!!! Need help on schizophrenia please !!!

[Michalchik]

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 well again!

	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 
working hypothesis.

	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.


Jeremy Winterson <J.Winterson at rhbnc.ac.uk> wrote:
>Hi
>
>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,
>                  Jeremy


-------------- next part --------------
From: Jeremy Winterson <J.Winterson at rhbnc.ac.uk>
Newsgroups: bionet.neuroscience
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>

Hi

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,
                  Jeremy