!!! Need help on schizophrenia please !!!

Michalchik michalcm at physlog-po.physlog.uiowa.edu
Sat May 13 15:37:42 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 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


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