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What Killed My Sister? (theamericanscholar.org)
390 points by jamesbritt on Apr 28, 2014 | hide | past | web | favorite | 152 comments

Psychiatrist here; glad to see this near the top of HN.Schizophrenia is a serious illness, and often misunderstood as "split personality." It is a constellation of delusions, hallucinations, and scrambled thoughts that is often (though not always) pretty devastating to work, school, relationships, etc. For some reason, because we have no blood test or genetic test for it, the diagnosis is still met with skepticism from many in the public, even though everyone seems to accept the diagnosis of migraine headaches which similarly has no clear-cut lab or imaging findings.

What most people don't consider is the change in life span: http://www.ncbi.nlm.nih.gov/pubmed/21741216

Life expectancy as about 17 years less for those with the diagnosis, which is worse than most cancers. It's mentioned in the article, but worth repeating.

I've heard schizophrenia can be triggered by prolonged stress, e.g. a stressful work environment. (This presupposes you have susceptible genes.)

There seems to be a lot of anecdotal evidence supporting this. Do you know whether it's backed up by any research? Or more generally, does anyone know of any (successful) research about whether schizophrenia can be avoided by avoiding whatever triggers it? Or are you doomed if you have the wrong genes?

What you are describing is the "Stress-Diathesis Model." The rough explanation is that many people have vulnerabilities for mental illness (including schizophrenia, bipolar disorder, major depressive disorder, and others), and that the vulnerability is triggered by environmental stressors. It is in some ways similar to the "two-hit hypothesis" for cancer.

A search for "Stress-Diathesis Model" will yield a lot of hits in the academic literature. It's well accepted as at least part of the explanation for why some people with a genetic vulnerability develop symptoms and others do not.

My mother developed schizophrenia after a nervous breakdown. In my family circle, it is colloquially said she 'got it' from stress, because her parents constantly argued and built a stressful environment for her.

As her child, I was always scared of developing it, because there were times when I definitely had scary symptoms. I learnt about various hypothesised causes or things that could 'bring it about', so I never did drugs and practised ways to keep myself calm (I used to be extremely nervous, had sweaty hands and feet, etc.).

Now that I'm 31, I think I've done pretty well. Even with medication, my mom cannot really identify who I am, though.

I guess I just want to thank you for sharing your knowledge about schizophrenia.

Thank you for your insight, and for referring me to the proper literature on the subject. It's very much appreciated.

Amateur here ... don't a lot of people have schizophrenic symptoms (voices), but as long as they are positive or the person can ignore them it's usually just ignored?

Like, some people might have "imaginary friends" who they chat to about the weather, quietly. Other people have "imaginary friends" who they have screaming arguments with.

In some cases, could stress either make the delusions / voices less benevolent, or send people into a cycle in which they are no longer able to manage them?

The voices with schizophrenia are outside of the head, a voice heard often clearly as though they were physically spoken. They are consistent auditory hallucinations. These can be quite nutural; one sign of paranoid schizophrenia is the voices making a running commentary of everyday actions.

If people are having chronic hallucinations, whether positive, nutural or negative, it's something to be concerned about. Usually there are symptoms outside of these hallucinations in this case where sufferers are not able to look after themselves.

In patients with bipolar during a manic/hypomanic phase, I could except hallucinations to be very positive in nature, such as supporting delusions of grandeur.

This may be much different from talking to ourselves or physically responding to dialogue WITHIN our heads, which I imagine is the source of many imaginary friends.

EDIT: I'm not qualified to speak on these subjects but I suffered from psychosis from a number of years and was misdiagnosed with schizophrenia at one stage due to the nature of my hallucinations (though still a bit over zealous on the psychiatrists part). I naturally came to learn a lot about what it is, how it's treated and spoke to many patients with psychotic illnesses in my stay in hospital (for mental disorders, a stay of 3 - 4 months is a short amount of time, many who I was in there with had been in for a year or more)

You're right, and as I read your post I wondered if you'd suffered the voices, or at least been around it enough to know.

The running commentary was the worst. For me it was 20 years ago, first year uni. Made lectures interesting but also ridiculous as your brain interprets sounds around you.

I was lucky it only affected me for a year or so then faded away after I tackled the subject and read a lot about how the mind works and other people's experiences. I had to get objective and not take shit from myself any more. I never sought professional help, but haven't had the voices since.

Even just regular noises like a car horn in the distance... your brain's imagination is secretly working overtime in the background to connect dots that aren't there. Your own mind delivers you a frank and confident explanation about the story behind the "car horn in distance". That car horn, you learn, was actually sounded by someone you know, and they're checking in as arranged, they have connections with people in this lecture hall...etc. But you never grasp exactly the explanation, or receive real proof, but there's a conspiracy nevertheless, a rambling unflattering, disapproving conspiracy - and you're at the center. That you're sure of.

It's like you're constantly on the verge of exposing the conspiracy, if only you had one more piece of evidence. But you don't need to fish for evidence, your imagination drip-feeds it all day.

"a voice heard often clearly"

That's interesting. I had assumed coming from a RF EE kind of background that it was very much like having a gain control turned way up from a noisy input resulting in peculiar signals being demodulated, but perhaps not so.

For example last night the weather was really awful and at the limit of perception almost asleep (well, I was probably actually asleep) I thought I heard a very unhappy cat meowing outside, so I actually got up and tried to find it, perhaps let it in my dry warm garage to warm up a bit. No cat existed of course.

So under my hypothesis if I had the disease I would hear phantom cats and stuff in general all the time not just once, maybe multiple ones at the same time, and specifically in that situation hear my wife (soundly sleeping like everyone else) telling me loudly and clearly to let the stray cat in to warm up, verbally and clearly and loudly.

However the alternative model, is I'd solely hear the wife telling me to let the stray cat in to warm up, maybe not even hearing the phantom meow.

An individual spurious signal model vs a generally increased noise level model.

A side orthogonal issue might be requiring it to have substantial influence on life. While almost asleep I once thought I barely heard a stray meow outside in the freezing rain so I got up and looked out the windows for a minute has no real influence on my life as an isolated although unusual incident, in comparison, constantly hearing voices loudly tell me peculiar things would have a huge influence on my daily life. So that is interesting too.

some people might have "imaginary friends" who they chat to about the weather, quietly. Other people have "imaginary friends" who they have screaming arguments with.

That's very interesting. I hadn't heard of that before. I wonder if it'd be possible to conduct an anonymous survey as to whether people have imaginary friends that they routinely chat with or get into screaming arguments with? I wish such a survey could be trusted, but it'd probably attract troll results.

You might find "the origin of consciousness in te breakdown of the bicameral mind" interesting. It references studies as such. It's from 1975, and either a stroke of genius or complete crackpot. But it is interesting, well argued, and potentially mind blowing. I have no idea if anyone studied voices among normal people since this book was published.

Julian Jaynes' book was required reading in my geeky circle of friends, and the root of many "voices of the gods" jokes. Good for endless drunken campfire discussions.

Basically, he said that before we developed language, the voices of the gods ('imaginary friends', 'voices in our heads') told us what to do when instinct didn't. The development of language pushed out the voices of the gods. I don't remember much more than that.

I heard that he had retracted the whole thing, but can't find any evidence of that retraction.

My understanding is that it's not "before we developed language" - but rather, before we developed modern culture, which silences these voices ("imaginary friends") during upbringing.

However, Jaynes argues that various conditions (schizophrenia, non-schizo "voices") are a non-silences version of that natural tendency, albeit often harmful - the revenge of the forgotten imaginary friends, if you will.

About to make the same comment. I have not had any contact with a schizophrenic sufferer. The closest I got was via the movie "a beautiful mind", which is pretty distant. In that movie, it seems to portray the life of a schizophrenic sufferer as you have described it, but I really wonder how close it is to reality.

You are not doomed if you have the wrong genes, but from what little I know it does seem like an environmental stress explanation is rather appealing for addressing why mean schizophrenic onset occurs later for those in highly structured environments, such as the armed forces.

> because we have no blood test or genetic test for it

I was reading about this: http://ge.tt/3nXdgiQ/v/0, its from Reddit where the article stated:

"However, when we examined the whole data set of 298 assessments, a cross-validated probabilistic neural network model was superior and could discriminate all cases from controls with near perfect accuracy at 98.3%."

Is this not the case?

(article here: http://www.scotsman.com/news/health/schizophrenia-diagnosed-...)

Depending on what they're measuring, 98.3% can be pretty bad. Given that there's about a 1% portion of the population with schizophrenia, if the test is right 98% of the time (irrespectively of everything else), then it'll misdiagnose two healthy people as having schizophrenia for every correct diagnosis.

Yes, but wouldn't it be obvious (or obvious eventually) that these healthy people clearly don't exhibit other symptoms of schizophrenia? Or am I forgetting something?

What about terrifying people with the thought they have schizophrenia but just haven't demonstrated visible symptoms yet? That concern comes up a lot with genetic testing because many things aren't certain but people panic and make significant life-altering decisions after a positive test result.

EDIT: … I should also have noted that humans are notoriously suggestible – with a mental illness it's really easy to imagine people both assuming every quirk is proof of a terrible disease or even starting to demonstrate symptoms psychosomatically after being told that this will happen eventually.

Good point. I suppose it should be limited to people who are already showing other symptoms of schizophrenia...

… or with family histories, etc. The real challenge, though, is probably just for doctors to be very open about false positive and negative rates and explain the issue directly. I think a lot of these issues would be easier if someone was frankly told “3 times more people receive positives on this test than actually have the disease“ instead of “it came back positive for [scary]”.

Nevermind the classic problem that was addressed in One Flew Over the Cuckoo's Nest and others: how do you prove you're sane? If the machine says you're insane, what way is there to prove otherwise?

You are assuming errors would be random, which is probably false. A false positive would probably be more likely for someone with similar symptoms, than for someone without any symptoms.

Hm, that's interesting. A lot of parkinson's related disease (different than schizophrenia, but still involving dopamine a lot) have eye movement findings that are pretty recognizable.

Culturally, not sure if psychiatrists are in the habit of examining eye movements as closely as, say, a neurologist or neuro-opthalmologist, but it'd be interesting if this is replicable by other groups.

It's only another tool in the diagnostic toolkit. My presentation is, um, "non-classical" to say the least (intentional tremor being, perhaps, the weirdest part of it) and arriving at a diagnosis of Parkinson's disease pretty much involved ruling out everything else that might have been causing my symptoms (which is a rather long process, all things considered). I've met dozens of people who I could have spotted as Parkinson's sufferers two blocks away at night during a blackout, and a few who, like me, seem to have a bespoke version that "isn't the other things" and responds to treatment for Parkinsonism. Well, as well as anything does, at least - meds are always a pretty blunt weapon and can't exactly track the body's own chemistry, so there will always be good periods, and under/over-medicated periods as well. When it comes to neuropathy - or normal functioning, for that matter - we're not quite stumbling around in the dark, but there's still one hell of a long way to go before we can say that we understand much about the machine.

There was another test involving anomalous speech patterns, http://www.idt.mdh.se/kurser/ct3340/ht11/MINICONFERENCE/Fina...

it might not be the canonical work.

In the near future most laptops will have the ability to do realtime eye tracking so these kinds of tests could be administered broadly, probably even through a web page.

how close are consumer eye tracking devices? It'd be interesting to see. My group works w/ the PD side of things, and doing a desktop-based eye test might be something we'd be interested in...

I have used an eye tracker in about 5 years but I think the cost back then was on the order of 4k+-1k.

http://www.tobii.com/en/eye-experience/ this is probably better than what we were using.

So I'd say all the pieces are in place to do this. The architectural design of the tobii and the leapmotion is almost identical. High frame rate cameras over USB3 illuminated with IR.


Throw in an http://emotiv.com/ EEG and one could do all sorts correlations.

What I don't like about Emotiv is that external EEG is never that great - it only gets aggregate LFP's from signals from > 6 square cm of cortex at a time, and high frequency signals don't get through the bone and muscle. Still, data is data....and the sad part is neuro people have been looking at EEG for over a century and never really bothered to do real signals analysis on them...

I was reading about this: http://ge.tt/3nXdgiQ/v/0, its from Reddit

Would you mind linking to the Reddit thread that it was mentioned in? Just curious.

Totally forgot about that and to refesh on the comments too. Here ya go: http://www.reddit.com/r/science/comments/12gxgs/schizophreni...

In the mid-90s, I remember hearing that in my state, cancer research received $150/hospital bed, heart disease received $100/bed, and schizophrenia received $7/bed. My amateur theory on that was that the first two affect old, wealthy people, whereas the third affects young people with no power.

Here in Virginia, we recently had a pretty striking demonstration of what you're talking about. One of the leading politicians in the state, state senator Creigh Deeds, was attacked with a knife and nearly killed by his own son, Austin, who was 24. [1] After the attack, the son killed himself with a self-inflicted gunshot wound. Deeds was in dire condition, but survived.

It came out afterwards that Deeds' son, who had been diagnosed in the past with bipolar disorder, had undergone a psychiatric evaluation the day before the attack, and as a result of that evaluation had been placed under an emergency custody order. But Virginia law only gives mental health authorities six hours to find a bed to put the patient into in such cases; and in this case no bed could be found in that time, so Austin Deeds was sent home. [2]

This has naturally provoked a great deal of concern in these parts, both about how so little resources are available for mental health patients that a potentially violent one could be turned away for lack of an available bed, and about the ridiculously short 6-hour limit on how long such patients can be held. And rightly so -- if help had been available for Austin Deeds when he needed it, he might still be alive today, and his father might never have suffered such a horrific experience.

Deeds has recovered now, and upon his return to the legislature announced that he would be pushing hard for mental health reform in the state, garnering wide support. But it's telling that the issue had to strike at a political leader for anyone in the political class to care about it overmuch. One wonders how many other families in Virginia have suffered their own horror stories, their own tragedies, in total silence -- just because, since they weren't rich or powerful, nobody in a position to fix things could be bothered to care.

[1] http://www.washingtonpost.com/local/crime/virginia-state-sen...

[2] http://www.nbcwashington.com/news/local/Va-Senator-Recalls-S...

It's a complex issue. De-instiutionalization was driven both by cost concerns and advocacy for keeping the mentally ill in the community. At one time, the cops would use "searching for a bed" to detain people for excessive periods of time.

That advocacy was driven by the horrific conditions that became common. Google Willowbrook.

That sounds like a really positive result from a horrible occurrence. Mental health care is woefully underfunded in much of the US. Here in Florida they have 24 hours to place someone at a facility after they've been medically discharged, and they still have trouble. Most places that can take people have a very limited number of beds that are already filled, which in turn causes pressure to discharge people potentially prematurely to open up new beds.

The health insurance situation only exacerbates that: there might be 5 facilities in the area that can take people, but only 1 that can take the uninsured. Florida is one of the states that "wisely" chose not to do a Medicaid expansion, and so if you're poor but without a diagnosed, processed, shortlisted disability, you're uninsured. Hilariously federal subsidies for buying coverage only kick in if you're making some high percentage of the poverty line, which people with mental health issues often have trouble reaching a fraction of that.

Oh and to add to that for the one available facility they used the Room 101 description from Orwell's 1984 as inspiration. No windows. Smoothed concrete floors. Echoing cries and screams. Blood. Food barely fit for animal consumption. And of course nothing helpful like any sort of talk therapy. Psychiatrist in residence once a day for 30 minutes, allotting on average 30 seconds per patient. Sleeping in cots on the floor. Sitting against the wall for hours with nothing to do but stare. If you've never experienced it before it becomes pretty clear pretty quick how much meaningful care is provided to unprivileged people suffering from mental health issues in this country.

Also it's in part because mental illnesses still come with a huge stigmatization in this country (USA). If you're diagnosed with schizophrenia, you're not normal, and something is wrong with you. Even though mentally ill people are more likely to be taken advantage of than commit a crime because of their illness, society does not trust you if you're schizophrenic. In fact many people make fun of the mentally ill or totally ignore them. If you live in the bay area you don't have to look far for proof, just look out your window. When I visited I was surprised to see so little thought given to the countless, clearly mentally ill homeless people in almost every part of San Francisco. I can feel some of you scrambling to justify how it's somehow their fault, how it's okay to not care that they are mentally ill and homeless, that they somehow chose that life. I do it, too, because it's part of our cultural programming.

Someone fairly close to me is affected by the illness, and I've discovered it's not something you can just talk about. If someone close to you has heart disease, you'll get sympathy. If someone close to you has schizophrenia, it's almost shameful to talk about. It just doesn't get the same amount of sympathy.

What would be a good way to help a person who is mentally ill, homeless and is not fitting any structure like a hospital? I.e. if the person agrees to undergo treatment program, stay in the facility, etc. it's fine but what to do if they are not?

Homelessness is complicated, both the causes and the solutions. I am big on trying to light a single candle rather than curse the darkness. Here is my candle for homelessness:


I also speak out here and on Metafilter. My diagnosis is not a mental health issue, it is medical, but it is clear to me that it impacts my mental functioning. My answer for me is a) preserve as much agency for myself as possible and b) get my body well.

I have a cystic fibrosis. People accuse me of being mentally ill for thinking I can get well. I have been told that is not possible. It is possible. I have made ongoing forward progress for 13 years.

Unfortunately, most people do not believe me and the social fallout from that is pretty crazy-making.

Just because the answer is not easy or quick does not mean there is none. There are lots of ways to work on issues like homelessness and the mental health of other people. Each piece of the puzzle matters.

Well, if you look at cause of death, the first two are the big hitters in the US so that is part of the basis for more money. The history of funding treatment is pretty bad though.

It's not so much no power, it has been the lack of advocates because of the shame associated with all mental illnesses. A person with cancer can do the noble stand. A person with schizophrenia is much less capable of doing the needed advocacy. Things are changing as more people are pushing and not keeping quiet.

From a advocacy view, we better start putting this and brain problems in general front and center since we are living long enough that we need the understanding of treating the brain to use our longer lives well.

But we're not living long enough that we're all getting schizophrenia. We're living long enough that we're all getting cancer and heart disease. Even in the realm of mental illness, if the problem is "we're living long enough to develop new problems", wouldn't we want to focus on age-related problems?

You can still get schizophrenia in your old age. "23.5% of patients with schizophrenia developed the illness after the age of 40" Beyond that in the elderly it often get's lumped in with other form of Dementia and ignored.

IMO, finding real treatments for mental illness is probably the most important part of longevity research as a healthy body and a decayed mind is in some ways little different than a dead body.


If you could only develop schizophrenia young, it wouldn't make much sense to call it "age-unrelated". You can get chicken pox when you're old, too, and in fact it's particularly deadly to the elderly, but there's not much place in aging amelioration for anti-chicken-pox research. It's best addressed elsewhere (also, yes, basically solved already, but I'm trying to make a different point).

23.5% of schizophrenia sufferers is a minuscule quantity. What percentage of people over 40 develop schizophrenia? Over 60? What percentage of people over 60 develop one of "cancer or heart disease"?

> a healthy body and a decayed mind is in some ways little different than a dead body.

I don't disagree at all.

> finding real treatments for mental illness is probably the most important part of longevity research

No, the most important part of longevity research is getting the body to last. A dead body with a "healthy mind" (not clear what that would mean) doesn't qualify as longevous by any standard. Someone who won't go senile for 150 years is pointless if he dies at 82 like a normal person, and while that scenario is admittedly a kind of progress it (a) is undetectable, which makes research difficult, and (b) has no application at all until we can get the guy to live longer. Longer lifespans are more fundamental, are immediately visible, and have immediate application; they can take advantage of natural variation in the onset of mental failure.

I was thinking of Parkinson's and Alhizmers which hopefully mental illnesses can piggyback on the funding.

Another aspect of mental illness is that it directly affects how you relate to someone as a person. It's a behavioral disorder, it affects the personality.

A person has heart disease or cancer. A person is schizophrenic, or bipolar, or manic, or psychopathic, or depressed.

It's like the aphorism "you have a body, you are a soul".

A person with cancer or heart disease may be concerned and occupied by the disease or condition, but it's not who they are.

I've had my own encounters with people suffering from various psychological conditions, and ultimately, it's simply very trying to be with them in many cases. It's worse if you're not aware of the condition at all. In several cases the information emerged later, with a very strong sense of "well, that explains a lot".

Worse is when the person turns on you, whether emotionally, physically, or by other means. And yes, I've had that happen as well.

I do have a great deal of sympathy for those suffering from such conditions, but my own self-preservation (and sanity-preservation) instincts also kick in after a time.

Much excellent discussion here, I might add, thanks all.

Heart disease and cancer are somewhat more treatable, for one thing. None of the three particularly respects class lines.

But are heart disease and cancer "somewhat more treatable" inherently, or because more resources have been devoted to finding and testing treatments that work for them?

Or both. Brain is arguably the most complex system in the human body, and understanding of how it works is, AFAIK (I'm not an MD or a scientist), still not very comprehensive, much less than, for example, the heart. Treating extremely complex system which we don't know how exactly it works and are very limited in experiments (pigs or mice can have hearts not unlike ours, but their brains probably differ much more and while one can observe heart disease in mice, I wonder how you could observe mental illness like schizophrenia?) would probably be not easy at all.

I think it's more that anyone can get cancer, or heart disease... But I am never going to get schizophrenia- I'm not crazy!

It's perfectly rational for a disease that can strike anyone to generate more fear (therefore funding) than one which everybody believes they're immune to.

Some people are similarly skeptical that migraines without auras are "real migraines," but once you explain that it's otherwise the same symptoms (headache, sensitivity to light/sound, nausea, vomiting) and treated by the same specialized painkillers, they'll generally take your diagnosis at face value. According to Wikipedia, a pretty sizable majority of migraine sufferers don't have auras. But it's a distinctive symptom, so it's well known.

I wonder if the reaction to schizophrenia is partly due to not having as strong an understanding of how to treat it, in addition to not knowing what it's exact causes are. Having a well proven solution to a problem seems to make it easier for people to accept that the problem really existed.

What on earth is a migraine with an "aura"?

I used to get what I would very much consider "real migraines" as a child. Would lay in bed shivering with this crippling jack hammer bashing into the (always) lower left side of my skull.

Eventually the pain would get to the point where I'd get up, go to the bathroom and vomit; then within minutes the migraine would subside.

As an adult I rarely get them, but when I feel one coming I know to take a couple of Advil to head it off at the pass so to speak.

Anyway, what is a migraine with an aura? The only aura about me that I recall was my sisters telling me to shut the hell up from their bedrooms o_O

Thanks, interesting. I've never had that experience pre-migraine, although subtle scotoma is always there; i.e. transparent squiggly lines in the vision (assume everyone has this).

People in general seem unsympathetic to difficult mental states, especially people who can't imagine what it would be like

>Life expectancy as about 17 years less for those with the diagnosis

That's interesting. Is that due to some sort of biological action of the illness itself or is it due to behaviors that are associated with the illness?

To put it another way, is it due to illness itself shortening their life span or due to behaviors like self medicating with alcohol or a higher suicide rate?

Mix of factors. Drugs play a role (especially alcohol and cigarettes) but a surprising percentage of the deaths are non-drug cardiovascular deaths, related to poor diet (many mentally ill people are obese and diabetic by middle age) and high levels of chronic stress. Being low on the socioeconomic totem pole, even for a short time, is pretty dangerous to the heart, brain, and immune system.

An also shocking percentage: One in ten people who suffer from schizophrenia dies by suicide.

Aren't there structural brain findings reported in some imaging research studies? I'd be interesting to see some of the work in MRI volumetric studies (i.e. voxel-based morphometry) or dopamine transmitter imaging, especially comparing longitudinal progression of schizophrenia patients or in cross sectional comparisons against healthy controls

You see similar skepticism with autoimmune disorders. Invisible pain is something coworkers and families get bored with quickly.

My 10 year old daughter has autoimmune liver disease. It also affects her kidneys and bladder. She is being lined up for transplants. Its devastating to her, and the family. Yet, despite numerous letters and meetings with her consultants, therapists, and social services, the moronic arrogant staff at her school refuse to take it seriously and cause her and us unbelievable problems and stress. It borders abuse.

I'm very sorry to hear that. My wife has an as yet in diagnosed autoimmune issue. It's looking like either lupus or MS, but we have to wait until she's churned through the system to get a proper diagnosis. Luckily, her work place has been extremely understanding and supportive. But we've heard stories of people who see initial understanding that quickly turns sour. I hope all goes well with your daughter and that she can have a happy and healthy life.

Do you think home schooling could be an option? I've never looked in to it as we don't have children ourselves. I hated school because most of my teachers and the staff weren't qualified to teach tricks to a dog, much less teach life lessons and knowledge to children.

Hey there, do you have any place to direct me to look for mediators or malleable predictors of life outcomes for young men with schizophrenia?

Schizophrenia is a serious illness, and often misunderstood as "split personality." It is a constellation of delusions, hallucinations, and scrambled thoughts that is often (though not always) pretty devastating to work, school, relationships, etc. For some reason, because we have no blood test or genetic test for it, the diagnosis is still met with skepticism from many in the public

I'm glad you posted this.

These diseases (schizophrenia, bipolar disorder, depression, PTSD) are challenging and can be horrible but I feel like the stigma makes them a lot worse. It's like many natural disasters in which the human malfeasance after the event causes more harm than the thing itself.

The way people treat people who are afflicted by these diseases is, in many cases, an aggravating factor. Instead of helping them, plenty of people (especially in the corporate world, and in society at large after 1980 or so) kick them when they're down. It's pretty disheartening.

The stigma is absolutely the biggest problem with the treatment of mental illness.

It would be as if you went to someone with cancer and said, "Well, if you really wanted to, you could just shrink that tumor right now. You just don't want to commit to changing your life. It is your fault."

I never believed this until my sister died. Now I realize just how broken the system is.

Unfortunately, that stigma exists elsewhere in medicine, too.

I'm a quadriplegic. My father has the overwhelming opinion that since my condition is 'incomplete' (meaning that I have some movement in affected regions), that it's up to me to recover, and that I can't walk because I don't put my mind to the task at hand.

A shocking thing to say to someone, but his opinion has been echoed to me by various healthcare professionals and therapists throughout the course of my care, that the mind simply will not allow the body to recover without ample hope and work towards such a recovery.

I have encountered a set of people in life that , while seemingly uninfluenced by religion or mysticism, believe that certain parts of the body (the brain, especially) work on principles and ideas that we're completely uninformed about. Consequently, those people suggest and use themselves methods derived from mysticism, without a solid scientific backing(not to say that hope and patient mental well-being aren't important for recovery, they are, but you can't 'hope' a spinal cord back together as some seem to think).

Hopefully as we document more and more quantifiable physical changes associated to disorders which we know little about this trend will slow. It's important to consider the mental aspects behind a problem, but it's a waste of time and potentially destructive to put the recovery solely in the hands of the inflicted and their mental state.

And worse yet, the cause is wildly misunderstood. One person's debilitating depressing might be resolved spectacularly via light therapy, another via a single medication, another yet only moderated by a constellation of medications, and others who have undergone a variety of treatments for a decade with little improvement.

Compare that to, say, a broken leg, which is much easier to understand.

There's a huge stigma attached to certain cancers, too, like lung cancer not caused by smoking.

in society at large after 1980 or so

You are, as I recall, too young to know about times before 1980 by personal experience. I'm not sure what you are referring to here, but if you are referring to deinstitutionalization, that happened MUCH earlier, with considerable impetus from the personal experience of President Kennedy.


In the old days of Freudianism, stigma was worse and the affliction of people with mental illness was worse. (Basis of knowledge: much specific reading on these topics, including reading about the history of diagnosis and treatment of major mental disorders, and having lived through all the years mentioned in this reply.)

Why "after 1980"? What happened?

Under Reagan there was a national de-institutionalization of mentally ill people, who largely ended up as the multitude of homeless vagrants who occupy urban scenes across the country.

No, no, a thousand times no. A vicious libel, connected to the "fact" that the homeless are an issue when the President is a Republican, and almost entirely disappear when he's a Democrat (I don't remember it happening to Nixon, but per the timeline below this wouldn't be contributing; the 60's judicial nullification of anti-vagrancy laws also obviously contributed: https://en.wikipedia.org/wiki/Vagrancy_(people)#United_State...).

As mentioned by tokenadult, who's an older type like myself, this really got into action with JFK's Community Mental Health Act (https://en.wikipedia.org/wiki/Community_Mental_Health_Act) and had a medical basis in effective treatments for schizophrenia and bipolar disorder that required the institutionalization of "hopeless" patients (something my mother witnessed as an RN in the 1950s; note that the study/studies behind this started in the mid-50s). It was pretty much finished by the time he became president.

There's also no way the institutions could have been closed down so fast as to create the "Reaganomics creates homelessness!" headlines et. al., which happened rather quickly.

Yes, it began with the CMHA, but it was under Reagan's presidency that the people who really should not have been de-institutionalized (ie, not the older people with dementia/etc who were returned to their homes and families during the first wave of CMHA, and instead the younger people with very serious mental illness and no support system), were. This is very well documented in the book American Psychosis by Torrey if you're interested in the facts.

As I mentioned above, between my mother and myself, we were there, we lived through the whole period in which the existing system was systematically dismantled and we know the facts from following "current events". My mom's something of a junkie for that, more than a bit of which rubbed off on me; while this was not a major focus of her's, it got her interest when a while after 3 months of residency in a psych ward, she returned to work as an RN Nurse Anesthetist and saw one of her "hopeless" cases doing janitorial or orderly work there. After thousands of years of hopelessness, this was an earthshaking thing.

Sure, some was done after Reagan became president (heck, it continues today, my Missouri Democratic governor is shutting down an institution for the mentally retarded not too far north), but you're going to have to do better than a book published in 2013 that couldn't pass the gatekeepers without blaming it on that devil Reagan.

You're really going to claim that few of the latter, the very ones with the diseases we started effectively treating in the '50s, true miracles that prompted a Federal rethinking of our approach starting in that decade, somehow continued to be warehoused until 1980???

And for what it's worth, you claim finds no support in the Wikipedia article: https://en.wikipedia.org/wiki/Deinstitutionalisation#United_...

I think this is a case where Wikipedia is not a sufficient source (wonderful though the website is). While I respect you and your mother's experiences, I prefer published evidence over anecdotal. I'll refer you to the book rather than continue this thread: http://goo.gl/yjKGxj

You're confusing two things we're providing witness of:

My mother's anecdotal experience with the revolution of treatment of schizophrenia with anti-psychotics in the '50s, which merely dovetails with the Federal government also recognizing that this deserved a serious rethink of how we treat these formerly "hopeless" cases.

Our non-anecdotal watching of current events as this good impulse was totally botched over the next N decades.

E.g. I suppose it's an "anecdote" that I read not that long ago that the state is shutting down an institution for the mentally retarded a bit to the north of me, but that's not using the word in the way you mean.

Anyway, for us, "published 'evidence'" that per your statements contradicts the facts as we contemporaneously observed them, and for obvious political motives, is less than interesting. Especially when there are so many good, honest accounts of this out there.

You are right, and it was never corrected.

You will find that most if not all of the homeless became that way after they became mentally ill and there was no or very little support available for them.

If you want to end homelessness you have to bring back a mental health system that supports the mentally ill, helps them make house payments, and can train them for new jobs when they lose them.

All of these public shootings done by mentally ill people represent less than 1% of the mentally ill population, but the news media takes delight in vilifying the mentally ill as all being violent. This is, of course, not true. But news media makes popular opinion out there. If something is popular, it does not make it true.

All of these public shootings done by mentally ill people represent less than 1% of the mentally ill population, but the news media takes delight in vilifying the mentally ill as all being violent.

If you factor out drug use, the mentally ill population isn't more dangerous than anyone else.

I don't think that the media intentionally vilifies the mentally ill. Instead, I think that people in general seek mental illness as a partial explanation for extreme violent behavior. "He must be one sick fuck." It's much easier to explain human badness in terms of illness than to confront the more complex truths: (a) sometimes good or average people do bad things, and (b) some people are just horrible.

If you start concluding that all extremely violent people are mentally ill (which is probably false) and use the flawed (A -> B) -> (B -> A) thinking that passes for logic among many people, you start thinking of mentally ill people as all potentially violent.

I think that people in general seek mental illness as a partial explanation for extreme violent behavior.

Arguably: someone who's violent has a psychological disorder.

However several of the psychological disorders most associated with extreme violence or antisocial tendencies also leave the subject in a very high-functioning state. They can also be frustratingly resistant to any sort of treatment (drug, talk, or other therapies).

Lack of empathy is often not nearly as debilitating as hearing voices and seeing visions.

Lack of empathy is usually when one is a sociopath not suffering from schizophrenia or autism.

The problem is some people on the autism or schizophrenia spectrums cannot express themselves, but they have empathy and compassion, but are misunderstood by society and the news media. They just lack social skills and people skills, but can be taught them by books and therapy. Most are even nonviolent and very good people if only they were understood.

Sort of like Sherlock Holmes, only Doctor Watson seemed to be able to understand him, everyone else misunderstood him and didn't want anything to do with him because they thought he was a mean jerk with no empathy. He had empathy but got rid of distractions to focus on solving crimes to save humanity from evils like Professor Moriarty and his gangs of sociopaths.

Lack of empathy is usually when one is a sociopath

Yes. I didn't make that sufficiently clear.

Interesting contrast in traits and psychiatric profiles you highlight in Holmes there. Nice.

I always see people using 'sociopath' as different from 'psycopath', and I also see people claim they mean the same thing, and I also see people say that neither are used anymore, technically speaking (as in psychiatrists). Anyone with formal training on the area would be kind to briefly (or not) clear this up?

I don't have formal training, but as I understand it, the formal Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis is "antisocial personality disorder" (https://en.wikipedia.org/wiki/Antisocial_personality_disorde...).

See also https://en.wikipedia.org/wiki/Psychopathy_or_sociopathy and in general also note the WHO's International Statistical Classification of Diseases and Related Health Problems (ICD), which could be a less intensely political artifact than the US DSM.

"If you factor out drug use, the mentally ill population isn't more dangerous than anyone else."

Yup. In fact the opposite is the case. Folk with mental illness are much more likely to be the victims of violence.

See http://psychcentral.com/archives/violence.htm for example. Or the references from http://m.xojane.com/issues/for-the-last-time-stop-conflating....

The story that gets portrayed in the media of mentally ill people being a major danger to the general public is just that - a story. The facts don't back it up.

Even if it were the case that the violent and dangerous criminals were suffering from mental illness, wouldn't it make a lot more sense to strive to provide access to treatment for mental illness than just villify those who suffer from it?

Let this be a warning to all those who suspect. WE WILL GET YOU, EVEN IF IT TAKES 17 YEARS.

This hits me particularly hard because I lost my sister to mental illness not but three months ago.

Perhaps our society will one day treat those with mental illness the same way we treat those with cancer or ALS, with compassion and love, instead of with insults and shame. I hope that I am alive to see such an enlightened society.

My condolences for the loss of your loved one.

My brother has the illness. Every ounce of self-doubt I have, I worry is the beginning manifestation of Schizophrenia in my own mind. It's not a good place to be - that worry that every time you "hear voices", it's some sort of announcement about your own mental state? The worst for me is mishearing people, or muffled conversations, where I fill in the gaps with extremely negative content, causing a downwards spiral in emotion. I'm sure it's nothing, and I'm perfectly normal though.

What you're describing here could just be compulsive thoughts since you're worried about getting schizophrenia. If you do get it, it will probably be quite obvious, and you are at an advantage since you are already on the alert. Have you considered seeing a therapist about these thoughts?

If you do get it, it will probably be quite obvious

I think I once read that it's common for schizophrenia to damage the part of the brain that enables you to know anything is wrong, so whoever gets schizophrenia is unlikely to be able to figure out they have a problem. That's why most people with schizophrenia are convinced of their delusions rather than having the first instinct of going to a doctor. But that's hearsay, and my memory is a bit hazy on the topic.

It's hard for people who suffer from the disease to understand what's going on and apparently, they need some help from families and friends. Most people do not know when it's right time to visit a therapist and sadly friends are usually too afraid to say: you need some therapy.

Considered, but not with any great seriousness until probably the last 12 months. I'm taking a wait-and-see. I think it's just due to more responsibilities/commitments and you naturally question your actions/motivations/decisions

> If you do get it, it will probably be quite obvious

What? Do you mean "If you do get it, it will probably be quite obvious to those around you"? Given the rest of your sentence, I believe not. You should count yourself out on counseling.

Thanks, but no thanks, GalacticDomin8r. Obviously this was not professional advice, but I have many years of experience both from the inside of the mental health system and from helping others navigate it. I stand by what I just said. A skilled therapist would be able to see things that GP doesn't, so that would act as a counterweight if GP was to ever get sick and unable to see it for himself.

People tend to minimize the lethality of mental health problems. There's an assumption that completed suicide is the only cause of death for mental health problems. But people with MH problems suffer weird sub-optionalities in health care, even in England where we have the National Health Service.

Young people with a mental health problem will especially suffer from poorly funded treatment, often being sent many miles to get treatment.

Off topic: For any Googlers reading this article contained an advert that minimized Google Chrome and opened the App Store. That must be a bug. It is horrible horrible behaviour. Please can you poke the appropriate team and ask them to do something?

> People tend to minimize the lethality of mental health problems.

My sister fatally overdosed on heroin in January of this year. She suffered close to a decade of a progressively worsening bipolar/depression/substance abuse loop, even after spending over a year in voluntary, in-patient treatment centers. Serious mental illness is no different than cancer. The trouble with mental illness is that it manifests itself in socially undesirable behavior. Drinking, drugs, erratic actions, not a visible tumor hanging off of an organ. The lack of compassion for those people with mental illness is one of the greatest tragedies of our society.

I agree, I got schizoaffective disorder. I had too much stress in June 2001 and got sick, had a stroke, ended up in a hospital and got diagnosed with schizoaffective disorder. It is a rare mental illness that has part schizophrenia and part bipolar in that it has schizophrenic, depressed, manic, and normal cycles lasting about two weeks each.

Every time I tried to post about mental illnesses and startups here, I always got downvoted and flagged. I think that the high stress causes some people to develop these serious mental illnesses. Because there is no compassion or empathy for the mentally ill, they have to hide it and go untreated and this is why there are so many suicides in the startup community as well as the banking industry and financial industry with the youth.



I post about this on Slashdot and all other tech news sites. It seems nobody actually wants to care enough to help out a mentally ill person such as myself work on side projects and startup my own company or even join their startup or even help write a blog.

So I had made my own website and tried to do things with it. Nobody still cares enough to help.

I was told I would not live to see 40, I am 45 now. I hope to live a long time, but been out of work since 2002 because nobody cares.

I have a different condition but similar outcome in terms of not being taken seriously and finding that frustrating. But I will suggest you need to look for support from a position of strength -- what do you have to offer -- not from complaining about what has gone wrong. I know that's hard to do -- I often don't manage to pull it off myself -- but you need to figure out what you do have to offer.

I get told constantly (including again today) that I will not be financially successful with my projects. The reality is that I do make some money online, just not as much as I really need. That amount is sporadically improving. I have worked super hard on my health. Getting myself stable and more productive is one of the keys.

If you lived 5 years longer than you were supposed to (my count is 13 so far), then you must have some competencies. What are they? What is the position of strength you have to offer the world? What is the unique value proposition you bring to the table? There has to be one.

Finding a path forward is hard and my frustrations with other people not taking me seriously is a very big thing in my life. But I keep working on what I can do and I keep working on what I do have to offer and I keep working on my various projects and things are slowly improving. I expect them to pick up speed in the near future. This past month has been a major positive turning point in my health. I expect to be more productive, more able to communicate, etc in the future.

((HUGS)) if you want them.

Thanks for the hugs.

I learned over 37 different programming languages on many different operating systems over the years. Some might be old and outdated but thanks to open source projects they got compilers for modern systems. So I can do COBOL, FORTRAN, Pascal, Turbo C, Ada, and a lot of other misc languages that the current graduates and drop-outs don't even know. I can do legacy programming for that and convert code from one language to another. I can even do that with SQL databases and convert flat files and DBF files to SQL databases.

Many of my jobs for which I got paid $150K/year was upscaling a database from Excel, Access, etc formats to MS-SQL server and turning VBA code into Visual BASIC code. I used to write the program that would read the file, and then sync it up with SQL Server and then modify the Visual BASIC code to pull the data from SQL Server.

Yeah I know I got laughed at for using Visual BASIC, but it paid very well. I used quicksort and heapsort algorithms to speed up the code that coworkers write that was just too slow. It went from 15 minutes to generate a report to just 15 seconds. Most problems in Visual BASIC is due to the programer using a slow algorithm and if you know how to rewrite it, then it runs faster. most Visual BASIC programmers use the bubble sort, don't know why it is called a bubble sort or why it is so slow.

I do security and quality checks, read some stuff by Schnermann and Deming. I almost always write a function named SQLFilter that filters out control codes and SQL codes to prevent SQL injection attacks in order to sanitize inputs. I also write one named HTMLfilter that filters out HTML codes, because you don't want someone to exploit you by adding in HTML tags that do something nasty. Ask Pesico about that Name your own Dew contest and they didn't filter out HTML tags and how "Hitler did nothing wrong" won the contest due to some hackers and trolls on 4Chan and Reddit. Well if they used my HTMLFilter function, that would not have happened. I see spammers exploit Facebook using HTML codes and Javascript to automatically like posts and tag friends in a new post with an embedded video. If only they sanitized out HTML codes and rejected Javascript in the forms, spammers could not even do that.

Well maybe now you see how important what I do really is, most if not all of the 90% of startups that fail, don't do quality checks and security checks, because it 'takes too long' and they are in a hurry to get that code released so they can get a paycheck and start up that IPO.

I am a super debugger, you see, I fix the mistakes the rookies make. Most high school and college dropouts are rookies who make these rookie mistakes. I debug those mistakes and correct them.

Right now I am learning Haskell, I got my own GNU/Linux distro but I also use Lubuntu. I also know C++, Java, Python, PHP, C# and feel like given enough time I could learn any language and find ways to translate code from one language to another. Sort of a Polyglot for computer languages I suppose?

I do a little freelance work for money but what I do writing and does not pay well. You might be able to do freelance work for better pay. Here are a couple sites for that, in case you did not know:



> So I can do COBOL, FORTRAN, Pascal, Turbo C, Ada, and a lot of other misc languages that the current graduates and drop-outs don't even know.

I'm interested because you mentioned Turbo C, It's usually the ANSI flavour you get these days (I tend to write the C90 variety).

I think it was 1987 when I learned on Turbo C and Quick C later on and then Microsoft C.

My father worked for AT&T so of course I learned as many versions of C as I could because it was portable and Bell Labs invented it along with Unix. Learning Unix paid off as well.

This is a reply to your earlier comment, that no one cares. I care. I am about your age, and I suffer from depression (which borders on fear of what I may become because my mother had manic/bipolar) I am about to embark upon my own grand venture of start-up life - except it's not a real startup, I'm not looking for an exit, I'm looking for a lifestyle business type thing.

But I would love to connect and chat, as I also worry about how to deal with my illness when I set out on my journey to fame and fortune. My email is in my profile, and I will also email you.

So don't worry, you're not alone, and there are us out here who do care.

Thanks man, caring is worth more than money and success to me. You can't buy caring with money or anything else, people choose to care or not care.

orionblastar@gmail.com if anyone wants to contact me via email.

Snap (sort of).

My sister's father in law used to work for AT&T. He was based in England working as a project manager, but he travelled all over the place. Next time I see him I'll ask when he worked for them, since it was around 1983 that AT&T was broken up.

I started learning C just over two years ago (you beat me to it by 25 years), it was only recently that I put the two together.

I got a friend in Hong Kong that helps me run blastar.in and we do virtual machines in QEMU of old operating systems like IBM OS/2 2.0 and Windows NT 3.1 Advanced Server and each one has a Visual C++ or C compiler in it. Even some FORTRAN compiler as well.

He made this Windows NT 4.0 MIPS virtual machine using QEMU-MIPS and it has a Visual C++ for it that also does C90 I think. He compiled a version of Conway's Life in it for fun. There are these Watcom C/C++ compilers as well, Google for OpenWatcom for the free versions of them they exist for OS/2, DOS, and Windows compiling and I think they even use C90 standards.


We are trying to do retro software in QEMU virtual machines, we got a collection of Unix images between us like some old SunOS and Solaris stuff, etc. Got Solaris in QEMU-SPARC running for a bit but had problems with the network stack. Older versions work but Solaris 7 seems to have a NIC bug in the kernel.

My father worked for Western Electric, 1-ESS switches, had tried to turn them into minicomputers running Unix System V and other stuff by working with Bell Labs and other divisions. I think the 1983 breakup put a stop to that. He did some work on a DEC PDP I am not 100% sure but I think a PDP-11 or something using Unix. When I was young he introduced me to Dennis Richie, who told me to learn Unix and C when I was older. They even wanted to hire me at AT&T when I turned 18 in 1986, until the breakups prevented that. So in 1987 I was in college and took a C class, it helped me learn a lot of different languages out there. Sort of like learning Latin or Greek if you ask me.

My father died in 2010 of brain and lung cancer. But I am still trying to get things done. If you want to work on a project let me know, I might know others who know C90 and can join in via retro legacy programming.

We are all nothing but data-points on a distribution curve.

If you end up just a little bit outside of the very narrow band where the majority of people can be found, welcome to the land of the lost and ignored.

If you are lucky medical science has put a name on that part of the distribution curve and maybe they can help to move you closer to the peak of the distribution curve.

Myself and rest of mankind, please take a note.

Room for improvement: how we treat and interact with other people that didn't have the same luck in the big lottery of life..

Orionblaster, I want you to have better times ahead in your life than what you've seen so far. At least I can offer you my best wishes over the internet.

Thank you, I am a few standard deviations from normal I guess? Whatever normal is, I don't know.

Posting from a throw-away account.

Here I am, somewhere in the autistic spectrum. Quick learner, scores well on IQ-tests but I have a lot of problems understanding, interacting and connecting with other people. Although my mental illness is somewhat different and probably not as severe as yours I recognize my own situation very much from what you describe.

I don't have an official diagnose, and I'm not overly eager to get my mental illness on paper as that can be to your disadvantage in many situations and besides there isn't really much help available for someone like me within the public health-care system of my country.

From the outside I appear to be functional. I have a job, a home and a car, although I'm in my forties and don't have any family.

But I have to fight really hard with myself just to get by some days. Sometimes using self-medication, I've found SSRIs to be helpful. Although I'm not always sure why I should bother to get through that day, I still keep fighting. I'm thinking about suicide at least a few times every year and sometimes I have gone quite far with the actual preparations.

And you are so extremely spot on when you describe how nobody cares.

I try very hard to perform well at job, besides my illegal medications, which doesn't even have any narcotic effects, I abide every written law of society, I try to help and give kind words whenever I can, I donate money to charities every month.

And nobody would even care to listen, answer a question or give an advice, at least not with any truthfulness or honesty. Hey guys I'm not asking for your money, only a moment of your time and some honesty that I really could use to find my way onwards in life.

Some people around me, both at work and my neighbors have noticed my condition and are willing to talk about it when I'm not around. But they are obviously not prepared to give me 15 minutes of their time and just brief moment of truthfulness, they just want to get rid of the crazy guy and move on.

Nobody cares, for real!

Well people often fear what they don't understand.

High functioning autism just scares them as does my illness. They are misunderstood and so are we as well.

I always blamed myself, but it seems society shuns mentally ill people from all spectrums.

I wish you all the best with your condition and hope you find the right job at the right time.

Thank you, for caring enough to post that. Most people read what I write and just ignore it and move on.

Schizophrenia is such a hard disease to study in the same way that cancer is a hard disease to study - it not a disease with a common cause (like AIDS for example), but a collection symptoms used for diagnosis purposes. At least with cancer we have recognised that it is not one disease (Cancer is thousands of different diseases with thousands of causes), but with schizophrenia we seem to still be looking for the "cause".


Epigenetics—the way genes switch on and off—is another area of intense interest for schizophrenia researchers. Every nonreproductive cell in our body contains our entire genome, and in every cell, some genes are properly switched on and others off. We inherit our genes, but environment strongly affects the switching mechanisms. This was dramatically demonstrated in a study of persons born during the “Dutch Hunger Winter” of 1944–1945—a famine the Nazis created in the Netherlands by cutting off food supplies in retaliation for Dutch participation in the resistance. Infants born during the famine to half-starved mothers, a cohort now turning 70, have higher rates of all kinds of pathology, including schizophrenia.

I am super tired today, fall out from my own struggles with getting well in the face of a genetic disorder and doctor pronounced sentence of death. I feel pretty apathetic. I don't know how much is chemical, how much is situational. I get so tired of being treated like a loon by the world.

The disease, malnutrition, epigenetics, inflammation -- all that stuff is stuff I have worked on to deal with my own issues. I flail about, unable to find a way to speak of it. I have mostly moved on to trying to figure out how to make money instead of how to help other people.

I don't quite know what to say. Inflammation is rooted in acidity and promotes infection. Infection promotes malnourishment. Malnourishment does all kinds of wonky things to the brain.

I am not having a great week, physically, and it has a track record of impacting my mental functioning and mood. My only known auditory hallucinations are related to an overdose of decongestants. I have no reason to believe schizophrenia runs in my family but the article hits a nerve in some important ways.

Inflammation is rooted in acidity and promotes infection.

Do you have any more on this? I have stumbled across the notion before. Someone typically counters with "but the body maintains a constant pH" and the conversation dissolves.

Stay well.

I dismantled my website due to ugly public attacks and moved it twice. I kept the info but it is currently not published.

The body does not maintain a constant ph. The body maintains the BLOOD at a very narrow range of ph because if your blood leaves that very narrow range of ph, you die. But if you watch crap about dinosaurs and stuff, you learn that not only are bones necessary to support your mass when you leave the ocean, they are necessary to mediate your blood ph. You can have sharks and invertebrates in the ocean because the mineralized sea water maintains their blood balance. When you leave the ocean, your body strips the bones of calcium to maintain blood ph when the body is in crisis. This is consistent with the fact that my condition is known to promote acidity of the tissues and also known to cause early onset osteoporosis, as early as the teens.

If you develop acute acidosis (example: http://en.wikipedia.org/wiki/Diabetic_Ketoacidosis), they hospitalize you because you can die within 72 hours if it is not successfully treated. But then for my condition, they don't even treat the acidosis that they know it causes.

So whoever told you the body maintains a constant ph is full of shit. It isn't true. The body maintains a constant blood ph, a very different answer. I think blood tests are likely not a very good indicator of subtle or early problems because your body places a real high priority on keeping your blood in homeostasis in order to not die. I suspect we would really need to do tissue samples to genuinely track some things in a meaningful way. So I tracked things symptomatically since a lot of the tests the doctors ran said there was "nothing wrong with me" yet I was dying.

Feel free to email me if you want to discuss it further.

As somebody who follows this topic very closely (nutrition, inflammation, mental health and autoimmune diseases), I find Terry Wahls' work to be very encouraging. I also find the strong interest by the research communities in inflammation and its causes to be cause for hope. My personal opinion is we've created incredibly toxic environments through a thousand mildly-toxic cuts, and I hope we can make it better sometime soon.

I guess my frustration is I have been resolving my own issues for more than thirteen years. To me, this should not remotely be a hope of "sometime soon." It is something I think we have the information to be resolving in the here and now. I am baffled and frustrated that I get so much hostility for attempting to speak of my own experiences in addressing such issues.

Yes, a thousand mildly toxic cuts is certainly a factor in my life, snowballed in part due to a bottleneck in how my cells function.

Thank you for commenting.

When I look back on the objective history of nutrition and chronic disease, I get extremely passed off. The entire field has been driven by egos and check books, even as good studies have shown how wrong those egos were.

While we still have huge holes in our knowledge, there is a lot of good, rigorously tested information available today. The decision I've come to is that I'm going to trust nobody but myself. There are no authorities I trust, but there are people whose science I will read before others (people who've shown integrity and the ability to design and carry out good science (not very many, unfortunately)). Unfortunately, it's places like schizophrenia where our knowledge gaps are most pronounced. I hope some day we will understand the brain and, more importantly, be able to fix it.

Good luck with your own issues. So many people don't take responsibility for their own health, and that's when this go really bad. Our society believes doctors are the beginning and end of our health. They may be the end[1], but we, individually, are the beginning.

1. I'm referring to chronic conditions here. Doctors have done some amazing things for infectious and acute disorders.

Has there been any research about the prevalence of schizophrenia in communities with strong social bonds (multigenerational families under one roof, closeness with neighbors, etc) versus modern urban communities (nuclear families or singlehood, relative disconnectedness with the physical world, lots more disembodied communication (Internet, phone, SMS) as opposed to traditional face-to-face communication)?

Edit: Turns out there is - http://bjp.rcpsych.org/content/184/4/287.long

I was asking because I definitely notice that if I am in a situation where I am living alone, I am just flat out less happy than when my wife is home. And I'm one of those people who is actually even happier when both my wife and mother-in-law are home, basically, the more people living under my roof, the happier I am. I was wondering whether it was the same for others.

Actually, schizophrenia appears to be one of the few mental illnesses -- maybe the only one -- to affect all cultures almost equally. Schizophrenics can be found in small African villages, Chinese industrial centers, Tibetan mountain villages, and of course in the West.

There's some variation in the respective prevalence of certain symptoms across cultures (catatonia is more common in non-western cultures, for example), but the cluster of symptoms defined as schizophrenia in the DSM has been found in almost every culture known to man (I believe symptoms of schizoprenia have even been found among some people from the Yamomamo indigenous tribe of the Amazon).

My knowledge of this comes from graduate and undergrad psychology, neuroscience and global public health courses -- I'm definitely not a psychologist or psychiatrist. But I am somewhat skeptical of the study you posted. I suppose it's possible that prevalence of schizophrenia might be somewhat higher in urban environments, but there's pretty overwhelming evidence that schizophrenia occurs across cultures in similar proportions.

There have been many, many published studies on this phenomenon. Here's one:


I am curious: Is there a difference in the problems that show up with regards to the country that people look at?

> This parasite messes with the brain, causing rats, for instance, to feel a fierce attraction to its predator, the cat.

This is wrong. The parasite causes rats to lose their natural fear of cat smells, not gain an attraction to cats. The author mis-read the research:

"Infected rodents show a reduction in their innate aversion to cat odors; while uninfected mice and rats will generally avoid areas marked with cat urine or with cat body odor, this avoidance is reduced or eliminated in infected animals. Moreover, some evidence suggests this loss of aversion may be specific to feline odors: when given a choice between two predator odors (cat or mink), infected rodents show a significantly stronger preference to cat odors than do uninfected controls."


I'm not sure I'd trust wikipedia as the final word


For example, rats infected with the parasite lose their fear of cats, and are even attracted by their scent, making them easy prey

The Violinists Thumb,

Toxo does even stranger things to rodents. Rodents that have been raised in labs for hundreds of generations and have never seen a predator in their whole lives will still quake in fear and scamper to whatever cranny they can find if exposed to cat urine; it's an instinctual, total hardwired fear. Rats exposed to Toxo have the opposite reaction. They still fear other predators' scents, and they otherwise sleep, mate, navigate mazes, nibble find cheese, and do everything else normally. But these rates adore cat urine, especially male rates. In fact they more than adore it. At the first whiff of cat urine, their amygdalae throb, as if meeting females in heat

I haven't read the source research myself but the author isn't the only one drawing the conclusion that toxo-infected rodents are actually attracted to cat urine.

> Every nonreproductive cell in our body contains our entire genome, and in every cell, some genes are properly switched on and others off.

Not entirely accurate: http://www.salk.edu/news/pressrelease_details.php?press_id=6...

Fascinating. There's so much we're only just beginning to learn about genetics and epigenetics.

An amazing story. And so sad. It could affect any of us. I don't know how to react other than to be thankful it has not struck anyone in my immediate family. Hopefully we will make progress in better understanding schizophrenia and work towards a better way to manage it.

Deranged nutter here, glad to see mental illness being discussed in a mature manner on any website.

Ignorance of mental illness is widespread, but what is becoming more popular is abusing the terms to describe your own problems. When the term "bipolar" starts to be used to describe someone's mere eccentricity, it indicates awareness of the condition has increased, but the level of ignorance has remained the same.

A good example of ignorance related to depression:

Many people who suffer from depression have problems with anger. From my experience being diagnosed as a loony correlates with an increase in aggression among your fellow humans that is mainly directed towards yourself. I don't see how subjecting someone with anger management problems to more anger and aggressive behaviour is going to help them.

A diagnosis of mental illness is a diagnosis, not an answer to or explanation of a problem, which is usually how it is interpreted. Appropriate action will help the problem, as opposed to thinking that a prescription of escitalopram or fluoxetine will just make the problem fizzle away.

One more point: people with mental health problems dislike being talked to and treated like naughty children. That is the quickest way to lose their respect.

A very interesting submission. If you like long-form videos of scholarly conferences, there is an amazing video of a public presentation by two identical twin sisters who are discordant for schizophrenia.[1] As you can imagine, the sister who didn't have schizophrenia thrived much better in life, and indeed is a psychiatrist.

I am privileged to know Irving Gottesman,[2] one of the world authorities on schizophrenia research (he was the consultant credited by the author of the John Nash biography A Beautiful Mind). He used to be one of the few researchers on the topic who thought that there were genetic influences on schizophrenia, which is now established medical knowledge. In the bad old days of Freudianism, schizophrenia was thought to develop solely from "schizophrenogenic mothers," whose bad parenting caused their children's suffering. It was adoption studies in several countries that conclusively showed that genes matter more than parenting in early childhood in triggering schizophrenia.

And yet environmental factors of various kinds plainly matter too, as the cases of monozygotic ("identical") twins not having identical disease course in schizophrenia make undeniably clear. Gottesman and most other researchers on schizophrenia believe that there are a variety of genetic vulnerabilities that people may or may not have that increase risk for schizophrenia, and then stressors in the environment (and it is not excluded that some of those stressors may be purely psychological, influenced by interactions with other people) trigger the expression of full schizophrenia symptoms. This is called the diathesis-stress model of schizophrenia, and the same model is believed to a helpful research hypothesis for study of depression and suicide.[3] So if you know someone who suffers from schizophrenia, the compassionate thing to do is to help the person find current medical treatment (which has improved enormously over the course of my adult life) and to cope with day-by-day life stresses.


Several other comments here involve participants who have close family members with related diseases, or who have related diseases themselves. That's rough. I hope Hacker News is always a compassionate community where you can share your experiences and then encounter empathy and helpful advice. We should support one another here.

[1] Video hosted on YouTube:


Transcript of presentation:


[2] http://www.psych.umn.edu/people/facultyprofile.php?UID=gotte...

[3] http://www.ncbi.nlm.nih.gov/books/NBK107203/

I found the 2010 Discover Magazine article, I believe referenced in the American Scholar article (the stuff about Torrey and HERV-W), fascinating. A couple of excepts:

"One, published by Perron in 2008, found HERV-W in the blood of 49 percent of people with schizophrenia, compared with just 4 percent of healthy people."

... "In the past few years, geneticists have pieced together an account of how Perron’s retrovirus entered our DNA. Sixty million years ago, a lemur like animal—an early ancestor of humans and monkeys—contracted an infection. It may not have made the lemur ill, but the retrovirus spread into the animal’s testes (or perhaps its ovaries), and once there, it struck the jackpot: It slipped inside one of the rare germ line cells that produce sperm and eggs. When the lemur reproduced, that retrovirus rode into the next generation aboard the lucky sperm and then moved on from generation to generation, nestled in the DNA. “It’s a rare, random event,” says Robert Belshaw, an evolutionary biologist at the University of Oxford in England. “Over the last 100 million years, there have been only maybe 50 times when a retrovirus has gotten into our genome and proliferated.”"

And then our bodies reaction to HERV-W seems to be involved in most schizophrenia. It's odd to think of modern problems like that being down to an ancestor getting a virus millions of generations ago.


The link in the article about the neural network developing schizophrenia is broken, leading to the UTexas homepage instead. I've tracked the linked article down to here: https://www.utexas.edu/news/2011/05/05/schizophrenia_discern...

More info: http://neuroskeptic.blogspot.ca/2011/04/schizophrenic-comput...

Publication abstract: http://www.ncbi.nlm.nih.gov/pubmed/21397213

And the full scholarly article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105006/

>A model 1987 longitudinal study of 269 patients suffering from severe schizophrenia and released from the Vermont State Hospital between 1955 and 1960 found that one-half to two-thirds of them had significantly improved or fully recovered. These were the most hopeless back-ward cases. These patients had benefited from social workers and therapists and employment counselors—an extensive support system continuing over several years and consisting of one essentially unchanging professional team. By the time of the study, a significant number of them had reintegrated into the community.

i always suspected something like this. Looking at the obviously mental ill homeless people, i always feel some guilt that we, as a society, are just leaving them behind by not mustering the necessary support and help.

Sorry I cannot reply to every thread.

My condolences to everyone who had a family member or friend die of complications caused by schizophrenia or some other mental illness. I myself have schizoaffective disorder since 2001 which is like schizophrenia and bipolar mixed together and less than 1% of the population gets it and it is very rare and misunderstood.

I have lost friends I worked with and went to high school with to mental illnesses and they killed themselves. I've been suicidal myself in my life in the past. But I vowed I would not try suicide ever again and work to improve myself so that one day I can return to work and earning a living.

You have my deepest sympathies, empathy, compassion, and love. I really care about mentally ill people and their families and friends, even ones that passed on.

" Two University of Texas computer scientists programmed a voice-recognizing computer with neural networks and taught this artificial brain simple stories. They then simulated a hyped-up dopaminergic system by reducing its ability to forget or ignore. This unfortunate computer became delusional. It made up wild, disconnected stories, even claiming credit for a terrorist bombing. If computers can go crazy, can they be cured? If computers can be cured, can we be cured?"

I would like to know how they drove the computer "crazy" (and how this maps to human neurology, if at all).

If you are currently helping someone go through this disease - or suffering from it - all I can say is: hang on there.

Dealing with irrationality is one of the most frustating feelings out there. You will get very tired sometimes. You will get overwhelmed. Nevermind. They are having the worst of it.

Keep going. You owe it to them to comfort them, no matter how many times. Remember two things: It's not their fault, and it will get better.

Nice story especially that the infos here could be of great help for people who are suffering from the illness.

I think I am having schizophrenia right now !

No one gives a damn about your sister, only self righteous pricks who will still do nothing just "care". Caring, so usefull...

At least caring presents a better statistical outcome on action than simply praying.

More to the point, it gives a better statistical outcome than not caring.

Is this really... Hacker News? Edit: Note to self: read guidelines first.

Yes! This post is appropriate for Hacker News. It's a solid article on an intellectually interesting subject—exactly what the guidelines call for. Although the human-interest angle ('what killed my sister') often signals fluff, here it is appropriate and tasteful.

As I hope everyone knows, HN has never been only about tech and startups. Intellectual diversity is something we cultivate, and we've been running a little short on it lately. So consider this a general call for (a) more thoughtful pieces on (b) substantive topics from (c) out-of-the-way sources.

(Since ngcat has read the guidelines and already turned his or her comment from a bad one into a good one, I think would it would be fair for the rest of us to apply the corrective upvotes policy and get this comment back to par. I'll go first.)

"Imagination, suggests Princeton molecular biologist Lee M. Silver, is related to the brain’s “noise” (random firings of neurons, or nerve cells), thus generating more associations. Brain scans of people with schizophrenia and their unafflicted family members show mega-amounts of random noise. Brain scans of control subjects (no schizophrenia in the family) do not."

Good enough for my first-pass filter. ;)

I posted it because I've known a bunch of smart, creative people who happen to have some sort of mental illness.

My guess is that many people on HN are in the same boat, or suffer from a mental illness, or both.

It frustrates me that it's still often quite hard to have sensible discussion about mental illness. If you have a physical illness people are instantly sympathetic. But you have a metal illness, well, to many people you're just crazy.

I think everyone knows people with a variety of mental health disorders. It seems that we're just now getting comfortable with the idea that we can discuss these problems publicly.

I'd also say that since the "nerd" personality types (at least from a Myers-Briggs [1] perspective) tend to be over-represented here, we would probably also find a larger than average percentage of us with Aspberger's Syndrome [2] (now removed from the "Diagnostic and Statistical Manual of Mental Disorders" [3] and considered an autism-spectrum disorder).

[1] - http://www.myersbriggs.org/my-mbti-personality-type/mbti-bas...

[2] - http://en.wikipedia.org/wiki/Asperger_syndrome

[3] - http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manu...

From the guidelines:

On-Topic: Anything that good hackers would find interesting. That includes more than hacking and startups. If you had to reduce it to a sentence, the answer might be: anything that gratifies one's intellectual curiosity.

This article is a nice survey of science around a disease that affects people I care about. Quite cool in that gives me a bunch of search terms, etc. Much better from my perspective[1] than the SSH Kung Fu article that only reiterated things I've been doing for a decade, and were old when I first read some article about "awesome things you can do with ssh".

[1] I won't complain about the SSH article though, I think it's needed for the community - see an old comment of mine for why: https://news.ycombinator.com/item?id=3735386

I just reread the guidelines. I am OK now.

As someone who has direct experience with schizophrenia I very much enjoyed the article. It is rare to read something on this topic that is anything more than fluff.

What's your particular objection to it? It seems to be a pretty good overview of many of the prime leads and perspectives we have to look at a fairly common and well known disease, especially one with significant cultural/social impact.

its called flag and move on.

However my simplistic bar for determining stories I like are, is it related to programming, new business ideas, or fields I am so out of my league I swap tabs to wikipedia or the like to understand the words I just read.

Having worked with a bipolar person I was always interested in what knowing how they separated the two.

I always ask when I see questions like this:

What do you think should be on HN?

Why do you think this specific article should not be on HN?

Look, people who always post "why is this on Hacker News": There's no active moderator here, other than the community. So whatever makes it to the front page is decided by the users. If it is here and people are commenting, then it is where it is supposed to be. I understand longtime users who rant the it used to be more techmical/strict hacker stuff, but the user base has grown, and it seems people on Hacker News like what ends up on the front page of Hacker News. Go figure ;)

> There's no active moderator here, other than the community. So whatever makes it to the front page is decided by the users.

I'm afraid you're mistaken. HN has always been actively moderated, and what makes it to the front page has always been a combination of upvotes and curation. Also, the call for intellectually diverse subjects has been there as long as HN has been.

Ok, my mistake, I though it was only moderated in exceptional cases. And about the diversity on HN, just this week somebody here was complaining about the good old days of HN when it was only technical stuff, so I thought that's how it was. Thanks for the clarification!

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