About Schizophrenia

I write a lot about having schizophrenia, but I don’t often write about what it is and how it differs from other mental illnesses. Here’s a short article over at PsychCentral that discusses the difference between schizophrenia and bipolar disorder.

About schizophrenia:

Schizophrenia is less common than bipolar disorder and is usually first diagnosed in a person’s late teens or early to late 20’s. More men than women receive a diagnosis of schizophrenia, which is characterized by having both hallucinations and delusions. Hallucinations are seeing or hearing things that aren’t there. Delusions are the belief in something that isn’t true. People who have delusions will continue with their delusions even when shown evidence that contradicts the delusion. That’s because, like hallucinations, delusions are “irrational” — the opposite of logic and reason. Since reason doesn’t apply to someone who has a schizophrenic delusion, arguing with it logically gets a person nowhere.

Schizophrenia is also challenging to treat mainly because people with this disorder don’t function as well in society and have difficulty maintaining the treatment regimen. Such treatment usually involves medications and psychotherapy, but can also involve a day program for people who have more severe or treatment-resistant forms of the disorder.

Because of the nature of the symptoms of schizophrenia, people with this disorder often find it difficult to interact with others, and conduct normal life activities, such as holding down a job. Many people with schizophrenia go off of treatment (sometimes, for instance, because a hallucination may tell them to do so), and end up homeless.

When Having a Disability Means You Can’t Work

Right now, my doctor doesn’t want me working. I’m simply not ready, and I have to come to terms with the fact that I may never be ready.

I have a very good friend who has bipolar disorder. He is also on disability, and we recently discussed working. He was feeling like he should work, but was unsure about whether he could handle it.

He’s been stable for a few years, and here’s the conclusion we came to: He remains stable by (1) taking meds, (2) going to counseling, and (3) maintaining a therapeutic lifestyle 24/7.

We concluded that, without any one of these, he would probably go back to the hospital.

It’s the same for me.

I continually do things that are therapeutic—whether it’s participating in poetry, painting, writing, reading, photography, walking, and so forth. I maintain a therapeutic environment for myself 24/7, under the advisement of my doctor.

It’s only been a year since I have been in the hospital, and just under a year that I’ve been on my current medication. That’s far too early to tell whether my medications will prevent me from having a psychotic break if I should try working. I have, in the past, had a psychotic break every six months to a year. I still vividly remember my last break, and I don’t want it to happen again.

Keep in mind that I was given a poor prognosis. The very first psychiatrist I saw told me I should expect to lose a lot of cognitive functioning. I’m lucky to have not lost as much as they thought. I chalk it up to having good care, and fighting like hell.

But I still struggle with not working. The feeling of not working for a living.

If you browse around my website, you will see that, from an early age, I have been involved in many things, and have been very career oriented. For a person like me, not working is devastating.

This is true even though I have doctors’ orders.

I know I have a legitimate disability. There’s no doubt about it. I have had serious psychotic breaks. I am trying, each day, to maintain my health, above all else. I don’t like becoming psychotic, and it’s not like my medicine is so magical that it will, with 100% efficacy, prevent a psychotic break.

They know that, for example, stress can exacerbate psychiatric symptoms. So, I try to limit my stress, and engage in stress-reducing activities, like practicing mindfulness.

Currently, I have to come to terms with the fact that I cannot work—my doctors says so, even—and that I may never be able to work again.

For me, coming to terms with this myself is one thing; a big thing. Realizing this is but one step in coming to terms with my condition and lot in life.

But the even bigger thing is having regular people understand this. When people meet me—when I am out in public—they may not know I have a mental illness. (Unless I am symptomatic. In that case, I may be in my pajamas in public, or looking a huge mess.) I have an “invisible disability.” Not to mention, many people still have stigmas about mental illness, making them think a mental illness is not a real illness just because you can’t really see it.

So making other people understand that I may not be able to work—and that I may be on SSI (and poor)—for the rest of my life is difficult. But it’s something that’s important.

I hope that, if you are reading this, you will not judge people who have to be on disability and who cannot work due to disability. There’s a segment of society that makes people feel like it’s not a legitimate option. This often stems from conservatives who tout the notion that people exploit the safety net system. For so-called Christians (as most of them allege they are), they are highly skeptical and not especially loving when it comes to caring for the wretched of the Earth. (WWJD?)

In my experience, it’s very difficult to get disability. It wouldn’t be easy to fake it. I had to be hospitalized eight times and given a poor prognosis from several doctors before I was given SSI. I was suffering, and denied SSI (and, thus, healthcare) for several years. The whole process is insult to injury. And then you end up living in poverty, anyway.

But my whole point is that each of us can make a difference. We can change things so that people like me, who have to be on disability, do not have to constantly feel like we have to justify this to people who have no business prodding for our medical information.

The fact is, I have tried working several times. Everyone who knows me knows I didn’t want to go on SSI. I wanted to work. Take a look around my website—I like professional accomplishments. But I had to go on SSI because I simply could not work.

Let’s try to make things easier for people who are already suffering enough.

How We Treat Mental Illness

I read an article recently about the current method of treating mental illness, which was referred to as “the shotgun approach.” Basically, when you have a mental illness, they try different medications on you until they find one which works (hopefully). They do this even though the medications used to treat, say, bipolar or schizophrenia work in different ways.

In schizophrenia, at least, the current theory is that there may be different underlying causes for the same symptoms. So, the reason I have schizophrenia may be different than the reason someone else has schizophrenia. The underlying issues with the brain, or past trauma, or environmental factors, may all be different. That’s why Abilify may work for me, but not for someone else. And that’s the reason why other medications I have tried, which react in the brain differently than Abilify, have not worked for me.

So, people with schizophrenia may present with similar symptoms, such as hearing voices, paranoia, and so on, but the reason they have these symptoms may be completely different.

For me, it’s really hard to tell why I have schizophrenia, with the exception of looking at the drug Abilify and seeing how it works in the brain. Of course, there may be environmental factors at play with me that triggered things (it wasn’t easy being a teen mom, for example, and conservatives, who kept telling me how I was going to Hell or cutting funding for my high school, didn’t help), but there may just be something organically different in my brain. (Not structurally, though. I’ve had CAT scans.)

There are genetic and other tests they use for people who do not respond to medications which can give doctors more insight as to why someone has a certain disease, but these are not readily available. In my opinion, they should be. Too often, as in my case, several years are wasted trying different medications to no avail. Often, it takes years to find the right medicine. That’s wasted years for many people—when they could be productive years…if they had the right medication.

That was the point of the article: there must be some way to get people the correct treatment much sooner than what is currently happening. I know, in my case, it would have been helpful to have the right medication much sooner. I may have been able to keep working, or, at least, finish some projects I was working on. At any rate, I would have more sooner been able to enjoy a Spring day like today.

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Good Films Depicting Mental Illness

Do you know of any good films depicting mental illness? One that comes to mind for me is Call Me Crazy. If you haven’t watched it, I urge you to. Not only does it deal with my illness, it also deals with PTSD, Bipolar Disorder, and more. It’s a really good film, and, in my mind, helps end stigma.