
Schizophrenia’s Tangled Roots - antigizmo
https://www.sapiens.org/body/schizophrenia-tangled-roots/
======
tudorw
If you're interested in this do have a look at some of the work on
Psychoneuroendocrineimmunology (PNEI for short), emerging understanding of the
microbiome, the gut brain axis, the role of bone-marrow in all of this, for
example;

Neuropeptides and the Microbiota-Gut-Brain Axis
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359909/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359909/)

or something a little more mainstream that appeared on HN, "Don’t hate your
gut: It may help you lose weight, fight depression and lower blood pressure"
[http://www.salon.com/2017/07/14/do-not-hate-your-gut-it-
may-...](http://www.salon.com/2017/07/14/do-not-hate-your-gut-it-may-help-you-
lose-weight-fight-depression-and-lower-blood-pressure_partner/)

------
DanBC
Jacqui Dillon is an influential person in UK mental health care.

This submission starts with a description of her service experience 25 years
ago. It's clearly an awful experience.

But it doesn't talk about the things that have changed.

People who report sexual abuse are much more likely to be believed. Things
aren't good, but they're much better than they used to be.

There are early intervention in psychosis services in some parts of England.
(Regional commissioning mean they don't exist everywhere). These work with
people who have a first episode of psychosis.

Very recently there has been a lot of work around perinatal mental health (the
Twitter user Rosey - @pndandme runs some Twitter chats and they'd have lots of
info about how good / bad services are).

Importantly, mental health teams are multidisciplinary teams. That team would
include social workers (who have some statutory duties), mental health nurses,
occupational therapists, and a psychiatrist. They'd arrange access to other
teams - psychologists, housing advice, debt and benefit advice, employment
support, social activity, exercise support. (Not all of these would be "THE
NHS"' see of it would be charities or community interest companies or private
companies. They should all be free at the point of delivery).

MH Professionals are much more comfortable with "breakout symptoms" \- they
know that antipsychotic medication has pretty devastating side effects, so
they want the patient to be on the minimum needed dose. This might mean that
people still have auditory hallucination, but are given support to cope rather
than being heavily medicated.

The article suggests that many psychiatrists are only there to prescribe meds.
That is an important part of their job (they're the only ones who can
prescribe meds), but there are plenty of doctors who fully accept the "bio
psycho social" model, and who focus on the psychological and social factors.

The article.makes it sound like none of this is happening.

Also, go careful with Lurhman, there are several critiques of that report.

~~~
dsego
Why should we believe reported sexual abuse from someone experiencing a
psychotic break? I have a family remember who spent two months in a psych ward
last year. They had secretly stopped taking their meds and started practicing
some weird form of meditation that triggered vivid recollections of childhood
abuse. This culminated in accusing everyone in the family of sexual abuse and
even talk about a secret pedophile society in our town. It took heavy doses of
anti-psych meds and injections to get them back to reality. Now a year later
they don't even mention any of the experiences.

~~~
phkahler
>> Why should we believe reported sexual abuse from someone experiencing a
psychotic break?

You should not take it at face value. But neither do I think you should tell
them it didn't happen and it's all in their head. The later is telling them
there is something wrong with their mind (to shame the patient can be
extremely bad practice). Also, if you reject the notion of abuse and it turns
out some of it was true, you'd be gas lighting the patient which will lead to
additional distress and a distrust of the very people who are trying to help.

On a purely speculative note: Perhaps your family member had experienced some
of that abuse. Perhaps the stress they were under (and that is a very broad
term) lead to those thoughts mixing with all sorts of present day events and
people. Whatever the cause, given what they went through to get pulled back to
reality do you think they'd ever mention any of it again?

~~~
xxyxx
>> Also, if you reject the notion of abuse and it turns out some of it was
true, you'd be gas lighting the patient which will lead to additional distress
and a distrust of the very people who are trying to help.

Absolutly true.

If you deal with a psychotic it is very hard to convince them it's a delusion.
People won't understand the patient and will treat them like an idiot and
crazy person. Try to treat the patient and the delusions with respect and at
least try to understand the situation. If you dismiss it as "crazy talk" and
insult the patient's intelligence you will only make it worse.

I suffered for years and it was a neverending nightmare. Nobody will ever
understand the horrible things I went through. And the worst part of it all.
You get told everything is delusions. No one believes you and you doubt
yourself. I will never know what experiences were real and what experiences
were only in my mind. And it's really hard. I know some of it was real. But I
don't know how much and what. I have the constant feeling everybody is
gaslighting me and just wants me to believe I'm crazy through and trough.

These days I avoid social interactions and keep to myself. I don't trust
people anymore and isolated myself. I read a lot and feeding my brain somewhat
intellectual content to keep it busy. It seems to work. I haven't had a major
episode in 2 years. Which further confirms my theory, that it was the
environment and the people around me.

I'm happy when I'm alone and I can relax. But I have the constant feeling that
I will never know the truth about my experiences and nobody will ever tell me.

My point is never, ever under no circumstances lie to a shizophrenic. Not even
If you think you are doing a good thing. Tell the truth, even if it will hurt.
Not knowing is really really bad for mental health. And we are not exactly
good on social cues, so tell it like it is and don't be subtle.

source: I was diagnosed 8 years ago

edit: typos

~~~
SolaceQuantum
I'm schizotypal so I'm not as bad but I can definitely echo these sentiments,
and I would also say that dismissing someone's experiences is incredibly
invalidating, especially when it comes to just trying to make friends. I
struggle reading human behavior over my paranoia and people can be upset and
call me an abusive person for my asking their behavior or seeking their
confirmation for their behavior, which often itself becomes them behaving in a
gaslighting manner to me in order to prevent me from questioning them. It's
really upsetting because I cannot tell if what I am understanding from
people's behavior is correct and I am scared of asking.

~~~
phkahler
I believe this applies to all the cluster A personality disorders. Traditional
and widely taught forms of therapy can be harmful to them.

------
macawfish
I am convinced there are times I could have been diagnosed as schizophrenic or
schizoaffective. Certainly I've experienced psychosis. When I was in my early
20s, I smoked nasty weed (not enough CBD) in blunts, cause that's what my
friends did and I didn't have the humility yet to accept my own limits. I
gradually developed a very heightened sense of my own inner voice(s), and also
became intensely paranoid of certain symbols, which I would subconsciously
check for everywhere, while consciously they seemed to pop up all over the
place, as if by fate or chance. I knew things were getting out of hand, as my
"inner critic" would sometimes feel alien and beyond my control. It would
speak loud and clear, ruthlessly. I started to feel very split. Somehow, I
managed to cool it on the blunts and took a step back from my regular friends
to focus on school. I'm grateful that I had this insight and was able to find
the humility to let myself have moderation. That humility did not come from
the inner critic. It came from a small, incredibly gentle voice that I rarely
noticed at the time. It said "you don't have to smoke, don't worry, its
alright not to."

Now all along I was able to recognize and hold onto the idea that these were
"my voices," and I trusted in that. I'm so grateful that even in the turmoil
(e.g. anxiety/panic attacks) I never fully repressed or made enemies of these
experiences, I never fully dissociated. I never let myself dis-identify with
even the scariest voices. I was lucky too that nobody ever brought me in for
diagnosis. Looking back, I think that could have triggered a full blown break,
complete with dependence on powerful psychiatric drugs.

Thankfully, I let myself stop smoking weed, other than very
cautiously/irregularly, for years, and very rarely smoke to this day. One
thing I've realized is that my immune system can't stand the smoke. I
basically get an allergic response, throat swelling, etc. In my pride, I had
ignored that.

Since then, I've also had very healing and grounding experiences with the
right kind of weed. I know now that the mixtures of cannabinoids are
critically important, as is dose and intake method, and last but not least the
setting and company you're with. But back then, in the dark fog of
prohibition, I had no idea what I was smoking, and exposed myself to energies
and people I didn't "vibe with". Its frankly dangerous and absurd that weed is
federally scheduled rather than regulated and understood.

And as for my mental health, it took a long time to reintegrate the
sensitivities I developed in this time. More recently I finally got some good
therapy to work through stuff. A rough relationship triggered the need for it.
I found a gestalt therapist who specialized in working with artists and
creative types. She just about refused to diagnose me with anything. Instead,
she helped me affirm and recognize my own inner sensitivities, perspectives
and myths as tools for self-cultivating good mental health. She carefully
affirmed that my inner symbolic perspectives and experiences need not be seen
as illnesses to be abolished, that I should instead retool them as indicators
for self understanding and realization, and as sources to be channeled
creatively. I recognized in this time things I was already doing to ground
myself when life got overwhelming. For me it's piano, hiking, jogging,
chamomile/lavender/holy basil tea, writing, and if I need to talk, finding
someone who listens without judgement or fear.

I am so glad to have made it through to my 30s with my psychological freedom
intact. Others are not so fortunate.

------
doomlaser
Anthropologists are not doctors qualified to redefine medical diseases.
Autoethnography is not scientific.

I think this is the wrong place for this piece.

~~~
dang
I'm not sure what you mean by that but HN is an emphatically pluralist place
and articles of all disciplines are welcome here.

------
given
Doctors just don't want to admit that they don't have a clue what is causing
the sickness (and not just this one). And because of that they pretend to
know, inventing far fetched theories. That is a large part of their profession
in health care. To make people _feel_ they know and can help. The drugs are
there to keep the cycle going. Because then patients depend on them for
further medication.

~~~
gmarx
Doctors "admit" this all the time. Stories in the popular media are where we
get claims that doctors have the answers. As for the idea that doctors only
give out psych drugs to keep patients dependent, nonsense. There is just a
strong presumption for any treatment, any hope, over no treatment. On my psych
rotations I never heard any attending claim anything about antipsychotics
other than they helped a little, were very "dirty" and had bad side effects
which made a lot of patients stop taking them...but, they're all we've got

