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Understanding schizophrenia: What exactly is schizophrenia? (paulmorrison.org)
93 points by DanBC on Sept 23, 2018 | hide | past | favorite | 75 comments



I was diagnosed with schizophrenia and ten years later, bipolar.

I didn't trust that western psychiatry could heal the underlying causes so I basically just shut up about it for a decade.

After about 10 years, I was suicidal and couldn't ignore it anymore.

My intuition told me to find another way, so I started to research on my own. I found a way through that involved MDMA therapy, NARM therapy, holotropic breathwork, and creating a loving romantic relationship.

I now live symptom-free, with no medication, and am really grateful I trusted my intuition and made my own path.


I am very happy for you. It is great that you are able to recognize your schizophrenia. Many people who suffer from schizophrenia also suffer from anosognosia, which is a condition of not being able to recognize one's illness.

A person close to me is suffering from schizophrenia. We found, to our surprise, that anti-psychotic medications work very well. It changes a person who is not able to function (delusions, disorganized speech, unable to focus or carry conversation, very poor judgement and actions that result in total loss of all possessions and homelessness) back to a person we know well and who can be a normal member of society.

Unfortunately, they don't recognize any of their past symptoms. Eventually they stop taking medication (which is logical on their part, because why would you take medication, if you are not sick?), and a scary slide back begins.

Imagine, if sometime last week, family or friends came to you and told you that you have schizophrenia, and that you should take medication because you have delusions. You don't know what they are talking about. If this happened to you, what would you do? This is the situation many find themselves in.

For any mentally healthy person out there who finds themselves surrounded by loved ones telling them they may have schizophrenia and to please get treatment - please do, even if that sounds ridiculous to you. If you are on and off medication, keep a journal to record how you feel. Do not rely on your own judgement alone - please listen to your friends and loved ones.


This kind of stuff is super scary for me. Although I don't suffer from any mental illnesses (that I know about!), I take medication for high blood pressure. At one point I was taking amlodipine which eventually caused some bad side effects with swollen legs and the like, so I changed to a different medication. Pretty quickly, I noticed that my life was dramatically better and, for want of a better word, I wasn't in the least depressed.

I've never suffered from depression before, so I hadn't been aware of how depressed I had gotten while taking amlodopine. After switching, I checked the known side effects and sure enough depression is one of them -- to the point where some countries have disallow its use!

It really surprised me how much this drug affected my life without my noticing anything out of the ordinary. What's even more interesting is that this summer I got very stressed about work (something that has never actually happened before) and ended up having a panic attack. So now I'm wondering about the new medication! It's crazy.

The big thing that I keep thinking about is, how much of my state of mind is "me" and how much is my medication (or any other things, like drinking coffee, or beer, or not exercising enough, or whatever). It's made me much more conscious about monitoring my mental state and taking some actions rather than just assuming everything is OK. But it's incredibly scary. I've had quite a few friends with mental illnesses and this helps me understand a tiny bit better what they are going through.

Oh, and +1,000,000 on the journal. It's the only way I can keep track of what's going on in my head.


>"anosognosia" is a terrific word.

I think of it as "ignorance broad enough to encompass one's ignorance" or "to not know _that_ one doesn't know"


That's why you have slow releasing intramuscular injections of xeplion or abilify. They can stop taking pills, but this is harder to avoid. Learned this the hard way with my brother.


I learned to surrender to the diagnosis of the people around me, but I also decided to make the diagnosis a dharma and not a dogma.

Meaning that I didn’t try to convince people they were wrong in classifying what they saw through their paradigm, but rather took it up as my work to navigate from that point forward.

I also began to see “mental illness” as a context vs. some discrete thing inside ones brain. And that many of the symptoms an individual is experiencing are manifesting for the collective.

An example of this is imagine a father who grows up with a mother with intense and dangerous rage.

He will very often never learn to feel his own rage in a healthy way. He meets a woman and they have kids.

He spends so much time avoiding his own rage that it begins to show up in his wife and family. He tries to control it in them as well, making sure no one feels it.

Perhaps one kid ends up diagnosed with depression due to not having a safe context to feel emotion in the home.

The mother escapes into work.

The child, never having felt safe with the father ends up angry as an adult and violent toward the father.

The mother becomes rageful with the father as well for not having a relationship with the child.

If anyone of them would goto a traditional psychiatrist they’d most likely be prescribed medication — another attempt to suppress the emotions.

If one looks at the overall system and begins to help the father heal his trauma of the rageful mother, he can begin to grieve and heal himself.

His capacity for his own anger increases and he is better able to hold space for that of his family. He can understand now why he’s felt so much anger directed at him — he recreated the rage he was accustom to as a child but now in his home as an adult.

The other family members do their own work as well and collectively the family learns deeper self regulation and connection.

Soon their entire social circle and community is beginning to transform and wake up and learning to feel more fully.

Very often a family or social system will unknowingly “push” their unfelt feelings into a single individual and then try to medicate or eliminate that individual.

In some tribal cultures they say “the schizophrenic sits at the seat no one else is willing to sit at”.

The shamanic approach acknowledges that some folks with a greater sensitivity will begin to experience the pain of the underrepresented values of the tribe.

With proper mentorship and context, that person can become a wise leader, deeply intune to the unackowleged needs of the tribe.

This was the approach I took and have continued to take with the folks and families I’ve worked with.

I start off with a position that the persons experience is inherently valueable and contains useful information for me and the community.

From there I seek to connect with the reality they are in and to join them there while still maintaining my own sense of safety. I seek to see where my own behavior could be changed in support of this person.

I also encourage the folks who care about the person to examine their own lives and see what might be connected and to work on healing it.

A fantastic book on this topic that was really helpful was Rethinking Madness by Dr. Paris Williams (you can download the PDF for free).

There are also some incredible results happening with a process called Open Dialog in which the community gets together and speaks the truth of their experience and this has incredible results.


This is the very inspiring, I'm glad you found a way to deal with this terrible affliction. I have a close friend who suffers from schizophrenia, and the medication they put him on turned him into a zombie. I hope the methods you used become more widely known and adopted.


It's great you were able to find a solution! Best wishes.


Thanks! I’ve found my greatest liability has become my greatest asset.

My experience and scaffolding it left behind allow me to support some incredible people and organizations around the world in their own growth and transformation.

I’ll even be at the UN this Wednesday for a meeting on global mental health.

It is really wild to think that just a few years ago I was being told I’d be on medication the rest of my life; my girl friend at the time (a Stanford Psychiatrist) told me her advisors had said “Stanford psychiatrists don’t date men with bipolar! They never get better, they are like alcoholics!” and that she’s be ruined professionally for associating with someone who thought they could heal without medication; I was suicidal and sleeping in a vacant house in San Jose...

Now I’m living in NYC; engaged to an amazing yogi; a full practice of clients; my relationship with my family is better than ever and we just bought an Island in Panama to build a healing village.

When we go within, anything is possible!


I’ve been diagnosed with Delusional Disorder after a long term infection with the Epistein Barr Virus. I spent a period of time in a deep psychosis. What it seems like now is my brain trying to make meaning out of something traumatic. I believed I was one of the most important people in the world when I was in a state of shock. The delusion still persists despite heavy doses of psychiatric drugs.


I wonder if something like exercises for the concept of psychological flexibility could help. In reality we're all equally important, as we are one - so within this context, your belief isn't wrong. The important part then becomes in how you treat yourself and other people, being kind, and practicing non-violence (towards yourself and others). I wonder if any shamanic traditions like Ayahuasca ceremonies or one more potent like Iboga could be beneficial of "flushing the brain out" as a sort of ego mind reset, dissolution. I haven't looked into or nor had personal benefit or experience related to a Delusional Dis-order, however if you feel called to it, you can find organizers or shamans to see if ceremony would be safe for you; you can't be on certain medications as it wouldn't make the ceremony safe, though some shamans have different requirements or understand than others.


The part of it that was damaging was that I was attempting to work as a data center security guard (to later become a data center tech). my employer responded to my inability to do my job or even get up and leave the building, by interrogating me. it constantly replays in my head for years now and the only time I really calm down is when I smoke weed or get drunk or something.


I don't quite understand the connection to your original post relating to the diagnosis of Delusional Dis-order, however what you're saying here sounds like post-traumatic stress? MAPS (https://maps.org/) recently did a study using MDMA to help treat PTSD with psychotherapy - perhaps a worthwhile path to explore, and worth contacting them? Perhaps there's PTSD that is acting like a linchpin causing a cascade of problems further down brain processes?

Maybe a slightly random question, though there's a purpose for me asking: do you remember having any ear infections as a child, and were they painful at all?


I had ear infections as a child. I don’t really remember my childhood tho. I got sick every three months after getting Kawasaki disease at age 3.


I'm curious why you're asking, as I used to have a pretty bad ear infections as a child.


How does the delusion persist if you’ve clearly just stated that you realize it’s a delusion?


It doesn't matter if you consciously know something is false if your brain still presents it as true.

Think anxiety. Or like on the movie A Beautiful Mind (I know it's a movie but it happens IRL too). Or being under the influence of some psychedelics (you know you're under the influence but it still feels like reality).


It may be episodic.


I’m not entirely convinced either way. Without medicine I’m convinced it’s real.


Many HN users seem to be affected.


I'm surprised the article still considers schizophrenia as a single entity, when evidence points to there being several diseases with symptoms overlapping to some degree...


At the bottom it says that the next post will be on what causes schizophrenia, and I imagine the author will get into the different diseases there.


Schizophrenia is not a disease and never was. It is behavioral disorder.

Who is then defining what is schizophrenia?

Is it a physician? Does it have any pathological evidences?

The clear answer is NO.

So it cannot be a disease.

It is defined by psychiatrists by voting the "disorders" in their meetings of American Psychiatric Association. Such disorders are then published in the Diagnostic and Statistic Manual: https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Man...

Further, by researching, one will come to conclusion that those mental disorders are added and removed as their assembly wants it. Or whatever the lobby wants.

It would be good to review the writings of Dr. Thomas Szasz:

https://en.wikipedia.org/wiki/Thomas_Szasz

https://www.cchrint.org/about-us/co-founder-dr-thomas-szasz/...

For human problems there exist human solutions.

How can be a "disorder" which cannot be pathologically proven be "healed" by taking more and more drugs?


I'm schizotypal, which is basically schizophrenia lite... pretty sure there's nothing "behavioral" about my recurring auditory hallucinations of a brass band playing nonsense music.


I think the parent is challenging the circular definition used by psychiatry. Aka you hear voices, therefore you have schizophrenia and you have schizophrenia which is why you hear the voices.

For example, I found the following texts thought provoking:

http://behaviorismandmentalhealth.com/2010/01/21/schizophren...

http://behaviorismandmentalhealth.com/2013/01/03/schizophren...


This is the first post in a series about schizophrenia, and will discuss the difference between schizophrenia and other forms of psychosis.


(For clarity, I didn't write this article).


Thanks for writing it. I'm looking forward to reading the rest.


I have a good friend who was diagnosed with schizophrenia before he graduated high school. It was very tragic to watch. Who was once such a bright and capable person, can no longer function in normal society. I found it very difficult to invite him places. Often times I would need to back him up in a physical fight. He wasn't violent, simply incapable of seperating reality from what he saw, often times taking the form of disturbing subjects such as women or children being raped. And being the good person he was at heart, would not let something like that go, but would rather confront it right on. At wich point the person being accused of such a heinous act would do one of two things; Realize the guy clearly has some kind of mental issue and leave the area a bit shaken but no worse for wear, or more frequent the case, challenge him to a fight, even assaulting him with deadly weapons in some cases. When he wasn't engaged in some form of direct confrontation, he would be yelling racial slurs at the tormentors in his head. And the torment was constant. I am sorry to say there was even a period in my life when I stopped being a friend and started being someone concerned with ones own social standing, wich of course in my mind, had no room for any social pariahs tagging along.

Fast forward 10 years when his mother passes away, his other family had written him off long ango, and we find our tragic hero homeless, with symptoms noticeably worse than before. being the only person he trusted, it was up to me to get him the help he needs. It was the hardest thing I've ever had to do. I gave him a room in my house, which was the least I could do really, and even helped cosign for a car. But all of this mattered little in changing his actual situation, which still seemed to be getting worse not better. The challenge for me was balancing the line between being a friend, and being just another person trying to convince him his mental model is faulty and he needs treatment. For one reason or another he absolutely refused to go. He called that place rape factory, and insisted he'd rather be homeless then spend even a single night there. And who am I to hold the definitive truth on reality? Where I saw dysfunction, he saw a "gift of sight," only a few are capable of. In the end, I'm afraid that my unwillingness to convince him he has a problem is coming more from a position of weakness rather than strength. Had I been able to convince him to get treatment, than perhaps he wouldn't be in jail today, and I wouldn't have lost the lease to my house; ultimately leading to my own homelessness to this day.

Despite all of the headaches, I learned some valuable lessons from Ben. Mostly, don't worry so much what other's think of you. Take life as it comes without being so serious all the time. And reality is not some fixed thing, and is mostly a function of the beholder.


I have a sibling who’s in and out of the mental hospital. It’s easy to show support in the early days, but ten years in when they still have psychotic breaks and most around them have given up is when the real test starts. Glad to hear your story and wish you the best. For myself I’ve vowed to never forget the person who was there before the illness. You still see the glimpses here and there


I also have a sibling like that. But there's no ifs or buts, when the situation gets worse, off to the institution you go until you get back to normal. At first, you cry and sob, it's hard seeing them strapped to a bed. But tough love is the best love, when everything else fails. Now he is on injections and there is no more horsing around about taking or not taking pills.


I’m sorry to hear about your experiences. As his friend early on, do you think anything ‘triggered’ the disease? Trying drugs, abuse, trauma, anything? Or is it just something that sort of slowly grew and evolved?


That is rough, you are still homeless now?


What a terrible disease.


You are a good person. A better peson than myself.


Maybe this is because I've been watching Maniac but I've been thinking about this. My hypothesis is based upon the idea that the brain's main purpose is to make sense of the world and to do that it makes predictions and theories of "world" as it goes about.

Schizophrenia just seems like this process on overdrive where some of the key processes involved with keeping this overall process stable go awry. One of these minor processes is probably a belief process where the brain classifies things by True / not True. Since minor psychochis can occur to recreational drug users using psychedelics that make their mind more open to ideas, this seems to make sense to me.


It seems more like a defect in attention, but not a deficit; it’s an overabundance of attention to irrelevant details that the brain ascribes significant meaning to. The reason I have this hypothesis is that ADHD patients tend to have lower concentration of dopamine, whereas schizophrenics have a higher concentration than normal.

An example would be ascribing significant meaning to an event that is random. But for the schizophrenic the event isn’t random, it’s the result of a persecutory delusion, at least in the paranoid variant. It looks very close to religious thinking, but in a negative way: “The dry cleaners I go to are secretly a front for a shady government organization that is attempting to study my every action”


On a lower level, the brain has two hierarchies of synapses: a top-down processing hierarchy, driven by the neurochemical AMPA, and the bottom-up processing hierarchy, driven by the neurochemical NMDA. These hierarchies have salience passed back and forth between them by dopaminergic and adrenergic signalling from other brain regions. Whichever side of processing is "dominant" at the time, is training its dual to respond with the signals the active side is receiving, in response to the signals the active side is sending. Additionally, the bottom-up processing hierarchy is wired to your senses and your motor neurons.

In short, the top-down processing hierarchy is "the model", and the bottom-up processing hierarchy is "the evidence." The brain switches between using the evidence to train the model (when the evidence is salient and the model is weak), and using the model to predict and "fill in for" the evidence (when the model is salient and the evidence is noisy.)

It would make a lot of sense to me if psychosis were simply a result of chronically overdriven AMPA signalling, such that evidence is always being "fit to" the existing model, with the bottom-up hierarchy never being granted enough dominance to use the evidence to correct the model.


This is fascinating. I grew up with a schizophrenic parent and relatives. My interpretation has been that the disease is a defect in the systems that weights between internal models and external evidence.

It’s interesting that to know that there might be a fairly straight forward mapping of the to brain chemistry/neural mechanisms.

Do you any references the AMPA signaling pathways and associated neurological structures that you can recommend as a starting point?


Ah interesting. I didn't realize we'd categorized such a hierarchy. Reminds me of something Hoftstadter wrote in one of his earlier books.


I saw schizophrenia described by a person with it as "dreaming while you're wide awake". In a dream, your brain jumps on any details to invent more details to continue the dream. In a dream, if your brain says the dry cleaners are a shady government organization, then that's a valid and successful continuation of the dream, and dream reality bends to that. In waking reality, not so much.


NMDA antagonists usually make it possible to dream while awake. Low NMDA goes with higher dopamine and higher NMDA with norepinephrine. Schizophrenia is said to be associated with poor NMDA signaling (high agmatine, low D-serine/coagonists, high NMDA receptor antibodies, etc).


I've been wondering about dopamine for a while. I seem to have symptoms of both too much and too little dopamine, simultaneously.


My landlady's son is schizophrenic. Could a diet of alcohol, pot, and sugar and carbs make the condition worse?


Alcohol and pot, yes, though use of the two are common because of addiction and self-medication. The other two, no.


Ketogenic diet showed better results in treating bipolar disorder than medication. Bipolar disorder and schizophrenia seem to have to do with mutant mitochondria which metabolize differently. Fed a normal (carb-heavy) diet they are unable to produce sufficient energy, which leads to neurological degeneration.


I think link to sources would help here.



A finding of this magnitude which was actually proven in a way that the post seems to suggest would not be something you see only in one hacker news comment, because it would be huge.


This.

Not to mention all of the other variables to check, such as simply putting less energy into food prep (less stress) and so on.


3 of those 4, and pot exasperating the mental condition after the fact, mhmm.


Weed is known to exacerbate psychosis.


40% of cases of schizophrenia are from the immune system attacking synapses in the brain.


Do you have any links to research or papers on this? Thanks.



Neuroscientist here. The study shows no such thing. Maybe you refer to this: ”for the first time, identifies brain tissue macrophages proximal to neurons in over 40% of individuals with schizophrenia who are in a high inflammatory state.”

But first, the authors are confused. All brains (100%) contain macrophages in proximity to neurons. Specifically microglia (which are macrophages) and perivascular macrophages.

Second, note that they studied cases already selected to be in a high inflammatory state.

Third, they do not show the direction of causality. It’s easy to imagine how a life lived with schizophrenia could substantially increase your risk of inflammation.


> Third, they do not show the direction of causality. It’s easy to imagine how a life lived with schizophrenia could substantially increase your risk of inflammation.

Schizophrenia is a manifestation of "stress" (infections/drug use/injuries/emotions/malnourishment/etc) that's worsened by standard treatments. Some of the drugs used to treat "psychosis" seem to cause inflammation. Patients treated with anti-psychotics have been found to suffer more deterioration than those who are never treated with anti-psychotics.

My friend was eating a lot of soybean oil and alcohol in the months before she was captured by the mental health industry. Soybean oil is a source of Omega-6 oil, which breaks down into inflammatory prostaglandins. Alcohol contributes to inflammation too. Instead of treating the causes of her presentation, the professionals treat her symptoms. At one point they tried to label her "schizophrenic".

Sometimes medical diagnoses are helpful. The diagnosis of "schizophrenia" is a non-helpful medical curse. There are some good psychiatrists, but the profession desperately needs help.


Thank you.

Any tips for lowering inflammation? I only know of these; lower intake of alcohol, sleep well, kurkuma, aspirin.

Just as a datapoint, I suffer from psychosis and experience a good response to aspirin.


Eat an anti inflammatory diet. See Anti-Inflammatory Recipes: The Complete Guide by David Colombo.

Also, take a glycine supplement or drink lots of bone broth to boost your glutathione levels (your body's natural antioxidant). Muscle meat has glycine in it too, but most of it goes towards counteracting the methionine that's also in muscle meat.

> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855430/


CBD oil is a very powerful anti-inflammatory; CBD can be more effective for people if mixed with some THC, CBD counteracts the psychoactive properties of THC, however I believe THC is contraindicated for the diagnosis of schizophrenia?


Thank you. CBD oil is something worth to try out then.

THC delivers the high in the weed. I know people who use pot, but I stay far away from it.


probably a good policy - THC exacerbates the inflammatory symptoms that CBD alleviates. There's a theory that older people who used to self-medicate with CBD-rich cannabis in their youth are now doing more harm than good because of increased breeding for higher THC content.


I've never heard this before. I echo the other commenter's request for sources.



interesting. Have you read up on the new research that shows that DNA from mitochondria leaks out during stress and is treated as a foreign invader?


No, there is no known cause of schizophrenia.


it'd be great if you also dove into the other less known schizotypees like schizoaffective and schizotypal aka "Schizophrenia Lite"

I think people have an idea of what schizophrenia looks like but they might be surprised by other very closely related disorders.


[flagged]


Religious flamewar has no place here. We've banned this account.


On the contrary, it's possible that transcendent experiences are built into the human psyche, and that schizophrenia-like disorders are examples of the extreme end of suggestibility and ruminative thought -- i.e., an inability to properly interface with subconscious processes.

The brain is a storyteller for the conscious experience, and yet the deeper that rabbit hole goes into creativity and analysis, the more discipline is necessary to turn away from it and delegate to the unconscious.


Wrong. The claim that you make has been subjected to scientific testing already and it has been shown to be bogus. There is no evidence for human-god communication and there is no evidence for gods.


The above poster did not imply human-god communication existed, merely that humans had the capacity for non-ill transcendent experiences.

Furthermore, a lack of evidence for gods does not mean that scientifically there are no gods. The only way for things to be disproven definitely is through mathematical proof. Because this cannot be shown in a mathematical proof (there is no mathematical way to represent godhood) the concept of a god cannot be definitely disproven in scientific approaches. Otherwise the most scientific claim is merely "we cannot find any evidence for <concept>" with the logical step being that therefore <concept> doesn't exist or has a low statistical chance of happening- but this is a cognitively easy conclusion and not what science is actually doing.

Science and the scientific method is actually extremely limited when dealing with the concept of dieties. It can only say that, given claim X, experiment(s) were run that did not verify X. After enough experiments are run, they are evidence X is not true. But none of these are absolutes, and claiming a mountain of evidence is a definitive scientific proof is itself unscientific.


Furthermore, a lack of evidence for gods does not mean that scientifically there are no gods.

True, but it implies the need for skepticism, especially given how many people have desperately attempted to find said evidence. Depending on your outlook it might also imply that a degree of disinterest in warranted, because the world of “things for which no evidence can be found or is required,” tends to be enormous and frankly, not that interesting. Unless we’re very specifically talking about a god who will damn you for a lack of faith, then ignoring the whole issue seems like a safe bet, and when you die you either learn the truth, or you’re just dead. It’s not like a human can do much either way, again, unless your assertion is about a specific and judgmental god.

Tl;dr I think the whole god thing is even less compelling and worthy of attention than the Bermuda Triangle. It’s just another thing that’s possible among an infinity of possible things lacking evidence for their existence. That’s pretty boring.


Very true, but I think a neoplatonic view of reality is extremely worthy of attention. The notion that there must be some unifying, self-enforcing, by-definition dissonant/entropic (we're here, aren't we?) oneness that runs through reality, and that the mere knowledge of it lends towards a rationally and emotionally mature wu wei ("effortless doing") sort of existence. Like an infinitely self-referencing stack of the "first principle" unfolding into time, matter, and ultimately reconciled through the cognition of it.

Self-help is one of the best selling genres, yet the most simple of which has been known to man for thousands of years.


> there is no mathematical way to represent godhood

    SHA3(x) == 0
If we agree that the hash function is secure, and find a value x that hashes to zero, then it might be reasonable to conclude that x was generated by a god.

Bonus points if x is human-readable text.


My point was that the human experience, all throughout history, hinges on a willingness to identify with deities, so it must be a reasonably effective evolutionary strategy. A deity is the ultimate expression of an applied ethics system, and it seems that in evolving consciousness we tend to unify around cosmological explanations for our behaviors.

Perhaps schizophrenia is a functional mutation that introduces cosmological insight to a group of people; the witch doctor/seer archetype, for instance.

It's obvious that deities are (as of yet) born of un-falsifiable hypotheses, although thank you for pointing that out...




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