"Mental" Illness: The Future of Treatment

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.

Liz,
Your comments appreciated. I’m with J. about ten times more time than I’m on computer. Reading from WWIII’s journal, I find the same things J. says, just in different contexts. I cannot really say much that would help him in this virtual venue. I can say things about J. and ask advice on how to help her. She is, for me, anything but virtual. She’s here and now, alive and suffering. She is not my "cause"or obsession. I love her and would exit from her life on her word alone. Given my family history, I have about ten years left to live. What better way could I spend these years than supporting someone I love, someone whom life has dealt a bad hand, as mine has. I have no ulterior motives or desires that go beyond here and now acceptance of what is. I come to sites such as this for my rational “fix”, since her life and mine include so much that is irrational.

I’m glad that’s finally out–it took you long enough! :smiley: I see no better way for you to spend your life than with someone you love and, as I said much earlier, I see no reason why it can’t be a ‘normal’ life as long as she stays with her meds and therapy. From what I understand of what WWIII wrote, part of his therapy was learning how he felt when he started slipping into a psychotic state and working himself out of it. Whether or not he learned that through group therapy, I don’t know–you might ask him in a PM. And I still think you both would benefit from an informal support group.

Have you met her family? I believe you should so they can see you for who you are and not as what they might think you are–the reverse is also true. I got the impression, early on, that you thought her family had abandoned her–and yet they’re supporting her. Perhaps she simply disappeared herself and her family finally found her and got her the help she needs. (I’d probably make a pretty good soap opera script writer–I have lots of plot lines running through my head.)

Whatever–

If J. returns your feelings, and I sincerely hope she does, I’ll pray that everything works out well–actually, I already do send my good thoughts into the oosphere, I’ll just send more of them.

PS I don’t think WWIII needs any help and I don’t think that’s why he published his journal on the board. I believe he wanted to answer questions and clear up mis-conceptions people here have concerning MI. We don’t read stories that often about bi-polar disorder unless it leads to homicide, which isn’t very often in the general scheme of things.

Again, thanks for your understanding.
Yesterday I met J.'s case worker. I engaged him only in trivial conversation. His duty seems to be to come to J.'s apartment on Fridays and bring her meds. This Friday he informed her that she would need to come in for a shot. That verified my suspected diagnosis. Shots such as those of Haldol are given to patients who are schizophrenic, whose meds are becoming ineffective or are not taken regularly.
After the case worker left J. told me the shot would turn her into a bug. Later when her meds kicked in she said that the shot would make a lie of everything she believed. For her, the hallucinations and delusions are a meaningful part of her existence, a real, alternative sense of reality. But many breakthroughs are happening. Good things among the bizarre.
For those who are turned off by these personal assessments, I’d still like to consider further the human sense of reality–what makes it happen. Schizophrenia has no known cause or cure. The best that can be done is to “soften” the symptoms. I think Jaynes was on the right track about an evolving sense of reality as is Wright (“The Evolution of God”–2009) in considering ideas of the last extant primitive societies. The brain chemistry of primitive peoples still alive can be assessed if they could submit to our imaging techniques. While they may not want to do this,their very words covey their brain activities. Also, the “psychotic” nature of dreams should give us some evidence of the sources of psychoses.

Yes, Haldol is given to schizophrenics–oftentimes because they don’t take their less strong medications regularly or when they’re first diagnosed and before they’re put on the less strong meds. So let’s talk a bit about the function of the limbic system, shall we? You can google it and find out where it is within the brain, the organs within the system, and its many functions. Basically, it’s about memory, spacial recognition, emotion, etc. all of which contribute to our sense of reality. Most people have the ability to ‘separate’ their inner, subconscious memories and/or percepts, from their conscious percepts. Other people don’t have that ability to a greater or lesser extent. The ‘separation’ is blurred. If the brain has a ‘clear separation,’ his/her conscious percepts are ‘closer’ to ‘reality’ than are those of a person whose ‘separation’ is less distinct. I think the brain ‘constructs’ reality in different ways–if the separation is clear-cut, it’ll treat a percept as the reality we see around us; if, on the other hand, the ‘separation’ is blurred, the brain will treat is as such. The schizophrenic, apparently, has the latter type of brain function, so the differentiation between what is ‘actual’ and what is hallucination becomes interchangeable and the hallucination seems more real than ‘reality.’ This could be a part of the neurological aspect of schizophrenia–the part that may be genetic.

Then there’s the emotional/environmental part, which could come from any number of stimuli. This is where psychotherapy can be useful. It’s hard to talk about this because of the plethora of pseudo-science so many people use, whether or not they understand what they’re saying. However, we all carry memories and we all react to those memories–whether they’re sub-conscious, unconscious, or even pre-conscious. We can deconstruct our thoughts–through introspection, meditation, and so on–by ourselves, or we can go through ‘guided’ deconstruction with the help of a skilled psychotherapist. Most people choose the latter method.

For a schizophrenic, however, the first thing that must be done is to control the symptoms. So far, that means drugs. If you get to a point of trust with J. and her care givers such that you can monitor her drugs, do so. Get her drug schedule and toddle on over to her apartment and watch her take the drugs she really does need.

Remember, until she’s stabilized, her illusions are her reality. You can’t ‘shatter’ that reality in one swell foop, nor can you go along with it. But you can take her for walks–or the zoo–or a museum–or an art gallery. If you get her stabilized with her meds and earn her trust, then I’ll plan your wedding.

In the meantime, don’t rely too much on philosophy–you’re not faced with a philosophy problem.

Ier, I’ve just re-read both this thread and WWIII’s. I hope I haven’t given you bad advice–although WWIII did advise against trying to introduce outside “reality” to a schizoid personality until the person recognizes the difference between the two realities and trusts your reality over hers. That’ll be one hell of a leap, and it’ll only happen with drug therapy.

It makes no difference what a schizoid personality ‘feels’ when they’re taking their meds–their perceptions aren’t ‘normal’ to begin with. Is rational thought possible for an irrationally thinking person?