The doctors probably are lying.

Your other friend has been brainwashed by extreme right-wing ideology. Perhaps he's been reading Thomas Szasz. He should be medicated at once.

I seem to remember that Silvano Arieti's Understanding and Helping the Schizophrenic: A Guide for Family and Friends (1979) was a good book.
Definitely.
Of course not. And don't you think that that happens already?
What for?
Someone who's cursed with a raw experience of reality which can't be integrated into their culture, nor can it be suppressed. Someone living a nightmare, one so bad that the part of the mind which integrates raw experience into the form of an individual ego and an external world cracks under the strain, and gives up almost completely, so that self and world become merged, confused, and split, in various terrifying ways. There could be a whole lot of reasons why this happens, in any individual case - all the usual suspects. These are just my guesses. But the idea that doctors actually know what's going on and have medicines to put it right is laughable. They have brain-damaging chemicals which, if the patient is lucky, clobber the part of the brain which is manifesting most of the trouble, while leaving enough of the rest of the brain intact for something like a 'normal' life to result. Again, just my guesses. I've met and lived with some schizophrenics, and I live on the verge of psychosis all the time, without ever actually having been psychotic. (Not just my opinion, psychiatrists agree.)

In practical terms, I have no idea what to do with someone who's schizophrenic, other than (just rules of thumb): (1) don't ignore the problem; (2) don't trust doctors to know what they're doing; (3) research all prescribed medications; (4) try to find a support group, for yourself and/or your friend and/or their family; (5) expect them to abide by the same standards of rationality and decent behaviour as anyone else; (6) also expect to learn from him just as you would from anyone else, don't pretend to know it all just because you are 'normal' in comparison (I'm not implying that you do, and the fact that you are asking these questions speaks well of you); (7) don't force normal social conventions on them, except those implied by (5), or for their own safety in a hostile and uncomprehending world; (8) read Arieti, or any other good book you can find (be critical!); (9) don't believe anything I tell you, or anything else anybody tells you on the Internet; (10) talk to your friend (if he'll let you); (11) try to find out what he thinks he needs from you (not what I or any other random Internet kook thinks, or what any doctor thinks); (12) trust your own judgement; (13) try not to let him drive you mad (he's almost bound to try, knowingly or unknowingly), and keep up your other contacts; (14) see if some form of supportive individual counselling is available; (15) be very wary of 'psychotherapy', especially 'group therapy'; (16) consider the possibility of finding a 'therapeutic community' for him (but I've had absolutely terrible experiences of two of those, so be very wary of them, too - again, use your own judgement, it can't be said often enough); (17) try to be as sane as you can for him, when he can't be sane for himself (he'll probably be relying on you for this, whether you or he know it or not, and the strain on you could be enormous, so take care, especially take good care of yourself).

Having said which: I got nowhere when a close friend of mine became clinically paranoid (cause: excessive consumption of amphetamines, prescribed by his NHS GP), and I lost that friendship, which was important to me. And I'm almost totally fucked-up myself, and almost nothing helps, so what do I know? The trouble is, nobody else seems to know much either.

Twirl,

I appreciated the combination of knowledge, common sense and humanity in your post. I hope you don't mind my adding a few points. I'm not an expert. Since I naturally write with an arrogant, opinionated style, my posts sometimes come across as know-it-all. So I re-iterate, I'm not an expert.

1) My first addition would be simply to re-emphasize the importance of not dehumanizing a person with a mental condition -- specifically, not to replace the whole person with a label. This principle, IMO, applies across the spectrum of physical and mental conditions.

There is a tendency among family and friends, some well-meaning therapists, and, of course, patients themselves, to replace someone's human complexity with a "label"; this is especially true with mental conditions. How would you feel if you were found to have a chronic heart condition, and then found that others' perception of you had changed from "Joe, my friend, brother, etc.", to "Joe with the Bad Heart"? If they could no longer enjoy certain activities, certain foods, etc., in your presence -- because they always seemed to be watching you for symptoms? If they stopped talking about particular subjects with you? Good luck getting a date! You'd probably start thinking more and more about your "condition", and in time, that label might become the center of your life, your self perception.

I'm not suggesting that we completely forget about mental conditions in ourselves or others, just that we keep them in perspective as a part of a much larger whole.

2) The second "sin" I've seen too much of is, frankly, mediocre physicians and therapists. And they're usually the most adamant about the correctness of their diagnosis and treatment.

The best outcomes, IMO, come from physicians/therapists who treat each person individually. Psychiatric "labels", with the exception of the rare "textbook" case, are no more than guidelines,at least to a competent practitioner. Apart from the obvious uniqueness and complexity of each person's psyche and history, in less-than-clear psychiatric cases, sometimes two or three diagnoses could appropriately be applied, all of them fitting the symptoms and signs partially, none fitting symptoms/signs 100%.

Physicians and therapists absolutely must be able to "think out of the box" with every patient, view every patient as an individual, and place high value on the input of the patient and family/friends. If a therapist cannot do this, then find one who can; those who are limited to labels and textbook treatments do more harm than good.

3) Related to #2, if a patient or family/friends is uncomfortable with a medication's effect or its side effects, any "good" psychiatrist will be very interested in specifics, ascertaining what exactly is "not right" about the medication. He should be quick to answer your questions about alternative medications. If medication complaints are only casually regarded or are over-generalized (well, that's normal -- don't worry about it) by the practitioner, find another practitioner.

4) Related to #3, unfortunately many (most) drugs do affect more than the target area of the brain, and do have side effects. There must be frank discourse between physician and patient about positives/negatives of any medication. The patient should, as much as possible, be involved in decision making -- but with mental conditions which affect a person's cognitive ability (or thought processes), as schizophrenic-type conditions often do, sometimes the physician or family has to insist on and monitor certain medications. As with 3, the physician should be able to competently answer questions about alternative medications -- if his answer sounds uninformed, it probably is.

5) There are way too many "therapies" on the market -- it's difficult to discern which ones may be effective. Many therapists seem too focused, IMO, on making the patient fit the theory.

The best indicator of a therapy's potential is, in most cases, the feelings and responses of the patient or family/friends. If a therapy or therapist seems "stupid" and ineffective, it/he probably is stupid and ineffective. If a therapy requires time to show positive effects, find out, in the beginning, how much time can be anticipated before improvement is seen. If there is no time frame, the therapist should at least be able to explain to you why in a clear, informed manner -- if the therapist sounds like a used car salesman, Danger, Will Robinson!

The next best indicator, IMO, is supportive credible psychiatric and neurological studies. Every quack therapy on the market will offer "evidence" of its effectiveness, but by asking about "hard" neuropsychiatric evidence, you can filter out some of the bad ones

6) I hate to bring up this term, but there are some new "music therapies" showing great promise -- and there are many more music therapies that are stupid and ineffective. Again, as with any treatment, the patient and family/friends should be involved in therapy choice. Many patients don't really feel comfortable sitting on the floor banging toy cymbals -- as most people would not.

The music therapies (of which I am aware, anyway) that are showing some amazing results with not only mental conditions but also brain injuries, stroke, hypertension, neurological conditions, etc.. fall under the umbrella of "neurological music therapy" (NMT). In the few studies I've seen, the most effective therapies are almost "common sense" music therapies, for example, playing a coma patient's favorite song. I have not yet read a hard study of some weird, counter-intuitive music therapy proving effective. HOWEVER, this an exploding field, so who knows what the future holds.

I'll end with three links that look good, to me, as starting points for independent research and/or consideration.

Neurological Music Therapy:
Newzpool

Oliver Sacks, M.D.
NOVA | Transcripts | Musical Minds | PBS

Schizophrenia as a Neurologic Disease
A Hypothesis: Schizophrenia is a Neurological Disease

rebecca

Isn't one of the symptoms of schizophrenia the kind of paranoia that would make someone think "all the doctors are lying to me"?

I think it's kind of an umbrella term though.

Schizophrenia is an interesting disease.
Prior to the advent of neuropharmacology, institutions and hospitals were filled with patients diagnosed as schizophrenia of which paranoid schizophrenia is a common form as well as catonic.
No amount of counseling, enviromental manipulation or other non pharmacologic interventions ever cured these patients.
Now, almost all schizophrenic patients who agree and consent to take their medications can lead relatively normal and productive lives.
"Schizophrenia is the poster child for mental illness as disease (neurotransmitter imbalance) and for neuropharmacologic intervention as cure.
Help him decide to take his medicine.

:detective:

:perplexed:Why should people be pitied, persecuted or even pardoned ? I am also categorized by the DSM/American Psychs because of Anglo-American influence in my country. I think it's basicly very sick in-deed to label a human being first, lock them up and deprive them of their rights.

Before this "scientific" approach people accepted deviations of the "norm" and took care of people suffering. I surely do not need a pardon from any-one since I try not breaking any human laws. How ridiculous they may be...

Once I Found a pass for the American Association of Pharmaceutical [EMAIL="[email protected]"][email protected][/EMAIL]. Funnily aaps stands for monkey business in Dutch. I hope theirs no connection with the story of the monkeys on a type-writer...or a DNA-sequencer for that matter.

:perplexed:I think it's shocking how material some states of mind are discibed. I faith-fully took my medication, mainly because my mother took the same. In both my families we learned to co-operate, but keep our own believes.

I am not a scizo, but I have met a few and did go to therapy with my friends. I am Moon-Struck my dictonary tells me. I am not para-noid; I am menthaly sane at the moment. I just check Everything till I decide on important issues.

It's extra hard to keep in thouch with friends and family once you are labeled. Try talking to your local bank to pay for the damages !

I am glad to spill my mind on your PF

Pep,

I agree with your ideas of problems in mental-health "labeling", treatment and social mis-perception. I've been "labeled" manic-depressive (the politically correct term these days is "bipolar", but I'm old fashioned -- I had a "manic-depressive mood disorder" long before the present "bipolar" fashion craze -- there are too many "pseudo-bipolars" running around since it became a popular diagnosis. Usurpers.)

It's a good thing our modern mental health "professionals" did not get hold of Sir Isaac Newton, eh? They'd have kept him so drugged, a thousand apples landing on the top of his head would not have prompted his conception of gravity and the laws of physics.

Try this: make a board with colored dots for different mental "conditions" and black dots for "normal", per modern mental health standards. Then list beside it the geniuses of history's arts and sciences, and fill in the appropriately colored dots. Your board will look like a Christmas tree! Not very many black dots...

I gained knowledge through training and working in psychology, which, combined with my naturally stubborn, temperamental personality (probably a "personality disorder" by some standards), gave me the confidence to "rage against the machine".

I found a good psychiatrist, one of the few around as old as myself, who understands personal uniqueness, who does not equate "eccentricities" with "thought disorder". Clearly, yes, I do have a manic-depressive mood disorder, but I choose to retain my eccentric, sometimes absurdist, perspective.

If anyone has a problem with that, they can talk to my invisible little friend here... (I was surprised to discover that joke actually upsets some people -- they don't know how to react.)

It's true that many "mental health problems" do have a neurological, physical aspect, which can be treated with medications, BUT, as long as a patient is able to care for himself and poses no threat to himself or others, not/taking those medications remains his decision.

Yes, some of us have to learn how to "play a game" concerning employment, business and certain social matters. Fortunately I don't have to "play games" with my family or true friends, since they appreciate, or at least accept, my individuality. We have an agreement: they tell me whenever my "individuality" becomes annoying or seems inappropriate -- that's my cue to see the good doctor and probably temporarily medicate.

Pep, you are clearly a unique, intelligent, considerate and interesting person. Never lose "that person" trying to fit into someone else's pigeon-hole.

rebecca

Schizophrenia - is a disconnection with your higher mind which causes a person to become fearful of being here (in this universe on earth). Humans are not advanced enough to deal with this spiritual problem yet. So they (the schizophrenic) need to be loved accepted and helped in any way that you can. Drugs are also a good way to lessen the side effects of this spiritual difficulty.

Not necessarily a 'good' way but still a necessary avanue.
Spiritual training i think should be of a higher mark.
Relgion at its best is spiritual training.
Shame about the trust issues.

What are your thoughts on this? What part of it ..exatly?

What do you think it is? behaviour or disease? It's a mental illness, been defined long ago.

Inability or excuse? Inability, read up upon it lazy bum!

Describe what you think a schizophrenic is? Why not ask for facts, instead of free fiction?

What are your interpretations? Dude'e, why waste time with fictional answers? Ask for facts!

Should they be pitied, persecuted, pardoned? Surely dependant on their crime, if it's murder they'r a danger to society, if they just accidently slap someone in the face, they should be pitied and pardoned ..maybe.

Y R Right a'bout this umbrella.
Luckily I found a doctor who sees the changes his patients make. Sometimes they label me with something new; which I can dis-prove.

I have no serious ill-ness. I self-confident again and will strike back at the manuel DSM 4,5 or etc.
They have no real authority over US

Ophray's Dr Phil compares to wath-ever.
Witch-craft was more soundly based; Voodoo is an enlighted thought compared to conservative X-ians like him.

Feel up-set so many watch crap on TV.:bigsmile::a-thought:

PSH

Pep: is there some-thing in the DSM-V that deals with im-proper hy-phen-a-tion?

How would I know = not definite yet

Best lesson I ever learned from someone who had Schizophenia (or should that be Schizophenia had them?)...was that when it appears they are not listening to you it it's so much that as it is they are listening to others only they can hear. I taught be to be more patient.

Now how do I let them know there is no reason for me to be a part of that which they fear?

Lost1

Good pun!

I knew someone like that, who listened to and argued with the spirits of "fascists" all the time. She would have this seraphic grin on her face.

On one occasion she proved that she could hear some of my own deepest thoughts at least as clearly as I could hear them myself.


By sharing the fear (preferably without becoming a patient). At least, that's what I would find most helpful myself, but I'm not schizophrenic, so my guess might be wrong. (As I mentioned before, when a close friend became paranoid, I was to him only another part of the conspiracy, so I obviously didn't do a good job of reassuring him.) If my own case is anything to go by (and of course it may not be), worries which for most people are, at worst, difficult abstract philosophical questions are for me direct daily concrete threats to my existence, so studying philosophy (perhaps particularly existentialist philosophy) might help in understanding such a person (a bit).

I had to break of contact with a scizo-friend of mine. I tend to be 3 days in a manicy state which I don't like. Mind of this people is very strong, but they often choose the Power over others. A-noy-ing as Hell. :whistling: