal culture and thought influencing the ideologies of nation-states within the ME and Africa, don’t we? Does that lead to PS as an MI within our culture, however? uhmm–interesting… is that how an “insane” society or culture produces “insane indiviuals”. Are radicals ‘insane?’–or are those cultures and societies only ‘insane’ because they’re ‘different?’

I know you have to tread cautiously with J.–she’s fragile–but sometimes direct questions get better results.

Take all the time you feel you need and do your research wisely. Again, have you found a support group for you?

No, Valley, taking an aspirin for a head-ache isn’t going to alter our ‘habitat’ in any way, shape or form. Your use of the word ‘habitat’ isn’t correct–look it up. I’d also recommend googling evolution.

“is it not possible that as time passes as we evolve that we will come to relly on the various chemicals we have been takeing in order to function “normally”?”

Again, no. There’s a tremendous difference between drug ‘users’ and people who take drugs for psychiatric or physical equilibrium. You can learn those differences by researching them. Do that and make your own decision. Then we can debate the subject.

In the meantime, remember–spell check is your friend–just don’t rely on it too much. If you learn the spelling ‘rules,’ you’ll save yourself a lot of time.

Isn’t aspirin influencing our physical body which is a part of our environment? one can’t simply assert that the environment is simply outside of the body. The body is a part of the environment of our brain, and if you believe in something more fundamental then our brain then the brain is an environment for that. It seems perfectly plausible, i mean for example Chimps and apes mostly eat fruit, so at some point we had to begin to eat meats, and now our bodies require certain chemicals that are in meats, although there are now other ways of getting those chemicals. It seems perfectly reasonable to think that if we take aspirin for headaches long enough our headaches might become consistant to the point that in order to function normally we have to take aspirin constantly…

:angry: [-( No, you understood what I meant, why put in extra effort to make things look nice just to avoid having someone comment on one’s lack of asthetics. Its the message that counts not how the message is recieved… Most of the time…

Check this out: anvari.org/log/20030916.1803 … earch.html

Again, thanks Liz for understanding. After reading Torrey I found that many of my preconceptions were open to revision or deletion. First, about J.'s family “dumping her here”, I’ve learned much about what families are up against in trying to help their loved members who suffer these diseases. The greatest obstacle to efficient and timely help for schizophrenics is the cost of treatment. Government assistance through medicaid is severely restricted and sometimes entails inhumane conditions for assistance. In the 1980s I worked in a city that had a state mental hospital. When medicaid officials decided to help defray costs of therapy only for persons who went to hospitals that were not state supported, many state institutions closed their doors or forced the majority of their patients onto street or family. I saw this happen in the city where I worked. Some of these dislocated people made it in the outside world; some didn’t.
J. does not know what her diagnosis is. She claims it is “postpartum blues” that have persisted for nearly three decades. She did recognize some meds on a list I showed her as drugs she takes. These included a couple of antipsychotics and a couple of drugs for depression and anxiety.
Here in these apartments some tenants see J. as an easy take. Her family gives her spending money. Once she gets it she will give it away to alcoholics who spend time with her in order to buy their fix and to anyone who offers her a hard luck story. She often does this at the expense of taking care of her own needs. This is the situation I find problematic. I cannot tell J. how to spend her money or what friends to have. Neither can I persuade the sots and freeloaders that J. cannot afford being their bank or source of revenue or that alcohol intake renders her meds ineffective They see J. as the goose who lays the golden egg. I’m happy that recently she has asked me to hold money for her. That’s trust beginning; and, with her trusting in me, I can help her more.

Other 12-step programs than AA include Emotions Anonymous, Codependency Anonymous, Fundamentalism Anonymous, etc., etc., etc.,

On J. Because of our state’s doctor-patient confidentiality or privilege laws I am unable to ask her doctor or case manager about such important issues as what meds she is on, how long she has been on them, what are their known side effects, etc. I have to find this out from what she and her family are willing to tell. All I can ask of her case manager is how I can help without hindering.

I wouldn’t expect you to be able to question her doctor or her case worker–doctor/patient privilege and privacy are true in any state. I’d also question the advisability of questioning her family about her or her meds. That’s why I’ve recommended a support group for your benefit.

You say J. recognized more than one drug on your list of drugs. Is she on all of the recognized drugs at one time–now–or have some of the drugs been tried with her before and shown to not work? Let me put it this way–In my mind, she shouldn’t be on more than one anti-psychotic, and possibly shouldn’t be on an anti-depressant at all, if the anti-psychotic is working for her.

If you can’t find a support group, I suggest you go to your own primary care physician, explain the situation to him, and ask his advice on whether or not there’s anything you, alone, can do for her. And don’t be afraid of his answers, no matter what they are. IOW, don’t be angry if he simply says, “No, there’s nothing you can do.”

I have and I think I’ve more than answered it.

My main objection to your post is that it really has little to do with the thread, which is about the future of the treatment of MI.

Liz,
I’m contacting J.'s case manager, hoping to speak with him personally about what I can do to help her. This would probably not fall under any infringement of doctor-patient confidentiality/privilege laws. I’ll let you know what his response is. Thanks for keeping this thread afloat. I think its personal nature doen’t sit well with many who believe that only objective takes are relevant. I’d also like to discuss further the 12 Step approach as therapy. It has plusses and minuses. PS patients need no minuses. Yet, 12 step programs are currently accepted as a legitimate form of therapy by many psychiatrists.

Ier, Have you read WWIII’s thread about what it feels like to experience psychosis? I suggest you do.

Was J. either a bag lady or an alcoholic? Would that be why she gives her money away?

Have you found a support group yet?–I’m going to hound you about that, you know.

Stay well, L.

I’ll read WWIII’s thread with the reservation that these conditions are illnesses not claims to being special.
And, yes. J has run the gamut of homelessness and despair.
J.‘s case manager read the note I gave asking how I could help and left it on her coffee table without response. I went to check on J. after the CM had left. She had her microwave on 36 minutes with nothing in it. Clearly he could use my help. I briefly met her daughter who was delivering grocreries. She simply thanked me for helping her mom and quickly left. I can understand the reticence on both counts.
About support, I have NAMI for discussing these issues and Recovery-World.org, which has the 6-step schizophrenics’ recovery program, a condensation and customization of AA’s 12-step program, and a forum.
J.s desires to do “normal” activities such as working are heartbreaking to hear. But I will not give up hope. My problems are minimal compared with what J. faces daily. I’m OK.

Hi, Ier, WWIII’s thread is one thing–you have to read his whole op–including the 12 1/2 pages of his journal. In no way does he come across as thinking of himself as ‘special’–except when he thought he had esp and was able to give everyone else esp–which meant, to him, everything should be ‘free’ to him, because mankind had benefited so much from his giving everyone esp powers. Or when he thought he could guarantee every woman heaven and every man hell simply because he could.

There is a thread, of sorts, that runs through his psychosis–a desire to

Don’t just read the thread, read WWIII’s 12 1/2 page journal that he seems to have written as a part of his therapy. One sort of thread seems to run through the journal, WWIII’s trying to ‘explain’ his thoughts rationally while admitting that he can’t because he wasn’t rational at the time. I’ve not read the book, A Million Little Pieces, so I really can’t compare the two. I can only opine that, while Frey was writing a book–either fictional or non-fictional,-- WWIII seems to have written a partial journal as part of his therapy. Read it and decide for yourself.

Can you honestly say what I’ve underlined above?–Really? Is running your microwave oven with nothing in it a sign of psychosis? Has your concern for J. not, possibly, become an obsession? Rather than go to the internet for support, why not get out of your apt. and meet real people with real voices who aren’t afraid to say what they’ve experienced, one-on-one?

Ierrellus, I’m not a person–I’m a bunch of words on your computer monitor. You need real people and real people contact. As a virtual person–a bunch of words on your computer screen–I can say I care for you. But what’s more satisfying to you–to be given a virtual, verbal hug, or to be given a real-live hug by a real, live person who shares, at least to some extent, your real, live feelings.

This is rather garbled because I thought I’d lost my original start of a response to you. I’m not going to fix it–it’s too late. You’re intelligent enough to unravel the garble, I’m sure.