Wednesday, November 19, 2014

Hearing Voices at 20? A New Look at How and When Schizophrenia Starts

That is the title of this article I am writing about. “PHILADELPHIA The traditional view was that schizophrenia, the most devastating of mental illnesses, struck young people on the cusp of adulthood, often without much warning.  In their late teens or early 20s, previously healthy men and women would suddenly begin hearing voices no one else could hear and withdrawing from a world teeming with delusional threats. They faced a lifetime of disability even with strong medication and —in a country without adequate care —of increased risk of homelessness, suicide and prison.  Raquel Gur, a University of Pennsylvania neuropsychiatrist and nationally known expert on schizophrenia, is at the forefront of the new way of thinking about the disorder, which affects 1 percent of the population.  Scientists now view it as a neurodevelopmental condition that begins years before its most disturbing symptoms appear, in much the same way that heart disease begins long before the first heart attack.  Gur's painstaking work, done with the help of 9,500 Philadelphia children and their families, finds that those at risk for psychosis diverge from their peers in important ways as early as age 8. The differences in brain functioning —these are thinking skills, not psychosis —widen in the mid-teens.” I believe it starts at a younger age before you develop full blown psychosis.  Even though mine did not come on until I was twenty seven something was wrong when I was nineteen.
The article goes on to say: “The tantalizing question is whether early identification and treatment can delay or prevent the onset of psychosis, allowing young sufferers time to build a firmer foundation for life.  It's early, but there is some evidence that the answer is yes.  Schizophrenia experts are excited by promising results for cognitive behavioral therapy and, surprisingly, fish oil.  Work on the first stages of schizophrenia —what is often called the prodrome —is unfolding at a time when scientists are learning the brain is a far more dynamic organ than was once thought. True, the brains of people with schizophrenia do not look or function normally, but all of our brains are changing more than we realize. ‘Most people have gotten far more hopeful that we will be able to use experience or training or something else to help the brain rewire," said Thomas Insel, director of the National Institute of Mental Health (NIMH).  He sees hope in teaching people with schizophrenia how to focus and control their thoughts. Lack of cognitive control, he said, "is the on-ramp to psychosis.’  Gur's work, undertaken with $26 million in NIMH funding since 2009 and help from Children's Hospital of Philadelphia, is an ambitious effort that is following children over time to see how psychotic illnesses unfold. Four percent of the teenagers had symptoms of psychosis. The rates were higher for 8- to 10-year-olds, but Gur chalks some of that up to "vivid imagination." Because of funding constraints, Gur's team is closely following only 250 at-risk children and 250 who are normal. The researchers are analyzing genes and brain images, family history, neighborhood environment, and early life experiences as well as measures of perceptual and cognitive abilities and emotion processing. While much previous research has focused on positive symptoms —hallucinations and delusions —in schizophrenia, there is growing recognition that negative symptoms —problems with working memory, advanced decision-making and social skills —are equally disabling.”  I’ve read that they are using fish oil with some good results before you develop mental illness. I take it although for my eyes.  I really do not notice anything different mentally.  Although my Geodon works so well I would not know the difference. 
The article ends: “Gur's husband, Ruben, a brain/behavior expert at Penn who collaborates with her, will soon start testing the theory that acting may help at-risk youths recognize and express emotions better. Raquel Gur will test cognitive retraining as a therapy. That program will focus on improving attention, working memory (the ability to hold thoughts in your head while working with them) and problem-solving. Gur hopes for results within a year. Like other experts, she thinks early intervention will be better for schizophrenia, as it is for so many other diseases. ‘If you want somebody to continue on a fairly normal trajectory of development,’ she said, ‘you need to capture them before they fall off the track so much that it's difficult to bring them back.’  If schizophrenia strikes before victims have grown up, it's hard for them to catch up later. ‘They're not equipped to become adults,’ she said.  William Carpenter, a well-known schizophrenia researcher at the University of Maryland, says that, even if early treatment only delays the worst symptoms, it has to be better to have more time to develop life skills and relationships. Those make it easier to cope.  ‘If you have to become psychotic,’ he said, ‘it's a whole lot better to do it after you've finished school and got a job and got married.’  Carpenter chaired the American Psychiatric Association committee that decided not to list ‘attenuated psychosis syndrome,’ a term for people with psychotic like symptoms that are not strong enough to meet the definition of schizophrenia, in the official list of psychiatric disorders last year. The group questioned whether most therapists could identify the condition properly. There were also worries about stigmatizing young people and exposing them to antipsychotic medications, which don't work in this group.  And, there was the problem of false positives. Only about 30 percent of people who get what Carpenter called the "placeholder diagnosis" progress to having psychosis within two years. In Gur's sample, about half the children who had psychotic symptoms at intake still had persistent or worsening symptoms two years later. Among those who at first seemed normal, 17 percent later developed sub-psychotic or psychotic symptoms. One of the things she's learning is that a surprising number of children have perceptual problems that go away or don't become severe.  Her study could help define who is most likely to become schizophrenic as well as factors common in those who are most resilient. ‘It will become a national resource,’ she said. What she knows already is that the children most likely to have serious problems are different from an early age. If you look back at family pictures taken at 7 or 8, these are kids who are always at the corner, looking down. They often start to experience more serious interpersonal problems, perception changes and heightened anxiety two to three years before they have a ‘break’ or become actively psychotic. ‘It's not overnight,’ she said. ‘It's insidious.’ The Philadelphia Inquirer” I believe early intervention would be good if a person could just help these young people live the best lives’ that they can.  I have always been quiet person I do not know how that fits into my mental illness although I believe it does.  My only problem now is that my concentration is not the best.  If I could fix that I would be ok.

Monday, November 17, 2014

New Hope for Patients with Treatment-Resistant Schizophrenia

That is the title of this article I am writing about. “Researchers at Northwestern University Feinberg School of Medicine have discovered a genetic biomarker that could help identify schizophrenia patients who are resistant to antipsychotic drugs (about 30 percent of all schizophrenia patients).  ‘Many treatment-resistant patients are not identified as such and are treated with mixtures of ineffective antipsychotic and other drugs, accruing little benefit and serious side effects, said Herbert Meltzer, M.D., professor in psychiatry and behavioral sciences, pharmacology, and physiology.  By definition, treatment-resistant schizophrenia patients are those who continue to have psychotic symptoms, such as delusions and hallucination, after they have completed at least two rounds of conventional antipsychotic medications.” This is hope I know a lot of people still have voices when they are taking antipsychotics medications and that is a hard pill to swallow.  If there is some way to help them it would be great.
The article goes on to say: “For the research, Meltzer, Jiang Li, Ph.D., a research assistant professor in Psychiatry and Behavioral Sciences, conducted a genome-wide association study on a group of Caucasian schizophrenia patients – a combination of both treatment-responsive and treatment-resistant patients. In the treatment-resistant group, the researchers found a mutation in the dopa decarboxylase gene, which is involved in the production of dopamine and serotonin. Certain variations of this gene have been linked to psychosis in previous studies.  Many patients who were once treatment-resistant do eventually respond to a drug called clozapine.  However, it’s usually not administered in early treatment stages due to potentially severe side effects and required weekly blood monitoring.”  They need something that works as soon as possible so they do not get discouraged with seeking treatment.  They need some kind of medication that manages their symptoms and gives them some kind of relief.
The article ends with: ‘“This biomarker can be used to easily identify patients who should be treated with clozapine, avoiding the use of drugs that are not able to help them.  This can be life-saving,’ said Meltzer, who has dedicated years to developing atypical antipsychotic drugs to help these patients.  He was the lead researcher in the landmark clinical trial that led to FDA’s approval of clozapine in 1989.  Not every patient who benefits from clozapine, however, has the specific dopa decarboxylase genetic mutation.  The researchers will work with a greater variety of schizophrenia patients in the future – particularly patients from other ethnic groups – to look for other biomarkers and treatment options for those who don’t get better with conventional treatments. ‘In a broader sense, this work defines treatment-resistant schizophrenia as a distinct subtype of the illness,’ said Meltzer.  Schizophrenia is one of the most severe and rarest of the mental health disorders, occurring in about one in 100 people. It is characterized by symptoms such as hallucinations, delusions, paranoia, cognitive impairment, social withdrawal, self-neglect, and loss of motivation and initiative.  The finding were published in the journal Schizophrenia Research.” It is finally defined as treatment-resistant.  Again we cannot lump all schizophrenics in the same category.  I just wish there were more options there just clozapine for treatment.  I do not know in my lifetime if I will ever find out everything about this disease.  I would like to also to find out why I have it and how.

Wednesday, November 5, 2014

Scientist spends nine months in max-security prison to learn how prisons manage mental illness in inmates


That is the title of this article I am writing about. “Case Western Reserve University mental health researcher Joseph Galanek spent a cumulative nine months in an Oregon maximum-security prison to learn first-hand how the prison manages inmates with mental illness. What he found, through 430 hours of prison observations and interviews, is that inmates were treated humanely and security was better managed when cell block officers were trained to identify symptoms of mental illness and how to respond to them. In the 150- year-old prison, he discovered officers used their authority with flexibility and discretion within the rigid prison structure to deal with mentally ill inmates.  Galenek’s observations and interviews with 23 staff members and 20 inmates with severe mental illness, are described in Medical Anthropology Quarterly article, ‘Correctional Officers and the Incarcerated Mentally Ill: Responses to Psychiatric Illness in Prison.’ The National Science Foundation and the National Institute of Mental Health supported his research. ‘With this research, I hope to establish that prisons, with appropriate policies and staff training, can address the mental health needs of prisoners with severe mental illness,’ said Galenek, PhD, MPH a medical anthropologist and research associate at the Jack, Joseph and Morton Mandel School of Applied Social Sciences’ Begun Center for Violence Education and Prevention Research at Case Western Reserve.” He looks like he has the skills necessary to find out how to best treat mentally ill prisoners.  I know that this is a prison and they are there to do time.  Although I was once one of them and there is nothing crueler than being mentally ill while you are locked up.
The article goes on to say: “ Additionally, he said, ‘I show that supporting the mental health needs of inmates with severe mental illness concurrently supports the safety and security of prisons, and that these two missions are not mutually exclusive.  With the number of prisoners with severe mental illness increasing, efforts need to be made by all prison staff to ensure that this segment of the prison population has appropriate mental health care and safety.’ Galanek saw how administrative policies and cultural values at the prison allowed positive relationships to develop between officers and prisoners diagnosed with severe mental illness, among the prison’s 2,000 inmates. In this maximum-security prison, left unidentified for the study to protect the confidentiality of officers and inmates officers received training to identify symptoms of mental illness, which, in turn, led to better security, safety and humane treatment of potentially volatile inmates.  But officers were also able to use their discretion in handling some situations. Galanek observed, for example, the following instances where an officer’s decision—rather than rigidly enforcing prison rules—helped mentally ill inmates and maintain order within the institution.” It is always better when you can work a situation for the better for both parties involved.  A person just wants to make life easier for themselves and all.  If no inmates get hurt in prison it would be all the better.
The article ends with: “Prisoners are required to work 40 hours at an assigned job.  But one inmate chose to remain in his cell instead of reporting to work—a prison offense.  The inmate told the officer he was experiencing auditory hallucinations.  Instead of sending the prisoner to a disciplinary unit, the officer allowed the prisoner to remain in his cell until the hallucinations passed.  A correctional officer confronted a violent prisoner, who was off his medication and began smashing a TV and mirror and threatened other prisoners.  Instead of disciplinary confinement, the officer conferred with mental health workers, who sent the prisoner to the inpatient psychiatric  unit to get him back on his medication.  Prisoners aren’t allowed to loiter or talk to other inmates outside their cells.  But a high-functioning inmate with a bipolar disorder worked a janitorial job that allowed him to talk to other mentally ill inmates.  Through those conversations, he was able to let officers know when inmates were exhibiting symptoms of their mental illness.  That information allowed officers to quickly address potential problems and decrease security risks.  Conversely, Galanek said, if these inmates were sent to the segregation unit (“the hole”) to sit isolated for hours their thoughts could lead to agitation and hallucinations that often bring on prison security problems.  Mentally ill prisoner’s work was important and meaningful because it acted as a coping mechanism to decrease the impact of psychiatric symptoms, he said.  To gain such access to prison culture is highly unusual.  In fact, such ethnographic studies have declined in past 30 years due to perceptions that researchers are seen as security risks within these highly controlled environments.  But as a mental health specialist in Oregon’s Department of Corrections from 1996-2003, Galanek was uniquely prepared to navigate the prison for his research. ‘They trusted me,’ he said. ‘I knew how to move, talk and interact with staff and inmates in the prison.

Wednesday, October 29, 2014

Hickenlooper Signs Ban on Long-Term Solitary for Mentally Ill Prisoners


That is the title of this article I am writing about.  “Gov. John Hickenlooper this morning signed a bill that bans the practice of keeping seriously mentally ill prisoners in solitary confinement.  The bill, which passed with strong bi-partisan support, won the support of advocates and rights groups like the American Civil Liberties Union, who say the isolation of prisoners with mental illness violates the constitution’s ban on cruel and unusual punishment and endangers public safety.  But as Rocky Mountain PBS I-News has reported, state prisons aren’t the only place in Colorado where offenders with mental illness are subject to lengthy periods of solitary confinement.  In the state’s county jails, solitary confinement- or administrative segregation- remains common for inmates with serious mental illness.  The isolation can last days, months, or even years. In jails, this practice is left intact by the latest state law. The new legislation came on the heels of a series of tragedies in Colorado, including the killing last year of prisons chief Tom Clements by a man who had been released directly from long-term solitary confinement into the community. In an irony often noted, Clements had worked to reduce the use of administrative segregation in state prisons.” Why am I writing about this it is because it is a good?  My mental illness came when I was in prison and had been caught gambling and was sent to the hole or solitary confinement for three days.  I was locked in the hole and that is the last thing I remember.  I woke on a different tier than the hole and was insane. I must have blacked out when I was put in the hole because I do not remember anything after I was put in the cell. I know I was angry when they put me in there.
The article goes on to say: “The current corrections chief, Rick Raemisch, has continued the work that his predecessor started, publicly calling for a rethinking of the practice of solitary confinement in general, and pledging to remove seriously mentally ill inmates from isolation in the state prisons.  His concerns were echoed by Colorado legislators who worried about the damaging effects of solitary confinement on mental health, and the risks to the public from prisoners who will someday be released.  The law now etches some of Raemisch’s policies in stone, and adds funding and a level of oversight. Prisoners with mental illness won’t be kept in confinement for longer than 30 days, and will be guaranteed a period of therapeutic activity and out-of-cell time each week.”  I was wrong to keep gambling although I know all the stress that was happening to be prior to being put in the hole had a lot to do with what happened.  Although prison is not the best place to finally have a breakdown, my friends were trying to stick by me although I was mentally ill and did not understand. I knew done of the people on this new tier and that did not help.  I cut myself with a razor because I did not understand what was happening to me.
The article ends with: “The Colorado chapter of the ACLU took the lead in campaigning against the isolation of mentally ill prisoners. Denise Maes, the organization’s public policy director, told I-News the law signed today ‘makes a very important policy statement that it’s wrong to place seriously mentally ill offenders in solitary confinement.’  Now, Maes said, the ACLU-Colorado intends to turn its attention to the isolation of mentally ill inmates in county jails. But she acknowledged that a policy change there may be a heavier lift.  “Municipal jails are just a hodgepodge of different activities not very well regulated by the state,” said Maes. At the same time, a shortage of psychiatric beds and a lack of funding for alternative mental-health treatment put a huge burden on jails, she said. Resources are thin.  Still, said Maes, the same arguments that changed the policies in the state prisons also apply to jails.  “Keeping a seriously mentally ill offender in solitary confinement is unconstitutional, and at some point the state has to have the resources to deal with it. Otherwise, they’ll be faced with it in court,” said Maes. ‘Communities have to find the resources.’”  To be put in the hole after a person is already mentally ill is wrong can you imagine what a person would go through?  If you are not working or taking classes to help you spend your time the best way possible as can be is wrong.  From experience it is hard doing time when you are mentally ill.

Wednesday, October 22, 2014

Some Anti-inflammatory Drugs May Aid Schizophrenia Treatment


That is the title of this article I am writing about. “Emerging research suggests that some anti-inflammatory medicines can improve the efficacy of existing schizophrenia treatments.  A group of researchers at the University of Utrecht in the Netherlands discovered anti-inflammatory medicines such as aspirin, estrogen and fluimucil can help improve schizophrenia symptoms. This work was presented at the European College of Neuropsychopharmacology (ECNP) conference in Berlin. Although physicians believed that helping the immune system may aid the treatment of schizophrenia, until now there has not been any conclusive evidence that this will be effective.  In the study, researchers carried out a comprehensive meta-analysis of all robust studies on the effects of adding anti-inflammatories to antipsychotic medications.”  I hope it helps with a lot of symptoms to be effective. To think that aspirin can help schizophrenia is something.
The article goes on to say: “This has allowed them to conclude that anti-inflammatory medicines, such as aspirin, can add to the effective treatment of schizophrenia. Experts have known that the immune system is linked to certain psychiatric disorders such as schizophrenia and bipolar disorder.  Schizophrenia in particular is linked to the HLA gene system, which is found on chromosome six in humans.  The HLA system controls many of the characteristics of the immune system.  According to lead researcher Iris Somner, Ph.D., of the Utrecht psychiatry department, ‘the picture on anti-inflammatory agents in schizophrenia has been mixed, but this analysis pulls together the data  from 26 double-blind randomized drug trials, and provide significant evidence that some (but not all) anti-inflammatory agents can improve symptoms of patients with schizophrenia. ‘In particular, aspirin, estrogens in women and the common antioxidant N-acetylysteine (fluimucil) show promising results.  Other anti-inflammatory agents, including celecoxib, minocycline, davunetide, and fatty acids showed no significant effect.’  Although schizophrenia affects around 24 million people worldwide, treatment of the condition has remained consistent over the past 50 years.” It is good that they found how it affects people with schizophrenia and hopefully it will make treatment better.  Especially for those people that have a hard time with medicine and do not like to take because of side effects.
The article goes on to say: “Current pharmacological therapy for schizophrenia consists of correcting the regulation of dopamine. This strategy has shown to help symptoms of such as hallucinations and delusions, but has been unable to help many other symptoms such as decreased energy, lack of motivation, and poor concentration.  In addition, around 20 to 30 percent of all patients don’t respond to antipsychotic treatment.  Researchers and other experts believe co-treatment with anti-inflammatory agents holds the possibility of improving patient’s response to treatment. ‘The study makes us realize that we need to be selective about which anti-inflammatory we use,’ Somner said. ‘Now that we know that some effects are replicated, we need to refine our methods to see if we can turn it into a real treatment. ‘We have just started a multicenter trial using simvastatine to reduce inflammation in the brain of patients with schizophrenia.  Studies like these will provide the proof-of- concept for targeting the immune system in schizophrenia.”  I am glad to read that it will help with decreased energy.  I hear that affects a lot of people with schizophrenia and if something can help the better.
The article ends with: “An expert associated with the ECNP, psychiatrist Dr. Celso Arango of the Hospital General Univesitario Greforio Maranon in Madrid, said, ‘Inflammation and oxidative stress seem to be important factors in different mental disorders. ‘Patients with different mental conditions, including schizophrenia, have been shown to have reduced antioxidants in the brain as well as excess inflammatory markers. Arango said animal models and clinical trials have shown that antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders but also prevent the appearance of neurobiological abnormalities and transition to psychosis, if given early enough during brain development. ‘This work is a step towards the possibility of better treatment, but we need more research in this area, especially with younger subjects where we might expect more brain plasticity, he said’” It was the stress that finally made my mental illness appear. I hope this brings treatment that can help with negative symptoms for people with schizophrenia.

Wednesday, October 15, 2014

Work Proceeds to Address Cognitive Impairment in Schizophrenia


That is the title of this article I am writing about today. “The better- known symptoms of schizophrenia are devastating enough: hallucinations, delusions, agitated body movements, the inability to experience pleasure.  Yet even when these facets are controlled with antipsychotic drugs, cognitive deficits that make it hard to maintain relationships or hold a job can still consign patients to a life in the shadows, with few friends or little contact with family.  Those impairments – which include things like working memory, processing speed or the ability to interpret the emotion on someone’s face – affect 98% of schizophrenia patients to varying degrees according to a study at Sunday’s lunchtime session ‘Recognizing Cognitive Impairment in Schizophrenia: Neurobiology and Clinical Implications.’ Part of the US Psychiatric and Mental Health Congress in Orlando Florida.  Speakers Henry A. Nasrallah, MD, chairman of the Department if Neurology and Psychiatry, St. Louis University School of Medicine; Richard S. E. Keefe, PhD, Professor if Psychiatry and Behavioral Science, Duke University Medical Center; and John M. Kane, MD, chairman, Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine; discussed background implications, and current research efforts by academia and the pharmaceutical community to find treatments for cognitive impairments in schizophrenia.”  These are bad negative symptoms to have.  It does make it hard to hold friends when you cannot read emotions on someone’s face. I work on my memory that is one thing I do not want to lose.
The article goes on to say: “Cognitive impairment is a core feature of schizophrenia, not a secondary element of the disease, Dr Nasrallah said. Its near universal appearance among patients is made more complicated by the fact that fewer than half are aware of these deficits, and thus interactions with everyone from family, to strangers, to prospective employers are marked by failures to connect. ‘They may interpret a neutral facial expression as threatening,’ Dr Nasrallah said.  For decades, schizophrenia research focused on managing symptoms that could cause the patient immediate harm, or harm to others.  Only in the 1990s did cognition come back into focus, Dr Nasrallah said, and it’s long overdue, for these deficits that keep patients from fully taking their place in the world. ‘It’s a huge unmet need,’ he said; if this area is not addressed, most schizophrenia patients will remain on disability.  For years, there was debate whether cognitive deficits were caused by the disease or antipsychotic drugs that controlled its symptoms.  That has been settled, Dr Nasrallah said.  Cognitive decline is present early, and it picks up speed in the period before psychosis occurs, although improper dosing of some therapies can make the deficits worse.”  It is not the medicine that causes this.  It could hinder someone trying to work. I myself can never read people.
The article goes on to say: “ Dr Nasrallah and the later speakers suggested the knowledge of how early cognitive decline happens, and the fact that the loss of brain tissue at the onset of schizophrenia has now been documented, could provide an opportunity for clinician and researchers to create therapies to halt the worst effects. The ultimate goal, Dr Kane said later, would be to tailor treatment to a patient’s genetic profile.  Why is treating cognitive impairment just as important as treating symptoms like hallucinations? As Dr Keefe explained, these deficits contribute to functional outcomes, and they are the reason why schizophrenia is third-leading cause of life-years on disability for persons aged 15 to 44 years old. (They first is unipolar depression, the second I alcoholism). Data are compelling and sad. ‘Two-thirds of these patients never marry,’ Dr Keefe said.  Some 20% are homeless at any one time.  Fewer than 15% hold competitive employment.  Most chilling, 40% of individuals with severe mental illness are incarcerated, Dr Keefe said.  ( A study in The American Journal of Managed Care earlier this year linked prior authorization policies in Medicaid in certain states with higher incarceration rates for persons with schizophrenia.)  Cognitive impairment, Dr Keefe said, cause persons with schizophrenia to lead, ‘impoverished, challenging lives.’” If they can help more people with schizophrenia to work and lead content lives then I am all for it.
The article ends with: “As an example, he discussed how if an average person is given 16 words, he can remember 10, while a person with schizophrenia can only recall 6. ‘Try developing an intimate relationship when you can’t remember the things that he other person told you, things that re keys to your intimacy,’Dr Keefe said.  MATRICS.  As Dr kane explained, the age of onset of schizophrenia comes as a patient’s peers are moving into the world, making connections, finding jobs, are getting married. ‘ All of that delayed in someone with cognitive impairment,’ Dr Kane said.  Right now there aren’t any FDA approved treatments for cognitive impairment, but much work is going on to change that. Promoted by the National Institute of Mental Health, the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) project seeks to speed up the process of developing therapies to treat cognitive impairment in schizophrenia.  According to Dr Kane, MATRICS represents a collaboration among government, academia and the pharmaceutical sector, it was also described in a 2006 journal article as a ‘consensus-building’ process to agree not only on what are the best molecular targets for drug development, but also what the standards should be for measuring progress in cognition.  The project developed the MATRICS Consensus Cognitive Battery, or MCCB, which take 75 minutes to complete and measures not only cognition but also functional improvement as a co-primary endpoint.  As for therapies, Dr Kane said. ‘Pharmacologic interventions that target molecular mechanisms beyond  dopamine are in development to address cognitive impairment.’  Numerous potential therapies are being studied" That is good news. I hope they can find something that will help us all.

Wednesday, October 8, 2014

Schizophrenia is not a fatal illness, yet suffers are still dying 20 years to soon


That is the title of this article I am writing about. “We have to go beyond the well-meaning commitment to ‘combat stigma’ and be willing to share our time – that extra twenty years we currently have to ourselves – even when we are unable to measure what this will mean. In the UK today, people with schizophrenia have the same life expectancy as the general population of 1930s Britain.  Schizophrenia is not a fatal illness.  It can be hard to treat and the severity of symptoms can vary enormously.  It should not, however, kill you.  On the other hand, here are some things that can: heart disease; diabetes; respiratory disease.  Schizophrenia sufferers are dying prematurely, not from the disease itself but from conditions that are treatable and often preventable.  This is why today, at the start of Schizophrenia Awareness Week, Rethink are launching their +20 campaign, so called because sufferers of severe mental illness die, on average, 20 years earlier than the rest of the population.  You may be assuming that the main cause of premature death in schizophrenia is suicide. It is not.  Most deaths have physical causes, arising due to a mix of factors, such as failure to manage the side-effects of medication, unhealthy lifestyle and poor health monitoring.” I am writing about this because it is important if you want to live a full life that you monitor your health.  I have said before that this disease does not run in my family.  I was wrong to forget my cousin. We both were released from a state hospital about the same time. His was in Oregon.  They told him the same thing that was told to me if you do not make it on the streets you will be back and for life. He committed suicide when it looked like he was going to have to go back there. He was younger than me and did not know there is always hope.  Although it would be change of lifestyle for him.  I also knew a guy in the state hospital that committed suicide there.  I finally met his dad where I used to live.  This disease has downfalls.
The article goes on to say: “A fourth factor is ‘diagnostic overshadowing’, where a physical condition is overlooked or not taken seriously due to the patient’s mental state.  As sibling of a schizophrenia sufferer, this last one in particular resonates with me.  I know that doctors have done this to my brother; I have done it to him myself.  In theory it should be easy to accept that suffering from severe mental illness does not make one immune to the same ailments which affect the rest of the population.  In practice, however, this can seem ‘a bit much’.  Mental illness can be so overwhelming and so all-consuming, it can be hard to believe there is space for anything else.  Physical health then becomes subordinate to disease management.  Anti-psychotic drugs are necessary, therefore the side-effects must be borne without complaint.  Smoking is a comfort, therefore the normal rules of harm do not apply.  These are just some of the assumptions that Rethink are seeking to challenge, in what is a drive not just to promote healthy lifestyles, but to show that physical health matters for everyone.  Schizophrenia sufferers do not merely have symptoms to manage but lives to life.  And by that one doesn’t  have to mean getting a job/ partner// whatever else passes for ‘normality’ – it can simply mean living a life that is of value to you, with as much joy and as little pain as possible.” It is hard for a person with this disease alone to figure out if they are having something wrong with them.  Let alone have someone believe them.  The people who have this disease are just trying to cope with it besides being unwell.
This article ends with: “When I first heard the ’20 years earlier’ figure, I’ll admit that some small part of me felt relief.  So it’s 55 rather than 75, or 66 rather than 86.  How bad is that really, given how much pain and suffering the intervening year could contain? You can almost kid yourself it’s a mercy killing.  A slow, painful death, borne of ignorance and neglect, can be repositioned – by the living- as what was meant to be.  We can pretend it is a rational play-off between quality and quantity of life. It’s not that anyone has sat down and reviewed the pros and cons of all these needless deaths; no one has to. Collectively, as a society, we’re making all the little decisions which mean we never have to face the big one at all. Oh look! It’s just happened! How terrible! The drip-drip effect of not caring quite enough permits us to pretend the end result is out of our hands.  And yet however awful schizophrenia is – and when it is treatment resistant, with not periods of respite, it can be awful- so many other things are entirely within the control of the society surrounding the sufferer: whether you can walk down the street without being feared or mocked; whether anyone visits you when you are too afraid to leave the house; whether anyone cares that you are healthy and secure; whether you find places – any places at all – where there are people with whom you can talk and laugh.  None of this can be achieved by some vague but well-meaning commitment to ‘combat stigma’ on the part of non-sufferers. We have to be willing to share our time- that extra twenty years we currently have to ourselves- even when we are unable to measure what this will mean.  Even if there is a point at which empathy fails, we have to push onwards.  I am frightened of the future, but I want to face it with my brother. I want him to grow old with me and to live through that extra twenty years – the twenty years I simply expect – with as little fear as possible, I don’t believe any human being loses the ability to be happy, or to feel the warmth that comes from others.  Much as I’d like to picture old-aged us by some cosy fireside, exchanging fond reminiscences on 1980s TV, I know it’s unlikely to be that way.  But it is possible to imagine life and hope, and for some to be denied this due to stigma is a disgrace.”  As I have said before I want to see my grandkids grow up.  I do not want to suffer anymore though. I do not want to be a burden now that I am self-sustaining. I have always pictured when I get old to reminisce with my old friends to remember what we with through and talk about our kids.