December 31st, 2012


Schizophrenia in the News

The NYTimes ran a Christmas Day op-ed entitled “Our Failed Approach to Schizophrenia”. It touched upon many of the relevant issues: very few beds available, “too little education about the public health impact of untreated mental illness”, not enough psychiatrists specializing in “severe mental disorders”, etc., with the good news being we do have a lot of effective drug treatments now.

Steinberg further argues that an ethical rule within psychiatry makes the situation worse by preventing professionals from participating in public discourse effectively (no speculating about the conditions of people you haven’t examined). He concludes by arguing in favor of increased limitations on access to guns, increased access to mental health services including longer in-patient stays for patients with schizophrenia, public education on the issue and more psychiatrists focused on schizophrenia.

Two days before that, Ann Meyer at The Record Searchlight, a Redding, California paper, published a description of a personal experience with a young man with schizophrenia that she had been conned into putting up while his parents went on vacation -- and without any disclosure his either untreated or incompletely treated mental illness, or adequate contact information for finding his parents or other responsible parties. The day after Christmas, the same paper published Justin Howland’s response about how his family responded to his brother’s schizophrenia. While Howland and Meyer both emphasize the problems with family denial of very real mental health issues, Meyer emphasizes the real-world consequences to those with schizophrenia and other delusional disorder: becoming homeless, often the victims of violence.

While of course I am, like everyone else, deeply saddened by one of the causes of this discussion (the crime committed in Newtown) and horrified (if not that surprised) by another (the NRA attempting to redirect energy away from gun control by focusing on mental illness), I’m _really, really happy_ we are having this public discussion.

But it feels a lot like “take out the trash” Friday: knowing that this is news that needs to be covered, but knowing that it’s a bit of a thankless task and the sort of thing that everyone wishes would just go away, the coverage is limited to a time when no one is likely to be paying a whole lot of attention.


Other items about schizophrenia in the news include: treatment resistant (as in, the drugs don’t work, not, the person didn’t take the drugs) schizophrenia might differ from treatment responsive schizophrenia in terms of dopamine levels; schizophrenia may be associated with poor urban areas with greater inequality (some of the coverage and the original researchers may have the causal arrow on this one wrong); schizophrenia and unaffected relatives may have more cortical thinning than the general population; people with schizophrenia have impaired autobiographical recall (this one actually might be worth delving into); sympathetic biographical sketches of men with schizophrenia (who accept that they have this condition) and how their life is progressing, what their goals are, etc.; schizophrenia which is treated early, aggressively, and in which drug treatment is paired with cognitive therapy and other supports can allow people with this condition to attend college and hold down a job; long acting injectable versions of drugs should not be treated as a last resort but possibly as a first resort for schizophrenia to improve compliance and treatment outcomes. Also, this piece, which I have to say really pisses me off:

I can tickle myself. I’ve always been able to tickle myself. The idea that this is impossible has just always struck me as stupid. Really? Now you’re telling me I’m schizophrenic because of this.

I don’t think so. It is, however, evidence for my belief that I would have gotten my kids’ diagnosis, if I had been born post-2000 or thereabouts. It would have been helpful if someone had taken the trouble to observe that self-tickling within the ASD community is usually connected to hyper-sensitivity, whereas self-tickling within the schizophrenic community is more a matter of confusion about what is coming from within the self versus outside the self.

I’m going to stop for now.

Today's Activities Include: minor decluttering, playing book group, lunch out with one of the kids

I took a bunch of shoes that I don't wear anymore and which when turned over make it very clear why (wow some of those soles were a lot more worn than I had expected) out to the trunk of my car to deliver to a donation bin. I got extremely annoyed with my cake pans after I broke the second cake in less than a week. I ordered springforms to replace my two 9 inch rounds; the old pans are now headed out the door, altho this does not address the problem I had with the heart shaped cake pan (don't make heart shaped cakes any more? Maybe?). I do recognize that I'm not supposed to blame my tools, but I'm really happy about the springforms and still can't quite figure out why I didn't do this a decade or more ago. It's not like these things are that expensive.

I also went to the hardware store to buy a few more small bins with handles for the kids' shelves. As they get older, a lot of their toys get smaller, and come in more pieces and it's starting to be more and more helpful to be able to corral them in a way that is still visible to the kids -- if you put them in something they can't see into, they either get mad and yell that they want it when they can't find it (and then you have to figure out what they mean by whatever words they chose to describe that toy), or, worse, they forget it exists and never play with it again.

I took the opportunity to get rid of a few more toys from the upstairs hall, and retire a Large Crate Where Toys Go To Be Forgotten, thus making space in the hall for the easel and table and chairs that were living in T.'s room and largely being ignored. I'd tried to move them before, and he nixed it, but this time, he was good with the change. Once out, A. wanted to paint, and T. wanted to do a puzzle when he saw me moving them around on the shelves (I was moving them from sitting in stacks to being shelved like books, as this let me get a lot more puzzles into a lot less shelf space, thus consolidating all the puzzles in the house to one location -- well, all the kids' puzzles, anyway). So that was cool. A. and I did another puzzle, and after that she played with some of the other toys.

T. has been playing "book group" lately, which involves driving the Cozy Coupe around the house with (the same) 4 books, parking, and then settling in to be read to. After we're done, he packs it all up again, and drives away. Very cute. This morning, he drove to a "restaurant" for breakfast (a bagel and some cheese). Around noon, I asked if he wanted to go to a real restaurant and he agreed! Shocking! R., T. and I (A. was with B. for the day) went to Applebee's, since we figured he was going to want chicken, fries and apple juice and we'd better make sure we wound up somewhere that would serve him that in a form he would be okay with. It was a very enjoyable experience; the renovation at the one we went to made it a much better experience than it had been in the past (risers gone, bar now on the side rather than in the center, etc.).