!!! Need help on schizophrenia please !!!
michalcm at physlog-po.physlog.uiowa.edu
Sat May 13 15:30:23 EST 1995
First let me say that I am not a doctor just a scientist that has been
following the liturature and attending some conferences. I have a few
brief things to say about the issues that concerned you.
It is unusual to get a dual diagnosis of schizophrenia and manic
depression. If I were you I would be concerned that the doctors who
diagnosed your sister are confusing the psychotic symptoms that
frequently accompany the severe phases of depresion and mania with
schizophrenia. Delusions and hallucinations are not too unusual when a
person is severely manic or depressed. If your sister is only bipolar
and not schizophrenic the anti-psychotic medications are unlikely to do
her much good, but she may still have many of the more dangerous side
effects. There are many incompetant doctors out there try to find
someone doing research in the field. I have generally been favorably
impressed with the people I have met from NIH. Hope that she is just
bipolar, though this is an extremely serious disease that can kill
people and ruin lives, it is more treatable than schizophrenia.
As far as short term medical treatment for these diseases, I have to say
that though I perfectly understand your desire for this and have voiced
the same desire myself when I have talked to people in the field, this
desire is a VERY dangerous one. There have been several studies where
patients that responded well to medication and seemed to loose their
symptomatology were weened off their medication either on doctors advice
or by the patients own doing. The results were often disasterous; so bad
in fcat that there are several law suits pending based on the claim that
the patients were never told how dangerous going off medication was.
Usually there were severe relapses that happened after a short but
unpredictable time after the medication was discontinued. These relapses
often were the worst that the patient ever experienced. Much more
frightening was the fact that medication often seems to loose its
effectiveness if the relapse occurs; High functioning medicated patients
were turned into severely mentally ill people that had to be
institutionalized and will likely spend the rest of their lives in their
own private hell. NEVER, NEVER, NEVER allow a bipolar or schizophrenic
to go off their medication because they feel well. It is the medication
that is allowing them to feel well and if they stop they may never feel
Should they take medication in the first place? Both Schizophrenia and
Bipolar disorder almost always get worse with time. The longer they go
untreated the harder they generally are to treat. Think of it like this.
The brain is a learning device and I learns to be sick as well as
learning useful things. Diseases such as post-traumatic stress disorder
are examples of the brain overlearning an emotional response. Brains can
also learn to think disorganizedly or can learn severe mood swings. Give
a brain time off medication for bipolar disorder, schizophrenia,
epilepsy, etc... and you allow it to learn more amd more profound ways
to be sick. Treat-early and treat consistantly seems to be the way for
these three disorders. I wish I could tell you otherwise. I would like
it to be so.
You are probably wondering why these diseases are incurable and require
life long treatment. We can't say for sure because we don't know for
sure why these diseases occur. There is mounting evidence that
schizophrenia is the result of congenital brain damage. Schizophrenic
brains often seem to ahve shrinkage in critical areas related to memory
and cognition. One theory that I favor but thatis not widely accepted in
the field is that ceratin peopl have a genetic susceptability to damage
to these areas from either flu viruses or environemtal toxin while the
brain is developing in utero. This damage is subtle and does not result
in a severe problem until the brain fully matures in early adulthood. In
early adulthood long association pathyways are completed that allow a
person to weigh the full emotional impact of major life events and
decisions. Basically in adulthood the brain learns to cooperate on a
large scale to deal with complex life decisions. If part of the system
is damaged and a major life stress comes along the damaged area can get
overloaded and fail to organize critical information. (it is just pushed
beyond its limits). The rest of the brain is disrupted by the torrent of
faulty information and you get an ugly situation of garbage in garbage
out in a feedback loop. The antipsychotic drugs may cool down the
information flow enough for the damaged areas to keep pace. Since the
brain is constantly learning the disease will progress if untreated
because the brain learns the faulty patterns of information flow perhaps
also there is additional growth of long association pathways. I have
some problems with this theory, but I think it is adequate for now as a
Bipolar disorder is even more mysterious but seems to involve something
to do with the regulation of calcium and magnesium in the body, the
brains response to stress hormones, and the regulation of
neurotransmitters over long time scales. There is probably some genetic
disorder in metabolism that causes the persons body to respons
abberently to stress and causes a series of uncontrolled mood swings.
Since the underlying disorder is a biochemical one there is no permanent
way to fix it currently and if there was it may not be worth the
trouble. Similarly in schizophrenia the trouble is probably underlying
brain damage in a very sophisticated part of the brain. we may never
know how to fix such damage.
The good news is that treatment of these disorders is improving. there
are a variety of medications available for both disorders that in
skilled hands are effective and have aminimum of side-effects. For
Bipolar disorder in addition to lithium there are other drugs such as
verapamil and valproic acid that have been shown to be effective in most
cases where lithium is not. The depressive phase of the disease can be
treated with anti-depressents like prozac. For schizophrenia the current
treatments are more limited and less effective, but we are literally on
the brink of some major breakthroughs with drugs that are specific
antagonists to D4 and D3 receptors. These drugs will be able to treat
the hallucination and delusions without causing the movement
side-effects that traditional drugs like halperidol do, and also the D3
antagonists should be able to treat the apathy and disorganization that
many schizphrenics seem to experience. we do not really know how these
drugs work but they will be a big improvemnet over the previous
generations because of their specificity and strength.
I would also make sure that the doctors have ruled out any possibility
od a metabolic disorder, liver disease, vitamine deficiency, throid
problems , and blood sugar abnormalities can all cause some symptoms
that look like these disorders.
You might also check out the Huxley institute in Florida (boca raton I
think). They are alternative medicin people who claim that these
disorders are caused by vitamine deficiencies. I think that that is a
crock of shit but they may have found some vitamines that may help to
correct some of the metabolic components of these disorders. Vitamines
in high doses act like drugs. If you get the right ones they may help
some without hurting. Don't be sucked into the idea that they have all
the answers though modern medecin does alright with these disorders and
you'll be taking a foolish gamble with your sisters life if you abandon
it. If the doctors that you are seeing don't get good result or don't
seem to be listening to your concerns they are probably bad doctors and
I would find somebody else. Don't put much weight in reccomendations.
Doctors who are at the top of their field are often there because they
kissed ass correctly not because they are brilliant. Also nobody
dislikes the doctor they go to because everybody wants to believe they
are getting the best care. Go to a doctor who seems to be actively up on
the liturature, is not threatened by tough questions, and seems to care
about what happens to your sister. Don't get second opinions by having
your doctor reccomend some one. Ask your insurance company for
reccomendations or better yet go to your local library and have the
librarian help find you a list of specialists in your area.
Finally, especially if your sister is schizophrenic, talk therapy
(conversations with a psychiatrist where you talk about your life and
tried to figure out what went wrong) is BAD. There have been several
clinical studies that show that talk therapy makes schizophrenia worse!.
I do not know about its effectiveness is bipolar disorder but I suspect
it is a waste of money that will just piss your insurance company off.
Any psychiatrist that tries to drag your sister into a series of long
therapy sessions is proabaly ignorant or dishonest. for schizophrenics
the best thing seem to be properly tailored medication and leading as
normal and low stress life as possible. this is probably also a good
perscription for bipolar disorder though I have not seen studies on
this. Keeping levels of stress low is almost certainly helpful for both
these mental disorders, but don't start condescending to her or you'll
damage your relationship. I also suggest that you try to take care of
yourself contact support groups in your area. You can find them through
your local library and they may be able to help you in many ways.
-------------- next part --------------
From: Jeremy Winterson <J.Winterson at rhbnc.ac.uk>
Subject: !!! Need help on schizophrenia please !!!
Date: 12 May 1995 17:03:35 GMT
Organization: Royal Holloway, Univ of London
Message-ID: <3p04d7$7qr at sun.rhbnc.ac.uk>
My sister has been diagnosed as a schizophrenic and manic depressive.
She hasn't always been this way... at least not the schizophrenia... and
it just seemed to happen over a period of a few terrible weeks or so.
In the end she was diagnosed with both schizophrenia and manic depression
and is recieving medication. Problem is that apparantly she will be on
medication for the rest of her life. Is this really the case? Is there
nothing she can take as some sort of therapudic drug? Will she be in a
danger of remission? I realise it is inthe interests of medical companies to
develop drugs that the patient will rely on for the rest of his or her life
and therefore was wondering if there was some sort of other drug that she
could be taking.
Could you please e-mail me if you have any info.
Thanks in advance,
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