Concentratingontruckinright
Christianity and Homosexuality For my standing on homosexuality and Christianity see http://sites.google.com/site/homosexualityandchristianity/
Schizophrenic Against Suicide
If you are schizophenic, as I am, you will probably start out your recognisable sickness in a state of intense anxiety.
As a patient things started to go wrong when I divided the world into Knights of the Southern Cross and Freemasons. And one group was out to get me, while the other was sometimes my allies.
I would stand on street corners writing down number plates of cars that I knew were following me. I accused a man publicly of being a Knight of the Southern Cross; tasted poison in my food and laughed when two tall men walked into the resturant as I thought they were police coming to arrest the cook.
Eventually I went to the police, but they said (fortunately) that it was a religious problem.
Then the radio started to talk to me and I'd answer back in this conversation with the announcer.
I searched for a microphone under my bed.
Pretty soon one of my brothers must have realised the problem and convinced me to go to hospital with him for my depression. Two doctors signed a form and I was admitted involuntarily. And that was the beginning of about ten years of symptoms.
I have no qualifications in schizophrenia and hope this description helps. One thing about schizophrenia is you can't handle it yourself - see a doctor.
For years before I had been suicidal and during my exacerbations made a few attempts. I remember one time though - I was very sad and crying, I didn't want to end my life, but thought there was no way out of my disgrace. My symptoms were that I thought I was turning into a woman. It was only years later when I spontaneously (and passionately) kissed a homosexual friend (at a point where he was likely to beat me up because I had been rude to him) that my symptoms rapidly diminished (note, realiseyourdignity forgot password so created new account) This particular delusion is mentioned frequently in medical literature, but is held to be uncommon by the DSM. (Although some hold 20% of patients have that problem) [1] - the best thing about it is that 0% of controls have the same symptoms, so if you've had it you can almost be certain you have schizophrenia.
Don't commit suicide. As my doctor said, the first five to seven years are the worst, as you don't know what a delusion is. And you never have complete insight into the fact that it is a delusion. He said, one schizophrenic had said to him: "I know there are no Martians putting thoughts in my head, I just wish they'd stop doing it". Delusions seem to progress from one to the next and the memory of the intensity of a past delusion is totally forgotten. Like waking up from sleep after a nightmare - it is not permanent.
Why do I feel so depressed? Again, I'm only qualified by experience, but I have read that when dopamine levels rise in the brain, serotonin levels fall (O Benkert, H. Gluba and N. Matussek (1973)"Dopamine, Noradrenaline and 5-Hydroxythryptamine in relation to motor activity, fighting and mounting behaviour", Neuropharmacology, p179). Dopamine is one of the chemicals in excess traditionally associated with schizophrenia, while serotonin is your mood regulator and low levels lead to depression. Hence you may feel that depressed. Infact one of the fathers of research into schizophrenia Blueler, said 'suicide is the most dangerous symptom of schizophrenia'. If you feel depressed see your doctor.
Some schizophrenics I know of would like an answer to their symptoms - what causes it. Concisely psychiatrists may tell you they don't know, but the dopamine hypothesis is worth researching. One of its' champions, Philip Seeman, of the University of Toronto, who discovered the antipsychotic receptor d2, wrote in the journal Synapse recently of the many pathways leading to psychosis. It is called: "Psychosis paths converge via d2high dopamine receptors" Volume 60, Issue 4, Date: 15 September 2006, Pages: 319-346. (Ask your library for a copy). We may never know what triggered it in us - it could be hypoxia before or about birth, a gene mutation or drugs or many other causes. But they all result in a more highly sensitive dopamine receptor. Delusions are normally about important things. People even get more psychoticism when they think there is something appaulingly wrong with their appearance, like a small port wine stain - even less than 2 cm squared [2] .
You can trust your doctor's diagnosis. Using similar dignostic techniques scientists study schizophrenia on many levels and are getting closer to the solution. For example, if you doubt this, in 1993 in the Journal Nature, Philip Seeman et al, found that schizophrenics had six times the dopamine d4-like receptors in their brains. This study was replicated many times, which is why I quote it.
More accurately now, the results are described as a variant of the d2 receptor, but nevertheless, the results of the initial study were replicated and selection of patients was done by looking at their symptoms before death, which is the same way you or I are diagnosed.
As a last resort, ask your doctor for sickness benefits if the situation is too anxiety provoking. Don't be afraid to go to hospital for more intensive care. Or take sick leave, but tell your doctor straight away so he can write a certificate. Removing yourself from the situation is what one good pamphlet advised as a last resort(the pamphlet was published by SANE Australia, consulted Professor John McGrath and had something to do with Bristol Myers Squibb and had a picture of a mountain and forest and a reflection in a stream, copyrighy <2007 I think it was called "The SANE guide to schizophrenia" 2005 Victoria) The only problem with it is that when you believe you are turning into a woman, or being chased by someone, you truely believe it and may not think you deserve the benefits. Trust the advice of the medical community. There will be times like this when you think you are lying because you don't realise you are sick (see case study p49 "Schizophrenia, Symptoms, Causes, Treatment" by Kayla F. Bernheim & Richard R.J. Lewine, WW Norton & Company NY 1979).
One way to tell if a subject is a delusion or not, is to ask - is it totally egocentric? If you've thought about the delusion, or even discretely checked, and it seems 'it is most likely there are no Martians' it must be your hyper functioning ego (or striatum - with more d2high) that is creating important meaning in these things for you. One site mentions schizophrenia is more common in ego centric societies rather than sociocentric: "Schizophrenia is more common in egocentric, as opposed to sociocentric, cultures" (http://webspace.ship.edu/cgboer/genpsyschiz.html 2003, C. George Boeree as at 11-08-08). That is why precise answers to delusional questions are hard to find and you get no relief when a reasonable answer is proposed: because sciences are based on objective fact, not subjective ego anxieties. Even knowing this you may still be compelled to check to reassure yourself on a very detailed level. One way that sometimes works is to ask honestly and precisely - why wouldn't a reasonable person worry about this? and then try to find it somewhere. But this method has often led me to search for a year for something. Scientists have found the brain circuit for spontaneously abolishing a belief is a separate one to the one maintaining the obsession and the spontaneous extinction can be long lasting [3]. (I personally found the delusions don't disappear if you practice not checking). A better way is to have managed your lifestyle so well that driving questions arn't raised in the first place.
I say delusions are ego-centric because the striatum, which has the most d2 receptors, or psychotic receptors, is quoted as being the seat of ego-centric learning. Also in "Effects of (S)-ketamine on striatal dopamine: a [11C]raclopride PET study of a dmodel psychosis in humans", F.X Vollenweider, P Vontobel, I Oye, D Hall and K.L Leenders, in Journal of Psychiatric Research 34(2000) p 35: "...decreases the in-vivo binding...to striatal DA D2 receptors ... including ... ego-disorders...", Notpayingthepsychiatrist (talk) 20:08, 12 April 2008 (UTC)
People with damage to the caudate nucleus are incapable of feeling severe guilt or shame. Schizophrenics are capable of feeling this, and delusionally so (the DSM says delusional guilt is excessive or inappropriate), which is the ego part, or superego part; but if these two studies are anything to go by there will not be a feeling of remorse (which schizophrenics are also capable of) if it is a delusion (because the prefrontal cortex is still capable of remorse) (refer to white matter in the prefrontal cortex): http://www.eurekalert.org/pub_releases/2005-09/uosc-feo092805.php http://ajp.psychiatryonline.org/cgi/content/abstract/155/8/1049. RD Liang in 'The Divided Self', Penguine Books 1995, p130 says: "He had in fact, two entirely antithetical and opposed sources of guilt; one urged him to life, the other urged him to death. One was constructive, the other destructive. The feelings they induced were different but both were intensly painful". This is some reassurance against what most web sites say - that schizophenics are incapable of remorse. While the DSM includes lack of remorse as a diagnostic criteria for antisocial people, it does not do so for schizophrenia.
Since d2 receptors are associated with social dominance, the test is - will dwelling on this mean life or death for others. But harking back to the absense of remorse, this edition of Science says that concerning punishment of other people the pleasure of punishment in the striatum is modulated by the empathy of the prefrontal cortex: The Neural Basis of Altruistic Punishment Dominique J.-F. de Quervain, Urs Fischbacher, Valerie Treyer, Melanie Schellhammer, Ulrich Schnyder, Alfred Buck, Ernst Fehr Science 305, 1254 (2004).
After you've had it for a few years, you will kind of get used to it, and anything you have to give up. I think it was Seneca who said 'Time heals all those things reason can't'. Hopefully the medication helps. In a relatively large percentage it doesn't. In checking to see if the situation was the same with classic amphetamine psychosis I was surprised to find no controlled studies had been done on amphetamine psychosis and antipsychotics: http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=11687172&cmd=showdetailview&indexed=google . I am lucky. Even during the worst times my workplace has supported me. But I have learnt that no amount of reason can help if your sickness is at the stage when you are 'declaring' your sickness. My doctor said: "If we can keep it as a nagging doubt, rather than a conviction, we're winning'. Personally I've found coffee rarely crosses that boundary, but regular alcohol does, missing your medication does.
If you find you can be reassured by a smile, you are relatively healthy.
Beware of the seduction of madness [4]. There is a certain rush to a delusion - just like when people try amphetamines, the first feeling is as if they are the centre of attention. The best advice I can give is never give up your medications. I was doing pretty well until I ran out of money one week and medication (Risperdal) at the same time. I was only without it for two or three days, but have never been as good since. Set up an account at a chemist for this.
- Steve
L. Borras, P. Huguelet and A. Eytan, (2007), Delusional Pseudotransexualism in schizophrenia, Gilford Publications, Psychiatry: Interpersonal and Biological Processes, 70(2) p175
M. Augustin, I. Zschocke, K. Wiek, M. Peschen, W. Vanscheidt (1998) "Psychosocial Stress of Patients with Port Wine Stains and Expectations of Dye Laser Treatment" Dermatology. Basel: 1998. Vol. 197, Iss. 4; p. 353
Quirk, G.J. (2002) "Memory for extinction of conditioned fear is long-lasting and persists following spontaneous recovery", Learning and Memory.
Podvoil, E. (1990) "The Seduction of Madness" HarperCollins, New York.
- ^ L. Borras, P. Huguelet and A. Eytan, (2007), Delusional Pseudotransexualism in schizophrenia, Gilford Publications, Psychiatry: Interpersonal and Biological Processes, 70(2) p175
- ^ M. Augustin, I. Zschocke, K. Wiek, M. Peschen, W. Vanscheidt (1998) "Psychosocial Stress of Patients with Port Wine Stains and Expectations of Dye Laser Treatment" Dermatology. Basel: 1998. Vol. 197, Iss. 4; p. 353
- ^ Quirk, G.J. (2002) "Memory for extinction of conditioned fear is long-lasting and persists following spontaneous recovery", Learning and Memory
- ^ Podvoil, E. (1990) "The Seduction of Madness" HarperCollins, New York