Do you know if you are schizophrenic?

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It's important to remember that ALL mental health conditions are not real diseases in the sense that there are NO biological tests that can be carried out to say this person has this condition. They are ALL diagnosed on a list of symptoms, symptoms that are based on what in many instances are normal behaviours, but which can become abnormal at times. There is no real line between when something becomes a problem and when it does not. Depression is sadness it really is as simple as that. And we ALL get sad all the time. That is normal. What is not normal is to be sad for months and years on end. The question becomes when does something become not normal. At present they say it is 2 weeks, but since they also claim that over 50% of the population have depression, doesn't that make it a normal behaviour and so it is now abnormal to be happy??! !!

Scizophrenia is diagnosed when someone has been psychotic for at least 6 months. Psychosis in itself is a very common experience and the majority of the time does not develop into schizophrenia. For most people it is a one off experience. And like depression it also ranges from normal experiences to very abnormal ones. We have all had experiences of thinking we have heard someone talking to us or hearing a sound and not being able to find where it came from. If you go to church the priest will stand up the front and say "God was talking to me last night and he said.". How can something that does not exist talk to you?? How is believing in God OK, but believing in something else not OK. When does something become a delusion. A delusion is believing in something that is not real, but no one can prove that God is real. It is just something people believe in and it is perfectly acceptable to believe in that. And if they really are having God talking to them, are they not hearing voices, that are not there, that are not real.

This is not for one second to minise the effect that psychosis can have on someone, as it can and is very distressing for some people. Equally it is not distressing for many people. Research has consistently found that over 70% of people who regularly hear voices do not hear distressing voices. And sure the experience of hearing voices can be distressing for some people, but for some it is not. It is not for us to determine what is and what is not distressing for them. Only they know what they are experiencing.

Recovery from psychosis and even schizophrenia is actually very common, just not in the US and many other developed countries. The World Health Organisation has three times done research which has shown that recovery is significantly higher in third world countries than in first world countries, such as the US. They initally did the research expecting to the find the opposite. The WHOLE purpose of the research was to prove that our current medication based treatments, were great and that developed countries should be funding these treatments in third world countries. Any reseach has many things they need to control. There are a million and one variables that can control what is found and so research is designed to minimise those variables. When the research did not turn out as expected they went back and looked at variables and tightened it even more to ensure that no bias could exist. Problem was the same results came back. They then did it again and in the third study there is nothing at all that could possibly have been controlled any better, and the results were the same. They also found that in those countries that used medication the least the outcomes were the best and in those that used it the most the outcomes were the worst. The US did not have the worst outcomes as not as many people were medicated, and those that were not medicated had better outcomes, even though the ONLY reason they were not medicated is because they refused to take it, and were going against medical advice.

One region in Finland (like a state in the US) now has the lowest rates of psychosis anywhere in the world. It is at the point that they basically do not have schizophrenia anymore. And there are programs that are now setting up that same model in the US hoping it will have the same effect there. Put simply NO ONE is medicated for the first 3 weeks and very few people are ever medicated at all. They offer a form of family therapy and keep the person at home. They would hospitalise someone about 1% of the time the US does. If necessary they put nurses in the persons home around the clock to help the family. They have a team of therapists, including a psychologist, nurse and psychiatrist and they meet with the family for about 2 hours a day for the first few weeks. What is important to remember here is that this place has the SAME rates of psychosis as the US and other developed countries. What they do not have are people becoming disabled by it. Less than 30% of people are EVER exposed to antispsychotic medications, and less than 15% are on them for more than 2 years. Even if they are prescribed them, they would be at doses that would not be considered theraputic in the US. As for recovery well in over 70% of cases the person is back at work or school without any support at all within 3 months. They do not need any specialised employment services, they do not need any supports at schools or colleges, they are simply normal and not psychotic any more.

Research within the US that has followed people for over 20 years on discharge from hospital has also found that those who discontinue taking medication against medical advice also have a significantly higher chance of recovery than those who do not.

There are programs in EVERY developed country using a specialised form of Cognitive Behavioural Therapy to help people to live with and control the voices and that is having massive benefits. The best thing that has happened in developed countries to help recovery is the Hearing Voices Network, that is people who have lived experience learning how to control and live with them. And slowly they can begin with assistance to only allow the voices to have a voice for a short period each day. It starts with the voices being gone for 2 minutes and slowly increases. It is basically about the person telling the voices to go away. And it sounds stupid, and while it can't do it totally they can stop them taking control. They do talk back to the voices and they do tell them where to go. Those that use it rave about it and people who have been on 10 different antispsychotics all at the same time and nothing has helped, have been able to go back to work, college, etc, using this technique and also stop taking ALL medications.

That does not mean medications have played no role. Research shows they have some role over the short term. There is NO research that shows that they keep people well and the FDA will not allow drug companies to advertise that as they have never been able to present any evidence of it. The research that does exist shows they have a benefit over a 6-8 period. Like anything though there are people who do well on them, and Finland is the best example of that. What they have found is that most people do well without them, but there is a small group who do well on very very low doses. What they are now trying to do is to find out what those groups of people are, so perhaps we can find better ways of helping them.

And this should be suprising. One cannot develop a drug to treat something without first knowing what it is you want to treat. In order to develop antibiotics one had to put bacteria into a test tube and then they could put in different substances and find something that killed it. One cannot put hearing voices or thinking strange thoughts into a test tube!! There are NO physical differences between those with psychosis and those without at diagnosis. There are changes that are shown in brain scans on people who are medicated. Those changes are not there on people who are not medicated. Those changes also get worse the longer a person is on medication and the higher the dosage of the medication. The exact same changes are also shown on people who have NEVER been psychotic and yet are also on the medications. Most of these medications are now approved for the treatment of over 30 different conditions, including Autism, Intellectual Disability, Depression, Anxiety, etc. How can a drug that supposedly stops voices in the head possibly help so many varied conditions. EVERY psychiatrist I have ever spoken to and these are ALL ones who use these drugs on EVERYONE who is psychotic have said the aim of the medication is to sedate people so they can naturally recover? That does not sound like stopping voices to me.

As I said there are people who do do well on these drugs, but we do need to remember that there are many other ways of supporting people. And of course if someone does not want to take medication then surely the most logical thing to do would be to try other ways of supprting them first. IF you have tried all of those other things and they have not worked most people would be more happy to take them then. And of course ALL the medications have different side effect profiles and what is tolerable to one person is not tolerable to another. If a person can't cope with a drug then try another one, it really is that simple. And above all else it is the ethical way of treating someone.

And there certainly are people who are wrongly diagnosed. A close friend was one of them. She was diagnosed on the basis of saying that she had been raped. She was raped, and the police were called. She was taken to hospital to be forensically examined and for evidence to be collected. As is the norm a rape crisis counsellor was bought to her. She was acutely upset and so the counsellor requested that a psychiatrist be called in the hope that he could prescribe her something to help to calm her down. He refused to see her with the counsellor there. She knew her attacker and mentioned his name. The psychiatrist knew him and said he would not be capable of doing such a thing and she was delusional. She was susequently locked up for 2 months and forcibly medicated. She was then medicated in the community for 7 years all against her will. As for the acused. He was interviewed by the police. In the police interview which as required by law is videotaped, he said he would kill her for what she said about him. He was charged and released on bail. He had a right to be innocent until proven guilty. There was DNA and other evidence - his sperm was in her and there were bruises and the like. At the trail a number of years later he was found guilty, and given a suspended sentence - he never spent one night in jail. When the jury read out the guilty verdict he stood up and said your dead b***h. At the sentencing hearing he again said he would kill her for what she had done to him. Despite that she was considered the risk to the communtiy and he was not. Where was the evidence produced that she was psychotic it was not. It was assumed that what this doctor said was correct and nothing was asked about HOW he reached the diagnosis. At the final hearing to get the forced treatment order, lifted (which had been a yearly thing and all were fought for yer), he was cross examined and he admitted it was that she was delusional believing she had been raped, and that she was a danger to society, because she said she hated him. Again the interview he had with her was not videoed. There was no evidence she said anything to him - it was her word against the psychiatrist and no one questions them. And even if she had been psychotic, who is the bigger risk the rapist or her? Where were her rights the simple fact was she had none. I supported this friend through all of this and was present at every hearing. She is now off the medication, but permanetly disabled as a result of it. And of course the medical board has no problem with what the psychiatrist did, saying he had no reason to know whether he really had raped her or not, it could have been a delusion and that if she did say she hated someone she was a risk to the community and they needed to be protected!! Given how much the community and even she has been protected by the justice system in relation the rapist, one really question how anyone could consider that fair. Forced treatment varies from juristiction to juristiction and there are many places in the US where it is very common and the hearings are less than 5 minutes in length and no one questions what the psychiatrists have said. Other places it is much harder and they hearings are much better, but even then the standards are nothing compared the justice system. Surely there are more humane ways to keep someone alive than forcing drugs into them.

I think I might be.

Anosognosia, it's called. Different from denial.

Sometimes I feel sane, Sometimes I feel insanely sane.