
The Touch of Madness - fern12
https://psmag.com/magazine/the-touch-of-madness-mental-health-schizophrenia
======
wellthen
I was diagnosed with schizophrenia about 11 years ago.

The "double bookkeeping" mentioned in the article is a neat description of how
I sometimes dealt with the hallucinations. Everything I experienced was real
to me but I quickly realized that it was not "objectively real", for lack of a
better term. I had the luck of having a GREAT support network, and I highly
believe that its because of that I'm functioning today.

I'm currently symptom-free and have been for a few years (despite being a
dumbass who cold-turkey'd my meds without my doctors knowledge). I want to try
to help anyone who's feeling isolated due to "mental illness" (not a fan of
that term either). Drop me an email: helpful at hax dot xyz

(apologies for rambling and/or strangely formatted text, writing this on phone
whilst commuting)

~~~
SomeStupidPoint
I ended up stumbling on that idea of "double bookkeeping" as well, though in
the context of acute drug induced hallucinations.

What made it hard for me is that both sets of ideas are correct about some
aspects of my experience and wrong about some aspects. The hallucinations are
mostly wrong where they deviate from "standard" reality, but they're not
entirely so and seem to be capturing _some_ patterns that my brain is picking
up that I can't articulate through other mechanisms. Counter-intuitively,
admitting that there were facets of the hallucinations that _did_ make sense
made it easier to deal with accepting that there were parts that _didn 't_ as
well.

I view it as having two approximate models for reality which have different
faults -- one model is knowingly incomplete (but scrupulously consistent); the
other model is knowingly inconsistent (but has models for any experience, and
serves for "experimental" ideas). The goal is to try and work both towards a
shared (underlying, objective) truth trapped "between" them in some sense.

~~~
cvsh
>but they're not entirely so and seem to be capturing some patterns that my
brain is picking up that I can't articulate through other mechanisms.

Drugs made me more aware of how routinely our brains mildly hallucinate in
ways that are designed to be imperceptible so as to 'smooth over' our
perception of the world (i.e. our blind spots
[https://visionaryeyecare.wordpress.com/2008/08/04/eye-
test-f...](https://visionaryeyecare.wordpress.com/2008/08/04/eye-test-find-
your-blind-spot-in-each-eye/) ).

It always seemed as if drug-induced hallucinations were less some kind of
emergent or externally-imposed phenomenon and more of the drugs simply
ratcheting up the misfire rate on normal systems of consciousness like face
recognition, pattern recognition, piecing together incomplete information via
extrapolation from memory, etc.

Learning to recognize this kind of 'misfire' and label it as distinct from
objective reality was enormously helpful to me when it occurred to my emotions
later, because of bipolar disorder.

~~~
icebraining
The Charles Bonnet syndrome is a good example:
[https://en.wikipedia.org/wiki/Visual_release_hallucinations](https://en.wikipedia.org/wiki/Visual_release_hallucinations)

------
taneq
> When the director of the World Health Organization's mental-health unit,
> Shekhar Saxena, was asked last year where he'd prefer to be if he were
> diagnosed with schizophrenia, he said for big cities he'd prefer a city in
> Ethiopia or Sri Lanka, like Colombo or Addis Ababa, rather than New York or
> London, because in the former he could expect to be seen as a productive if
> eccentric citizen rather than a reject and an outcast.

I can't help feeling that this is based on some pretty skewed statistics.
Someone in Colombo or Addis Ababa who's 'a bit odd might' well be seen as as
'productive if eccentric'. I don't expect a first world country would be any
different. But the question is how do people further down the spectrum end up
faring, and I can't imagine a raving lunatic would do better, on average, in a
big city in a poor country than they would in a similarly big city in a rich
country.

~~~
SomeStupidPoint
> I can't imagine a raving lunatic would do better, on average, in a big city
> in a poor country than they would in a similarly big city in a rich country

Is this anything but an argument from failure of imagination?

As a neutral observer, it seems more likely that the director of the WHO's
mental health unit is informed about the experiences of the mentally ill
across the globe than your hunches are. My hunch about statistics is that your
feeling about statistics is rooted in unsupported beliefs about your society
as opposed to facts.

I think the implication is that some places (Ethiopia or Sri Lanka) are more
open in what constitutes "a bit odd" versus "deranged" than others (US or UK),
and that this _greatly_ impacts outcome once you account for general
conditions of living (ie, only talking about big cities).

> I can't imagine a raving lunatic would do better

Notice how you jumped to an extreme to make your point -- raving lunatics are
unlikely to do well anywhere so there is unlikely to be much variation in the
outcome for them, you are correct. But what does the distribution look like?
The median? The mode? etc. The vast majority of schizophrenics aren't raving
lunatics -- though they are very susceptible to how they're interacted with by
society.

I'm inclined to believe that when discussing the distribution of outcomes, the
expected outcome on average is better where the WHO director believes it is.

------
warent
Very inspirational and empowering story. It goes to show that a large part of
mental illness is inflamed by rejection from society, depleted self-esteem,
and lack of trust. There are too many doctors that are all too willing to
condemn their patients to a resigned fate of helplessness, meanwhile these
people can demonstrably be healing and living with the right support systems
and guidance.

Compassion, empathy, and true interest in the wellbeing of others are the keys
to happier, healthier humans-- as well as a better, more peaceful world
overall. This is particularly true for people we may not understand.

~~~
wellthen
Agreed.

As an anecdote, when I had been symptom-free for a couple of years, I decided
to move to a bigger city for work. Because I didn't know anyone else living
there, I fell back into old habits of isolation and my hallucinations came
back. I ended up explaining to my employer and we came to the conclusion that
I couldn't keep working there as remote work wasn't an option. A few weeks
after I had moved back home, the hallucinations stopped again. I quickly
realized that my support network was the main thing keeping me "sane", and as
such I started valuing them much more and ensuring they know that I'm here to
support them too.

------
puranjay
> Western cultures tend to send the afflicted into a downward spiral rarely
> seen in less modernized cultures

This reminds me of some of the "poet-saints" in Indian culture such as Kabir.
By conventional wisdom, these men would have been deemed insane - vagrants who
renounced all material possessions to walk about the earth, preaching a
strange amalgamation of various religious ideas. Yet, they are a part of
Hindu, Muslim and Sikh religious thought today.

