schizophrenia controversy

[hippopotamus]

Alto asked me to start a topic about controversies regarding schizophrenia, so here goes. I dont have the time and energy to dive deeply into it, but I can point to information that people can then use to look closer into the matter. Here's something to get started. I'm planning to add more info later on.

 

Schizophrenia and 'schizophreniform' disorders are lifelong, chronic and progressive disorders[/u]

 

Although this still is a widely accepted view in most regular psychiatric services, it doesnt reflect the actual state of affairs. See for example the following articles:

 

http://schizophreniabulletin.oxfordjournals.org/content/early/2012/12/04/schbul.sbs135.full

 

http://bjp.rcpsych.org/content/178/6/506.long

 

The gist of these articles is that schizophrenia is a heterogenuous disorder, meaning that people who share the same diagnosis all have different constellations of problems and symptoms. The outcome of schizophrenia is heterogenuous as well: There appears to be a group that is able to recover completely, a group that is able to recover to a significant degree and a group that experiences a bad long-term outcome.

 

As the first article shows, the still widely-presumed progressive nature of schizophrenia is a myth. According to this article, people with schizophrenia as a whole dont tend to deteriorate and there is no evidence for the theory that schizophrenia is a neurodegenerative disease like Alzheimers or Parkinson. See for info against the supposed 'neurotoxicity of psychosis' also for example http://www.ncbi.nlm.nih.gov/pubmed/16254059?dopt=Abstract

 

Schizophrenia as a genetically determined biochemical disease

 

Although there appears to be a genetic contribution to vulnerabilty for developing schizophrenia, according to this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632485/, 'the recent Gene × Environment findings in psychiatry suggest that genes are likely to influence disorder mostly indirectly, via their impact upon physiological pathways, and work by increasing (or decreasing) the likelihood of developing a psychiatric disorder, rather than as direct causes of disorder per se. Thus, the notion of “a gene for …” is misleading and diverts attention from more important issues'

 

it is also clear that there are many environmental factors that probably contribute to the chance pf developing schizophrenia, like malnutrition of mothers during pregnancy, use of cannabis, a history of childhood trauma (http://www.ncbi.nlm.nih.gov/pubmed/22901835 ), living in a rural environment and having a low IQ.

 

'People with schizophrenia need to be on the drugs for the rest of their lives'

 

This is a myth that has been heavily sponsored by the pharmaceutical industry.

 

First of all, the drugs are frequently ineffective or only partly effective. See for example this article that claims that up to 60 % of treated people still have psychotic and cognitive complaints despite active pharmacotherapy: http://www.psychiatrictimes.com/schizophrenia/content/article/10168/1433177?pageNumber=4.

 

Also, according to the article ' Full Disclosure: Toward a Participatory and Risk Limiting Approach to Neuroleptic Drugs' by Volkmar Aderhold and Peter Stastny, which can be retrieved via the website of psychrights.org (somehow I couldnt find it in Pubmed):

 

' at least 20% of all individuals first diagnosed with "schizophrenia" never experience a relapse in their lifetime. 5 - 10 % of people with schizophrenia dont seem to experience any positive effect of neuroleptics. 20-30 % of people only experience a temporary and partial reduction of mainly positive symptoms. About 40 % of people with schizophrenia experiences a relapse within one year after hospital discharge despite taking the medications and about 20 % of people with schizophrenia experience a relapse within one year even though theyre on long-acting depot medications. '

 

Second of all, this myth is based on research and meta-analyses that indeed show that people who are maintained on neuroleptics experience less relapses than people who go off the drugs. However, this research is flawed in a number of ways.

 

First of all, it doesnt take into account the fact that research and publications that are funded by the pharmaceutical industry (which is the majority of the research into medicine) are systematically manipulated and biased to make the medicines look more effective then they actually are. See for example: http://www.ncbi.nlm.nih.gov/pubmed/12775614 , http://www.ncbi.nlm.nih.gov/pubmed/18754841 , http://www.ncbi.nlm.nih.gov/pubmed/20490338

 

Second of all, it doesnt take into account the fact that relapses when going off of medication, dont have to be caused by the supposedly underlying chronic condition, but can instead be caused by withdrawal-effects: When going off of antipsychotics too quickly, people are vulnerable to experiencing supersensitivity psychoses. This is a DRUG-induced psychosis. This mechanism seems to be widely unacknowledged in mainstream psychiatry. Furthermore this mechanism is possibly partly responsible for a wide range of research-results that show that going off of antipsychotics leads to a high rate of relapses. See: Joanna Moncrieff *, which can also be found through psychrights.org http://psychrights.o...dhypdrugred.pdf

 

Another factor that can be an important contributor to people experiencing relapses when they go off or taper off their drugs, is the fact that they're continuously told by the people around them that they really need their drugs. This increases anxiety and stress, which in turn increases the chance for relapses. See the very important article of Joanna Moncrieff on this subject, ' Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem

Joanna Moncrieff *, which can also be found through psychrights.org http://psychrights.org/Articles/Moncrieffe2006medhypdrugred.pdf

 

Also, something that is generally overlooked when intepretating placebo-controlled drug trials, is the fact that, when treating people with obvious and serious mental and emotional problems, a placebo-control condition probably isnt a very honest control condition. It might be a way to see if the drugs are more effective than placebo's, but it doesnt say anything about the way these people would function without drugs when they instead had been offered adequate non-drug therapies.

 

Again, this is laid out in the earlier cited article ' ' Full Disclosure: Toward a Participatory and Risk Limiting Approach to Neuroleptic Drugs' by Volkmar Aderhold and Peter Stastny'

[hippopotamus]

I'd like to add that although I write about 'schizophrenia' and psychotic and 'schizophreniform' 'disorders' I prefer not to use those terms and I think people are much better of when they dont receive such stigmatizing, pseudo-scientific labels. In my opinion, people would be much better served when their problems would be described in normal, non-pathologizing terms. I wish everyone who is 'diagnosed' with 'schizophrenia' or any other official 'mental disease' for that matter, the strength and clarity of mind to not identify themselves with those labels and to think of themselves instead as human beings going through tough times, reacting in their own unique ways.

[BeyondLabeling]

This is an excellent beginning, to a very important conversation. I'll be interested to see where it leads. (My hat's off, to Alto for commissioning hippopotamus, in the task, of starting this thread; clearly, she chose the right person for the job; both posts #1 & #2 are perfect, imho. ( Great work, really!...

[Skyler]

Yes Hippo.. very nice job indeed. I'll be reading.. thank-you for you most caring and informative posts.

[hippopotamus]

I just came across this excellent article which pretty much says it all:

 

http://sicw.wikispaces.com/file/view/n09Poland.pdf

[Narcissus]

Anthropologists believe that many primitive shamans (who are sometimes called our earliest 'specialists') were schizophrenic. These people would not have been thought of as diseased, but as purveyors of secret knowledge about the workings of the universe. Even the most extreme mental illnesses depend heavily on the norms of the culture in which they are found.

[GiaK]

I do not believe schizophrenia is a disease or illness at all (at least most of the time). It's also not just one thing...what is labeled schizophrenia is unique in every individual.

 

Also there is tons of cross-over between what is labeled bipolar (when it presents as psychotic) and schizophrenia...again, because each manifestation is unique to the individual. Through my work I know 100s of folks who've had psychotic episodes and gone on to thrive and heal free of drugs.

 

I have a post with such stories:

 

Psychosis Recovery Stories

 

And yes, Shamanistic Experience is one way of understanding and processing such movement:

 

Shamanic-like nature of consciousness

 

and another way is to consider:

 

Spiritual emergency: one way of interpreting activity of the psyche that is often labeled psychotic

 

Glad this conversation is taking place.

[tezza]

I do not believe schizophrenia is a disease or illness at all (at least most of the time). It's also not just one thing...what is labeled schizophrenia is unique in every individual.

 

Glad this conversation is taking place.

 

 

I agree... My mother was diagnosed 'Paranoid Schizophrenic' after leaving off medicine CT. When I CTd the Risperdal, I 'felt like my mother looked'. It was only then that I realized what had taken place with my mother. After my father passed away, I was in charge of making sure my mother got the help she 'needed'.

 

This meant forcing her to be hospitalized and taking medicines. The last time she got 'sick', she agreed to take Prolixen shots. Prolixen has been taken off the market now, but I'm sure all the anti-psychotics she had taken were dangerous as well.

 

She died of stroke related illness and I will always believe the meds were a HUGE contributing factor.

 

You can imagine the guilt I feel over this now that I know.

 

Tezza

[Narcissus]

I do not believe schizophrenia is a disease or illness at all (at least most of the time). It's also not just one thing...what is labeled schizophrenia is unique in every individual.

 

Also there is tons of cross-over between what is labeled bipolar (when it presents as psychotic) and schizophrenia...again, because each manifestation is unique to the individual. Through my work I know 100s of folks who've had psychotic episodes and gone on to thrive and heal free of drugs.

 

I have a post with such stories:

 

Psychosis Recovery Stories

 

And yes, Shamanistic Experience is one way of understanding and processing such movement:

 

Shamanic-like nature of consciousness

 

and another way is to consider:

 

Spiritual emergency: one way of interpreting activity of the psyche that is often labeled psychotic

 

Glad this conversation is taking place.

 

 

Great stuff, thank you.

[hippopotamus]

Yes, that is a great contribution Gianna. Thank you.

 

Something else that shouldnt be missing in this conversation is the following website:

 

http://recoveryfromschizophrenia.org/about-ron-unger/ Mandatory for anyone involved with psychoseses and extreme states!

 

 

Tezza, my heart hurts reading what happened to your mother. It must be incredibly difficult to deal with the realization that you may have, unknowingly, aggravated her situation and physical health.

 

Please realize that you yourself were a victim of misinformation about her symptoms and 'best treatment' as well. You didnt know any better. You were misled by the ones who should have been authorities.

 

I'm giving you a big, big, big virtual hug.

 

Hippo