Broken Bones and Psychosis: Psychosocial Causes and Testability

Imagine that you get assaulted. You are kicked in the leg and it is broken. You go to the hospital. Your leg is x-rayed, and casted. You are given crutches, and asked if you want to press charges.

That’s the way it normally goes, I assume, when you are assaulted and get a broken leg.

No one says you aren’t really hurt, even though your broken leg was caused by a social ill—a bad person assaulting you.

Now imagine you have a psychotic break. Your symptoms cause your family to call the police so you can be taken to a hospital. At the hospital, your blood is taken, you are given a CAT scan, and are, after a while, diagnosed with schizophrenia.

The tests in involved—taking blood, and CAT scan—don’t reveal anything. They are done in order to rule out other things. You are given an antipsychotic, and released from the hospital after seven days, when the doctors see that your medication seems to be working.

At home, you peruse the literature, and find that some people think your illness is not real the way a broken leg is real—because your illness, they think, has psychosocial causes. Perhaps you experienced a lot of adversity, or trauma as a child. These are things correlated with experiencing psychosis.

Not everyone who gets kicked in the leg will get a broken leg. That depends on a lot of things—where you were kicked, how hard you were kicked, if you were kicked repeatedly, and if your bones were prone to breaking.

Not everyone who experiences adversity or trauma will experience psychosis, either.

Both of these things can be caused by social illness, and social ills in combination with your makeup. If you have especially brittle bones, and some bad guy kicks you, you are probably more likely to get a broken leg. Likewise, if you “are prone to” (we don’t know what that means, but let’s not assume it means you are less “hardy”) psychosis and experience trauma, you are more likely to develop schizophrenia.

But no one says you aren’t *really* hurt when you get a broken leg this way.

Unfortunately, they do say this when you become psychotic.

There is no test, they say, for schizophrenia.

True, the biomedical markers for schizophrenia are not testable in most hospitals. They can’t, for every patient, check for chemical imbalances. Instead, they rule things out, try a medication, and see if that medication (in my case, regulating dopamine) works to restore health.

Not long ago, before the x-ray, they couldn’t *see* a broken bone, either. They had to do similar things in order to diagnose and treat a broken bone. The patient would, I assume, report symptoms and people could observe symptoms. That doesn’t mean broken legs weren’t real problems before the x-ray, just like it doesn’t mean psychosis isn’t real just because not everyone has access to MRIs.

Just because something may have a psychosocial cause, or can’t currently be directly apprehended in the hospital doesn’t make it less real.

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.

Jennie 4 13 16

Would Changing the Name of Schizophrenia Help End the Stigma?

There’s an article in the Huffington Post about how changing the name of schizophrenia might help end stigma. The proposed term is “psychosis spectrum.” That may be more accurate in terms of what people actually experience. There are varying degrees of schizophrenia. Personally, I never related much to the descriptions that are provided in much of the literature because, for example, it rarely states that schizophrenia can be episodic. I have experienced psychotic breaks that are episodic, so I never related to the image of a person who is constantly in a state of psychosis. So, “psychosis spectrum” may be more accurate.

Chicago Trip

Two months ago, I visited Chicago. I stayed for a long weekend, and, during that time, I visited the Museum of Science and Industry, the Chicago SkyDeck, and the Art Institute of Chicago. I had a great time. All the exhibits were excellent. Below are some choice pictures.

This is the outside of the Museum of Science and Industry.

This is me in front of the nation’s only U-Boat:

U Boat

And here I am in front of the Art Institute of Chicago:

Art Institute

Lastly, here I am at the Chicago SkyDeck:

SkyDeck

Chicago is a wonderful place. I used the train or Metra to get everywhere I went. The Art Institute had many paintings I really, really appreciated. I took several pictures while I was there and thoroughly enjoyed my visit.