Should paranoid schizophrenics be forcibly committed?

[astro]

I was watching this show on Court TV this evening, about how this woman with paranoid schizophrenia killed a harmless man because she believed he was a government assassin out to get her. In the course of her trial it became evident that she had been suffering with this mental disease since her twenties, and had always refused help because she thought that everyone else was either clueless about the conspiracies that surrounded her, or out to get her.

If you have someone who's seriously nuts like this, but has not yet committed any crime, is it moral and/or ethical to enforce therapeutic measures, even if it is against their will, for the safety of society?

[Qadgop the Mercotan]

If you have someone who's seriously nuts like this, but has not yet committed any crime, is it moral and/or ethical to enforce therapeutic measures, even if it is against their will, for the safety of society?
I don't believe so. IIRC, the actual percentage of schizophrenics who do significant harm to others is quite small. So one would be pre-emptively incarcerating hundreds, if not thousands of individuals in order to prevent each serious assault.

Frankly, I think the odds are better in terms of getting risky individuals out of the way if we pre-emptively jail everyone ever arrested more than once for drunk driving.

[GorillaMan]

Agreed. It's quite probable that the woman in question never showed any behaviour that would have indicated violent tendencies towards others. And schizophrenia only rarely causes such behaviour anyway.

[norinew]

Originally posted by astro
has not yet committed any crime
This is the key phrase. They haven't committed a crime, so they aren't a criminal, therefore we have no right to lock them up. One might argue about the potential for harm to others, but one would be full of it. Everyone who gets behind the wheel of a car (and I'm not talking drunk driving a la QtM, just every day driving) could potentially kill someone. But we don't lock up the people who drive because the potential for harm is very small. Same with the potential for harm with mentally ill people.

[EsotericEnigma]

People are incarcerated in mental hospitals all the time without committing any crimes, aren't they?

Paranoia/schizophrenia seems like reason enough to legally force psychological treatment on someone to me. In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.

Has nothing to do with protecting society, though. It has everything to do with helping the people with those disorders.

[The Flying Dutchman]

In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.


Exactly

I'll be damned I'd I allow the "demons" to take control of my life instead of the state. Certainly some institutions might show up on 60 Minutes, but the record of the "demons" is pretty dismal. I would say "If they kidnap me, please rescue me and put me in protective custody".

Its a damn shame to see the degree of homelessness out there, with a significant proportion caused by dumping the mentally ill out onto the street.

[GorillaMan]

People are incarcerated in mental hospitals all the time without committing any crimes, aren't they?
If they are judged to be an immediate danger to themselves, yes.

Paranoia/schizophrenia seems like reason enough to legally force psychological treatment on someone to me. In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.
Schizophrenia does not often render somebody incapable of understanding and consenting to treatment. Cases such as the OP are very very rare.

[Qadgop the Mercotan]

I'd be pretty damn hesitant to give over more power to the state to commit "those not in their right mind". You want to be forcibly held and medicated because you didn't vote the straight-party ticket? It's happened in the annals of modern psychiatry.

It's very difficult (but not impossible) to commit someone these days in the US. And that's the way it should be. Commit crimes, or be a clear and present danger to self and others, and then there are legitimate grounds for commitment. Fail to manage your life the way others think you should? Not a good reason for commitment to me.

And yes, there's lots of grey area in between. And yes, there's big problems with homeless mentally ill people. And more should be done. And perhaps those with mental illness who depend on public assistance should have their assistance tied in some way to compliance with a treatment plan. But lets not go nu..... Ahem. Let's not go overboard here and give the government more power to decide what methods of thinking need "intervention".

BTW, the institution where I work was originally named "Central Hospital For the Criminally Insane". :D

[YWalker]

This is just one of those situations where it's hard to come up with the best answer. I read what Qadgop just said, and I can't argue with any of it. But then I look back at the situation that my cousin was in. He was diagnosed as mentally ill. He heard demons, and they told him that he should kill himself because he was bringing only danger and shame to his family. The freckles on his arm were a sign of the mark of the beast.

He tried to kill himself with carbon monoxide, but failed when the vacuum hose he had rigged to bring the exhaust into the car melted. His father found him and tried to take him inside, but he fought off his father and ran away The family begged the sheriff's department to take him into custody for his own protection, but they weren't legally able to. But they were able to help find his body hanging from a tree on the family farm the next day.

I don't claim to know the answer to this difficult question. But I don't think the system we have is working.

[DSeid]

While I am sure that AHunter will be here shortly* allow me just to chime in -

The burden of proof is that the individual is an imminent risk of danger to him or herself or to others. Without such proof involuntary treatment should not be imposed.

Now having admitted to voices that tell him to kill himself or having made an attempt to do so meets that burden. Just having a different perception of reality than you or I do does not.

*AHunter, for those who have not yet met him online here, is our resident untreated schizophrenic who is quite articulate (and convincing) in his defense of his rights to be as he pleases and to make the decision to avoid treatment that he feels has very significant side effects.

[hlanelee]

Being mentally ill myself and pretty much indigent, also, I can tell you that the government is lax on providing mental health treatment to people that want it and cannot afford it, now. I've known people that reach a point that they can no longer stand the voices and their only option is to go to an emergency room and rant in a corner till someone comes out and gives them a shot of thorazine and locks them in a pink room. I don't know that the government is prepared to provide treatment to people against their will even though they may need it.

[hlanelee]

Just so you know right now a month's supply of Resperidal, a good antipsychotic, costs about $300 to $400. Do I need to remind anyone on the government's stance on prescription drugs?

[Zagadka]

Screw medication and treatment, lock us in a deep hole and throw away the key!

[AHunter3]

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.

a) Define "paranoid schizophrenic". You'd better be prepared to do so if you're going to support locking people up for "being" it. You could, of course, defer to the medical definition thereof, but there's something you need to know: the working definition of "paranoid schizophrenic" is "person who has been diagnosed paranoid schizophrenic". There is no "rule-out mechanism", nothing that anyone can test for to determine that a prior diagnosis was made in error. And the initial diagnosis is made on the basis of reported and observed behavior and self-reported feelings. Do you really want to advocate locking up anyone who, on the basis of opinion derived from interpretations of behavior alone and unsupported by any labs or other rigorously empirical evidence, has been labeled as such?

b) Why lock us up? The conventional standard for locking someone up in our society is "for doing something illegal and being convicted of it". There are people in America who openly belong to organizations such as the KKK and ascribe to sentiments about the permissibility and appropriateness of violence, and yet we don't lock them up until they actually do something. Some of us may be really hard to understand (and find other people hard to understand, for that matter); you may be afraid of them and they may be afraid of you. And yet that only occasionally makes some of us violent some of the time (and we're more likely to be on the receiving end of the violence, picked on for being "nuts"). The psychiatric standard in most of the country is "mentallly ill and dangerous to self and/or others", not "mentally ill" by itself, and yet the ability of people to predict dangerousness is pretty limited and their accuracy rate is lousy (I'll dig up a cite on this if requested). So why not just treat us like everyone else and arrest us and charge us if we actually do something?

c) On the other hand, why stop there? I mean, already you're talking about having us locked up without due process (how could due process exist if we're being locked up for something we are rather than something we did? how does one defend against that? we can't even deny being "paranoid schizophrenics", see (a) above), and unless you had a finite sentence in mind (you'd release us after, say, a year? but we're still "paranoid schizophrenics" the day we get out, wouldn't you have us locked up again on the same basis as we were locked up the first time?), that means indefinitely. Having permitted this kind of an approach to public safety and security, why not just have us gassed? I mean, is there a human rights or civil liberties concern that gets invoked at this point, but not prior to this point, that would cause you to have problems with that? Or maybe burning us at the stake would be more the thing, depending I suppose on one's historical precedence preferences.

[laigle]

I dunno. I'm definitely for forced treatment. I might even be for forced hospitilization on a case by case basis, to get the people who are absolutely out of synch with reality some help. It's a rather touchy subject, because I am vehemently against locking people up when they only have the potential for harm, but you have to take into consideration that in these cases people may have no real control over that potential.

[BrainGlutton]

Yes, you should be. :D

[koeeoaddi]

I usually don't post in Great Debates, but this issue is of great interest to me. My grandfather, a First World War veteran, spent the last 30 years of his life committed to a V.A. Hospital Psych Ward. He was diagnosed with PTSD ("Shell Shock"), which changed over the years to Paranoid Schizophrenia.

It wasn't easy to have him committed, even back in the 1930s. It took a temporary commitment with psychological testing, a hearing in front a judge with the testimony of three doctors, his family and several witnesses on both sides. Still, once they had him, AHunter3 is right, they had him till his very last day on earth.

Though I understand why my family had him committed, a look into his medical records reveals just a glimpse of one of the saddest, most depressing existences imaginable. An utterly wasted life.

I don't know what the answer to this is, beyond the hope for more effective, accessible drugs.

[GorillaMan]

I dunno. I'm definitely for forced treatment.
Why, in cases where people are no immediate danger (assuming that by hospitalisation when 'out of synch with reality' means when shizophrenia does theaten people's safety)? Or are you in favour of forced treatment on a wider scale, such as blood transfusions for Jehovah's Witnesses, or animal-derived pharmaceuticals for strict vegans?

[Zagadka]

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.
Interesting, I am as well. What you said speaks volumes, but I'd like to add some to it.


b) Why lock us up?
The kind of thinking, "lock them all up" is falling back centuries in history. We've come to a point where we have medications and therapy that are effective. "Locking them up" is a solution that led to centuries of people with mental disorders having their lives RUINED. You may as well just execute us - it would be better than spending life in an institution rotting away. I've spent enough time there, thanks.

I don't have a problem with "forced treatment" - the problem is, how do you fund the treatment? I'd be happy if you want to foot the bill for me. I can't work, so have no insurance, and holding people in hospitals for long periods of time is very expensive... not to mention the thousands of dollars of meds every month.


c) On the other hand, why stop there?
On that note, romances cause way more murders than schizophrenics or schizo-effectives. I can think of a hundred things that you could prevent from happening to sanitize society before locking us all up and throwing away the key.

[laigle]

Why, in cases where people are no immediate danger (assuming that by hospitalisation when 'out of synch with reality' means when shizophrenia does theaten people's safety)? Or are you in favour of forced treatment on a wider scale, such as blood transfusions for Jehovah's Witnesses, or animal-derived pharmaceuticals for strict vegans?

There is no case where a threat is not posed to the public by a paranoid schizophrenic. In mild cases of the disease the symptoms can be recognized and controlled, but in an advanced state the person is unaware of actual events around them and convinced that those around them are trying to do them imminent harm. They are in a state in which they are presented with a situation that would cause a reasonable person to commit acts of violence against others. That situation just isn't real. It's unfortunate, even tragic, but their rights do not negate or supersede the rights of those around them.

We regularly commit the insane. We also quarantine those carrying dangerous, communicable disease. When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible.

What does your utter piffle about Jehovah's Witnesses have to do with mental illness? Or are you just going to plug up your ears and pretend that schizophrenia is merely a difference of opinion?

[GorillaMan]

There is no case where a threat is not posed to the public by a paranoid schizophrenic.
That is simply not true. Learn the facts before making sweeping statements.

What does your utter piffle about Jehovah's Witnesses have to do with mental illness?
I was asking how far you extend your policy of forced medication and treatment for people who do not pose a threat.

Or are you just going to plug up your ears and pretend that schizophrenia is merely a difference of opinion?Did I say that? No.
:rolleyes:

[AHunter3]

laigle, I may or may not be unaware of actual events around me, I may or may not be a danger to people, and on these matters you don't have any easy way of discerning. All you know is that a psychiatrist once diagnosed me as paranoid schizophrenic.

Do you propose that I should be locked up against my will indefinitely?

[EsotericEnigma]

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.

a) Define "paranoid schizophrenic". You'd better be prepared to do so if you're going to support locking people up for "being" it. You could, of course, defer to the medical definition thereof, but there's something you need to know: the working definition of "paranoid schizophrenic" is "person who has been diagnosed paranoid schizophrenic". There is no "rule-out mechanism", nothing that anyone can test for to determine that a prior diagnosis was made in error. And the initial diagnosis is made on the basis of reported and observed behavior and self-reported feelings. Do you really want to advocate locking up anyone who, on the basis of opinion derived from interpretations of behavior alone and unsupported by any labs or other rigorously empirical evidence, has been labeled as such?

b) Why lock us up? The conventional standard for locking someone up in our society is "for doing something illegal and being convicted of it". There are people in America who openly belong to organizations such as the KKK and ascribe to sentiments about the permissibility and appropriateness of violence, and yet we don't lock them up until they actually do something. Some of us may be really hard to understand (and find other people hard to understand, for that matter); you may be afraid of them and they may be afraid of you. And yet that only occasionally makes some of us violent some of the time (and we're more likely to be on the receiving end of the violence, picked on for being "nuts"). The psychiatric standard in most of the country is "mentallly ill and dangerous to self and/or others", not "mentally ill" by itself, and yet the ability of people to predict dangerousness is pretty limited and their accuracy rate is lousy (I'll dig up a cite on this if requested). So why not just treat us like everyone else and arrest us and charge us if we actually do something?

c) On the other hand, why stop there? I mean, already you're talking about having us locked up without due process (how could due process exist if we're being locked up for something we are rather than something we did? how does one defend against that? we can't even deny being "paranoid schizophrenics", see (a) above), and unless you had a finite sentence in mind (you'd release us after, say, a year? but we're still "paranoid schizophrenics" the day we get out, wouldn't you have us locked up again on the same basis as we were locked up the first time?), that means indefinitely. Having permitted this kind of an approach to public safety and security, why not just have us gassed? I mean, is there a human rights or civil liberties concern that gets invoked at this point, but not prior to this point, that would cause you to have problems with that? Or maybe burning us at the stake would be more the thing, depending I suppose on one's historical precedence preferences.

Your mental disorders are a medical condition. I don't advocate "locking you up" or indeed doing anything at all regarding the criminal justice system. This is not a criminal case.

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.

Why exactly have you decided not to seek treatment, by the way? It sounds like you recognize the disorder in yourself, and are intentionally avoiding treating it, which makes as much sense to me as getting stabbed in the leg and trying to walk it off while it bleeds.

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people. I personally know a severe paranoid schizaphrenic, who has made death threats and done violent damage to property due to his condition, and endangered his child's life during one particular episode while he was driving (an episode that ended with him in the hospital and his car completely totalled), before he was treated for the condition. His treatment involves psychology and medical prescriptions.

[GorillaMan]

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.
OK, so TB is a public health issue - but why on earth do you want to impose treatment on somebody with a broken elbow?

[yosemite]

OK, so TB is a public health issue - but why on earth do you want to impose treatment on somebody with a broken elbow?
Yeah, I wanna know too. Was that a typo?

[Zoe]

According to an article that was in the British Journal of Psychiatry in 2002, only .03% of schizophrenics are convicted of a violent crime each year. We can't look people up because they might become violent. They are human beings! You might have a brother or child who is schizophrenic. Can you imagine having that person removed from your family?

And think of how many groups might end up on that list as "potentially violent."


Zagadka: I can't work, so have no insurance...

Have you applied for Social Security? That won't help with medicine much, but Medicare does make a big difference in what you are charged to see a physician. And maybe there will be relief soon for expensive medications. It is a hassle to apply, but there are people who can help. I have a permanent disability because of chronic depression. (My illness responds well to medicine, but the medicine has side effects which also cause problems in functioning normally.)

[vanilla]

We also quarantine those carrying dangerous, communicable disease. When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible.




Who'se we?
You've described people with AIDS, and they are certainly not quarantined.

[Squink]

When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible. If that's the case, why do I see so many people driving down crowded city streets at 40mph with all their attention riveted to their cell-phone. I had to swerve to avoid one of these self-obsessed assholes today. Clearly he was a threat to me and himself.

[AHunter3]

EsotericEnigma: Your mental disorders are a medical condition. I don't advocate "locking you up" or indeed doing anything at all regarding the criminal justice system. This is not a criminal case.

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.

Why exactly have you decided not to seek treatment, by the way? It sounds like you recognize the disorder in yourself, and are intentionally avoiding treating it, which makes as much sense to me as getting stabbed in the leg and trying to walk it off while it bleeds.

1. Because I like me the way I am and I do not wish to be normal.

Allegory time: Not too terribly long ago, gay folks were regarded as being not merely different but sick. (In fact, it would not have been unusual for someone to receive a diagnosis of schizophrenic as a consequence of being homosexual). And "normal" (i.e., hetero) people of that time had no comprehension of how or why anyone would or could embrace such a difference. But nowadays most of us have a better grasp of gay pride. We understand that, occasional exceptions aside, most gay folks do not wish they had been straight instead; they would not embrace a therapeutic "conversion" to heterosexual if one were available and would wage a political fight against one if it were proposed that a conversion be forced upon them. Because they like the way they are. So do I. Think of it as "schizzy pride".

2. Because the institutions that have the forced treatments don't have a cure anyhow.

What they have is an arsenal of pharmaceuticals. Those pharmaceuticals have varying effects on our neurological functions, most of them muffling the tendency of nerve cells to do what nerve cells do: synapse. This is especially true of the class of chemicals that are prescribed for schizophrenics. No matter what you may have heard, these meds are not to schizophrenia what insulin is to diabetes. They are more akin to what demerol is to someone with a killer migraine. Taking demerol will enable some migraine sufferers to think coherent thoughts instead of being incapacitated by the pain, but for others the medication just muffles everything and puts them in a drugged-up haze. So it is for psych meds. They help some of us with symptoms that we find unpleasant. For others, they are worse than the symptoms they purport to treat. Oh, and they are risky, and tend to cause permanent brain damage if you use them for a prolonged stretch. Me, I'll pass.

3. You would really advocate forcing elbow reconstruction surgery on an adult who did not consent to it? Astonishing. Would you force open-heart surgery on an adult with a cardiac condition who preferred to just see if diet and good luck would get them through? If the enthusiastic neurologist who lives down the street from me decides you have Tourette's, is it OK if he has you strapped to the operating table while he does a little experimental surgery on your hippocampus?


I am not a disease. I appear to have a difference which I share with other people. I am an activist in a pluralistic society saying that I like who and how I am. I break no laws and I want no cure.

[AHunter3]

Oh, btw:

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people.

You are wrong.

I wish you were right, but you're not.

[Qadgop the Mercotan]

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people.
Snort

I trained in the "D building" of the old Baltimore City Hospital.

Pull the other one, it's got bells on it.

QtM, MD

[Guinastasia]

AHunter3, FWIW, you certainly don't sound like someone with paranoid schizophrenia, who happens to be untreated.

Is there research to find a better way to treat this disorder, so people WON'T have to go around in a drugged up haze? So it could be something like anti-depressants, that are used to restore a chemical imbalance?

[alaricthegoth]

might one not legitimately distinguish

danger to others

from

danger to self?

I'm far less uncomfortable with a preemptive involuntary intervention where homicidal ideation is demonstrable; suicidal ideation, on the other hand, is really no body's business.

[EsotericEnigma]

EsotericEnigma:

1. Because I like me the way I am and I do not wish to be normal.

Allegory time: Not too terribly long ago, gay folks were regarded as being not merely different but sick. (In fact, it would not have been unusual for someone to receive a diagnosis of schizophrenic as a consequence of being homosexual). And "normal" (i.e., hetero) people of that time had no comprehension of how or why anyone would or could embrace such a difference. But nowadays most of us have a better grasp of gay pride. We understand that, occasional exceptions aside, most gay folks do not wish they had been straight instead; they would not embrace a therapeutic "conversion" to heterosexual if one were available and would wage a political fight against one if it were proposed that a conversion be forced upon them. Because they like the way they are. So do I. Think of it as "schizzy pride".

2. Because the institutions that have the forced treatments don't have a cure anyhow.

What they have is an arsenal of pharmaceuticals. Those pharmaceuticals have varying effects on our neurological functions, most of them muffling the tendency of nerve cells to do what nerve cells do: synapse. This is especially true of the class of chemicals that are prescribed for schizophrenics. No matter what you may have heard, these meds are not to schizophrenia what insulin is to diabetes. They are more akin to what demerol is to someone with a killer migraine. Taking demerol will enable some migraine sufferers to think coherent thoughts instead of being incapacitated by the pain, but for others the medication just muffles everything and puts them in a drugged-up haze. So it is for psych meds. They help some of us with symptoms that we find unpleasant. For others, they are worse than the symptoms they purport to treat. Oh, and they are risky, and tend to cause permanent brain damage if you use them for a prolonged stretch. Me, I'll pass.

3. You would really advocate forcing elbow reconstruction surgery on an adult who did not consent to it? Astonishing. Would you force open-heart surgery on an adult with a cardiac condition who preferred to just see if diet and good luck would get them through? If the enthusiastic neurologist who lives down the street from me decides you have Tourette's, is it OK if he has you strapped to the operating table while he does a little experimental surgery on your hippocampus?


I am not a disease. I appear to have a difference which I share with other people. I am an activist in a pluralistic society saying that I like who and how I am. I break no laws and I want no cure.

Your points are not based on any logic that I can see. Paranoia and schizophrenia are medical conditions. Would you let a chipped tooth fester because you like the way you are, and don't want to be normal? That's just plain absurd. If treatment exists, there's no reason not seek it, especially in such a severe case like this.

I would not force elbow surgery on someone who has broken their elbow. I would force medical treatment for the broken bone if they insisted on leaving it broken. This point doesn't matter anyway, because I doubt anyone with judgement that is not impaired would intentionally avoid treatment for a broken bone. Surgery is not the only form of medical treatment. In fact, it's one of the least used forms.

Also, read above for my response to your hypothetical heart surgery patient. Seeking treatment for his ailment through proper diet and activity is still seeking treatment. Diseased hearts can and have become healthy through this method.

Honestly, I can't understand the stand you have taken here. You talk and debate like a person entirely in their right mind, but the end result of your arguments lead exactly where many other paranoid schizophrenics go, which is "I don't need treatment." The fact is, you DO, and the disease itself is what prevents you understanding this, the same as it prevents so many others with your same condition.

[yosemite]

I would force medical treatment for the broken bone if they insisted on leaving it broken. That's creepy.

You just can't do that. People have their agency.

For example, most of the people in my family are "crackpots," in that we believe in herbal cures and therapies. Not all of them, but some of them, some of the time. I have "cured" minor toothaches with goldenseal tea and I have "cured" other ailments by using teas instead of over-the-counter medicines. Some of these "cures" are deemed to be worthless by mainstream society, but I feel they have worked for me. One of my sisters (who is otherwise the most sane and sensible of the bunch) believes in homeopathic medicine and has inflicted it on her family from time to time.

If we prefer our "crackpot" cures instead of mainstream, medically proven ones, would you force us to be cured in the way that you see fit? Why? And if not, how is that any different than forcing someone with a broken elbow to get it "treated"? Maybe they are getting it treated, but in a way that they prefer (juniper berries, or who knows?).

[Lamia]

Paranoia and schizophrenia are medical conditions.Medical conditions that are not well understood even today. I don't believe "paranoia" is considered a disorder in and of itself anymore, but rather a symptom of "paranoid schizophrenia". It's not clear how the various types of schizophrenia are related or if they are related at all, and there is as of yet no actual cure for any of them.

Personally, I think it's stupid and irresponsible for a schizophrenic to refuse medication that would help them. The key phrase being "that would help them". If the medication does not in fact improve their quality of life, I cannot see much justification for forcing it upon them.


I would not force elbow surgery on someone who has broken their elbow. I would force medical treatment for the broken bone if they insisted on leaving it broken. This point doesn't matter anyway, because I doubt anyone with judgement that is not impaired would intentionally avoid treatment for a broken bone.The father of a friend of mine broke his leg after slipping on an ice patch and chose not to go to the hospital for it. He "took it easy" for a month or so, and considered that sufficient. I think it was a pretty stupid decision, but the man is, to my knowledge, not a lunatic so much as a macho type who also hates visiting the doctor. Do you think government agents should have been able to kick in his door and drag him into an emergency room against his will?

[even sven]

Your points are not based on any logic that I can see. Paranoia and schizophrenia are medical conditions. Would you let a chipped tooth fester because you like the way you are, and don't want to be normal? That's just plain absurd. If treatment exists, there's no reason not seek it, especially in such a severe case like this.

Drugs are not perfect. Despite what you may think, modern medicine doesn't have perfect answers- especially when it comes to psychiatric medicine. What we do have is a lot of measures that help some people but most all of them have some major drawbacks. We don't even have a good idea how a lot of them actually work- we just noticed somewhere along the way that it seems to help.

For example, electro shock therapy is very effective, but it can also dramatically change a person's personality- to the point that they "miss" who they used to be- and we don't have any idea what it actually does to the brain. It works, yeah, but it's not a cleancut answer like setting a broken bone.

Sometimes our medicines are big fucking hammers. It's like fixing a broken bone by cutting the arm off. Or making your whole body numb so you can't feel the broken bone. It's "doing something" but it's not really a solution. We arn't talking about cures here. We don't have cures.

And then there is the problem of what a "cure" even constitutes when it comes to phsyciatric issues. It's traditionally defined as being able to hold a steady job, have regular relationships and generally to "function". There is no denying that this is deeply dependent on the society your living in. Mental disorders are not clear diagnoses. Curing them is not a 1+1=2 kind of thing. It's more of an interplay of personalities and society and chemistry. But somewhere in there is a human. And that human may not want their brain chemistry altered. And that is their right. It's their brain. You don't know what trade-offs they are willing to make, and you don't have a right to alter the very stuff of who they are.

Mental disorders are a big tragedy. It sucks that people have them, and it sucks more that we don't have any real easy solutions. But it's insulting and outright wrong to liken them to broken arms.

[Zagadka]

Sometimes our medicines are big fucking hammers. It's like fixing a broken bone by cutting the arm off. Or making your whole body numb so you can't feel the broken bone. It's "doing something" but it's not really a solution. We arn't talking about cures here. We don't have cures.
No shit. My 1.5 mg of Xanax just about knocks me out. It isn't so much blocking it out as numbing everything. BUT - it and my other meds lets me function around other people. A cure? No, but it makes life possible.

As a side note, schizophrenia is not incurable. I've known many cases of people who, after years of work, have overcome it.


Mental disorders are a big tragedy. It sucks that people have them, and it sucks more that we don't have any real easy solutions. But it's insulting and outright wrong to liken them to broken arms.
No, it is more like paralysis. It is something you can be born with, or can get through tragedy (PTSD, etc). It affects your ability to be around people, to get around, to live life, to work. It puts a burden on your loved ones as they help carry your weight (and put up with you on your worse days).

I have two friends I met before my schizophrenia really kicked in, one who has been paralyzed from the neck down for life, and one who is blind. The three of us couldn't work very well alone, but together, we had a great time (the blind chick is also the best pipe packer I've ever met). It is a pain in the ass going out, but we manage to do it, and do it almost normally. Boy, did we ever get on the Disabled Students Program's shitlist. But I learned a lot from them - I learned that anyone can live a normal life. The only time I actually feel psychologically safe is around them, not at the hospitals or anything.

[laigle]

laigle, I may or may not be unaware of actual events around me, I may or may not be a danger to people, and on these matters you don't have any easy way of discerning. All you know is that a psychiatrist once diagnosed me as paranoid schizophrenic.

Do you propose that I should be locked up against my will indefinitely?

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?

[laigle]

Who'se we?
You've described people with AIDS, and they are certainly not quarantined.

Actually, if they go around spreading the disease,
we do. (http://www.volanteonline.com/news/2002/05/01/News/Huron.College.Hiv.Incident.Raises.Concerns-248420.shtml)

[laigle]

If that's the case, why do I see so many people driving down crowded city streets at 40mph with all their attention riveted to their cell-phone. I had to swerve to avoid one of these self-obsessed assholes today. Clearly he was a threat to me and himself.

A. Poor driving is hardly a condition, now is it?

B. Actually, reckless driving is a criminal offense for which said driver was liable for government sanction, now isn't it?


So you're actually going to suggest we don't lock people up for criminal acts. You do realize that's a non-starter, no? Let alone that it has no bearing on the debate of whether society should take measures to protect itself from people based on an innate condition.

[Lamia]

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?I don't think the fact that you don't know if he's aware of actual events around him or not makes him dangerous, and that's all the man was saying. That you don't know anything about his abilties or whether he's a danger to himself or others, just that he was once diagnosed as a schizophrenic, and you're prepared to treat him like a criminal for no other reason than that.

[Canadjun]

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?
Many KKK and Aryan Nations folk believe they are under imminent threat from non-whites. I guess that's justification for locking them all up (probably wouldn't be a bad idea, but that's a different issue :) ).

The fact that someone may or may not be aware of actual events does not imply that they believe they are under imminent threat. You hear about the few paranoid schizophrenics that do believe that and act aggressively upon it; you don't hear about the many that do not.

[AHunter3]

Guinastasia thinks I don't sound sufficiently schizzy



...and EsotericEnigma thinks I'm so sick I don't understand how sick I am:


Honestly, I can't understand the stand you have taken here. You talk and debate like a person entirely in their right mind, but the end result of your arguments lead exactly where many other paranoid schizophrenics go, which is "I don't need treatment." The fact is, you DO, and the disease itself is what prevents you understanding this, the same as it prevents so many others with your same condition.


From this, can we conclude that Guinastasia is sick and in need of treatment, since she's sufficiently sick that she doesn't see how sick I am?


::scampers off giggling and capering::

[AHunter3]

Laigle, you may or may not be aware of things around you, too. Statement of incontrovertible fact.

[laigle]

I don't think the fact that you don't know if he's aware of actual events around him or not makes him dangerous, and that's all the man was saying. That you don't know anything about his abilties or whether he's a danger to himself or others, just that he was once diagnosed as a schizophrenic, and you're prepared to treat him like a criminal for no other reason than that.

Bzzt. Do try another strawman. I'd suggest saying I want to treat him like a heretic, but that's already been tried. I want to treat him like someone who is ill. Period. End of fucking story. Nice try on the childish, purile race/religion/politics bullshit all, but it's getting you nowhere.

Schizophrenia is a valid medical disorder. It causes the sufferer to be incapable of distinguishing reality from delusion. Delusions for paranoid schizophrenics generally revolve around the idea that they are under imminent threat from people around them for no particular reason. This is not a moral judgement. It's a symptom of a disease.

A disease which, I might add, is treatable in many if not most cases. However, the nature of the illness causes those suffering it often refuse treament. Look at the comments in this thread. "You can't make me take pills, I don't need pills, the pills infringe on my liberty, you're persecuting us all, you're just like the Klan!"

This is someone who needs medication to prevent them from being a threat to others, who refuses medication, and who must thus be put into a system of monitored treatment because they cannot provide care for themselves.

[don't ask]

In the 1970s I was a Psychiatric Nurse and it was a common event for the police to bring in some floridly psychotic individual that they had found on the streets. We would assess them , and if appropriate admit them under a schedule (a legal document that allowed us no more than 2 days before the patient was presented to a legal/medical panel to assess their competence). They would be medicated and often begin to function again, and would then be returned to their usual environment with the support of a community health team.

With the demise of the Psychiatric hospital system, as pre-empted by Ronald Reagan (RIP) in California these people are now consigned to lives of abject misery on the streets. I see them every day - 30 years ago they were being cared for in public institutions.

Largely these people were admitted because they were likely to cause harm to themselves, not others.

[Squink]

A. Poor driving is hardly a condition, now is it?A habit of choosing to drive recklessly, which is what cellphone addicts do whenever they pick up the phone under inappropriate conditions, borders on sociopathic behavior. Locking up cellphoners would reduce their threat to society, and might even help them learn to think before they do something stupid and dangerous.
If a person kills someone, it doesn’t matter to the victim what the killers state of mind was at the time of death. Flipped out paranoid, or thoughtless car-phoner, you still end up just as dead. So why discriminate on the basis of the killers state of mind? Should we allow our personal squeemishness towards those with classically defined mentall illnesses to blind us to the larger threat posed by inconsiderate jerks with cellphoners?
That said, I don’t much like the idea of stripping people of their freedom without damned good evidence that they pose a threat to society.

[astro]

Guinastasia thinks I don't sound sufficiently schizzy


Well.. in all honesty AHunter3, you really don't, and please don't take this the wrong way as if I am imputing your credibility. I know nothing (really) of you and your mental health history, other than some of the threads I have seen where you discuss the ensnaring and stigmatizing nature of modern mental health treatment paradigms.

You have a very acute sense, and IMO, a largely accurate real world perspective on the current limits of medically diagnosing and treating serious mental health problems. I suppose the problem in seeing you - keyboard to keyboard - as a "paranoid schizophrenic" is that the condition in my layman's experience, based on the various paranoiacs I have met in my life (and I'm calling them that simply because IMO they behaved in an irrational and paranoid fashion), there is a seeming absolute inability to look outside the paranoia and understand that they are ill. Someone who can do this, consistently and successfully, is not a "paranoid schizophrenic". You apparently do this conversationally, and without medication.

In the show, the doctor they referenced as specialist on PS referred to it, as essentially having a "broken brain" and that there was no cure, period. The only real option was medication, and even that had its limits.

And yet here you are politely, rationally, cogently discussing the problem in all its details from a seemingly Olympian perspective. No one wants to dis your PS cred, but if what's supporting this definition (for you) is the egregious mis-diagnosis of whatever your problems were at the time, by some professionals in the past, the notion of your being really PS is a bit difficult to comprehend, (keyboard to keyboard at least).

[Squink]

the condition in my layman's experience, based on the various paranoiacs I have met in my life (and I'm calling them that simply because IMO they behaved in an irrational and paranoid fashion), there is a seeming absolute inability to look outside the paranoia and understand that they are ill. Have you been around a person with schizophrenia over a period of months or years? Often the condition cycles from better to worse, and back again. When times are good, it's not unusual for people with the disease to come across as cogently as does AHunter3. But you'd never know that if your only experience has been with strangers at a time of crisis.

[ultrafilter]

The thing to understand, astro, is that, like most mental disorders, schizophrenia isn't an either/or thing. There are degrees of it. On the one end of the spectrum, there are people who have no ability to determine what's real. On the other end, there are people like me, who can basically function in society (even if we are considered a little odd) but have episodes of non-lucidity (in my case, triggered by stress).

[gobear]

I work with several diagnosed schizophrenics at a non-profit that helps menatla healthcare consumers and their families, and contrary to your expectations, they look and act like ordinary people. As has been said, it's not a off/on dichotomoy between sanity and a full-on delusional state. Most folks with schizophrenia can live full, happy lives with the help of medication and continual monitoring of their health. I count my lucky stars that I wasn't saddled with a brain disorder and have to live with the stigma perpetuated by people who know the disease only from the inaccurate stereotypes they see in movies and TV.

For more info on schizophrenia, here's a fact sheet (http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=14842) to clear up some of the misconceptions about this illness.

[astro]

I work with several diagnosed schizophrenics at a non-profit that helps menatla healthcare consumers and their families, and contrary to your expectations, they look and act like ordinary people. As has been said, it's not a off/on dichotomoy between sanity and a full-on delusional state. Most folks with schizophrenia can live full, happy lives with the help of medication and continual monitoring of their health. I count my lucky stars that I wasn't saddled with a brain disorder and have to live with the stigma perpetuated by people who know the disease only from the inaccurate stereotypes they see in movies and TV.

For more info on schizophrenia, here's a fact sheet (http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=14842) to clear up some of the misconceptions about this illness.

Point taken re the TV examples, but the real life interactions (maybe 10 or so individuals total over time) I mentioned were in my day to day worklife in dealing with prospective clients and customers as a Bethesda Marriott front desk clerk in my youth, a Radio Shack clerk and manager in my twenties and a commercial real estate agent in my 30's until the present. Most of these interections happened a few times with the same people and they never gave me any indication other than that they were full on 24/7 delusional, as was the lady in the show. If PS is a disease that cycles in degree and intensity then AHunter3's perspective is perfectly understandable, and I apologize for mis-understanding the scope of it's manifestions.

[Lamia]

Bzzt. Do try another strawman. I'd suggest saying I want to treat him like a heretic, but that's already been tried. I want to treat him like someone who is ill. Period. End of fucking story.No, you don't. That is not the way other ill people are treated. I know because I'm chronically ill myself, and no one's forcing medication on me or threatening to put me away if I don't take it regularly.


Nice try on the childish, purile race/religion/politics bullshit all, but it's getting you nowhere.
Uh, where did I mention race, religion, or politics? Let me see...nowhere. Seems like you may be suffering from delusions. Perhaps we'd better start shoving some antipsychotics down your throat now.

A disease which, I might add, is treatable in many if not most cases. However, the nature of the illness causes those suffering it often refuse treament. Look at the comments in this thread. "You can't make me take pills, I don't need pills, the pills infringe on my liberty, you're persecuting us all, you're just like the Klan!"

This is someone who needs medication to prevent them from being a threat to others, who refuses medication, and who must thus be put into a system of monitored treatment because they cannot provide care for themselves.Why are you so sure that AHunter3 is a threat to others? As he said, all you know is that he was once diagnosed as a schizophrenic. What if the diagnosis was a mistake? If he'd proven himself to be a danger to himself or society through violent behavior, attempts of violent behavior, or even threats of violent behavior then that would be one thing, but apparently he has not. If he's refusing medication that would help him then he's behaving very, very irresponsibly, but I don't think either one of us is in a position to determine whether or not medication actually would help him. If you were his psychiatrist or had at least met the guy I might be inclined to take your opinion as to what sort of treatment he requires more seriously.

[laigle]

No, you don't. That is not the way other ill people are treated. I know because I'm chronically ill myself, and no one's forcing medication on me or threatening to put me away if I don't take it regularly.

Really? You have a disease which makes you a danger to others and you have not been medicated, quarantined, or had the health department checking up on you to see that you are being treated? Jeez, I thought the health system here sucked, and I got all that just for TB, hardly a life threatening illness in the states.

Remind me never to move to your neck of the woods.

[/i]Uh, where did I mention race, religion, or politics? Let me see...nowhere. Seems like you may be suffering from delusions. Perhaps we'd better start shoving some antipsychotics down your throat now.

Maybe you just need glasses, so you could read the word "all" in the quote. Oh, wait, you could, and now you're just purposefully ignoring the fact that I was referring to other posters in the thread in order to make a quip. :rolleyes:

Boy, that sure sells me on your point of view.

If you were his psychiatrist or had at least met the guy I might be inclined to take your opinion as to what sort of treatment he requires more seriously.

Bullshit. His psychiatrist diagnosed him with a medical condition that requires treatment. You have subsequently plugged up your ears and started the traditional "nu uh, not happening" routine in reference to the fact that he is ill. You are willing to lie, slander, and doubletalk to deny the horrible recourse I've proposed:

He needs to take some medicine which will improve his quality of life, and they should be provided by the public if necessary. I know, it's the worst thing since Mengele. There ought to be a special place in hell for people who even suggest such a thing. And yet here I am, in support of such an unspeakable atrocity.

[ultrafilter]

He needs to take some medicine which will improve his quality of life....

What you seem to be missing is that, for many people, the medication does *not* improve their quality of life. Sometimes it helps the symptoms but the side effects are intolerable, and sometimes it doesn't even help the symptoms.

[GorillaMan]

Schizophrenia is a valid medical disorder. It causes the sufferer to be incapable of distinguishing reality from delusion.
Wrong. It can, in some cases cause them to be incapable of that distinction.

Delusions for paranoid schizophrenics generally revolve around the idea that they are under imminent threat from people around them for no particular reason.
Wrong again. In most cases, the paranoia is not about individual people, but more generalised and non-specific.

This is someone who needs medication to prevent them from being a threat to others
You have zero evidence that this is the case, and you are speaking from ignorance. Go and google 'schizophrenia myths'. Oh, and while you're at it, go and look up the horrific range of side effects of antipsychotics, and you'll understand why people don't want the drugs. They were bad enough for me to stop taking them.

[Mr. Excellent]

Your points are not based on any logic that I can see. Paranoia and schizophrenia are medical conditions. Would you let a chipped tooth fester because you like the way you are, and don't want to be normal? That's just plain absurd. If treatment exists, there's no reason not seek it, especially in such a severe case like this.

I would not force elbow surgery on someone who has broken their elbow. I would force medical treatment for the broken bone if they insisted on leaving it broken. This point doesn't matter anyway, because I doubt anyone with judgement that is not impaired would intentionally avoid treatment for a broken bone. Surgery is not the only form of medical treatment. In fact, it's one of the least used forms.

Also, read above for my response to your hypothetical heart surgery patient. Seeking treatment for his ailment through proper diet and activity is still seeking treatment. Diseased hearts can and have become healthy through this method.

Honestly, I can't understand the stand you have taken here. You talk and debate like a person entirely in their right mind, but the end result of your arguments lead exactly where many other paranoid schizophrenics go, which is "I don't need treatment." The fact is, you DO, and the disease itself is what prevents you understanding this, the same as it prevents so many others with your same condition.

A few points, if I may. First: Enigma, this is Great Debates. As I understand it, this is the place where we debate controversial issues based on logic and well-argued ideas. Your assertion that AHunter's position *must* be flawed, because he is a schizophrenic and his illness keeps him from seeing that you are "obviously" correct, constitutes an ad hominem attack - that is, an attack on the person rather than the ideas. If you don't agree with what AHunter is saying (and I'm not sure I do, but I'm keeping an open mind), then by all means, use all the rhetorical and logical skills at your disposal to go after his position. But saying, essentially, "you're wrong because you're schizo" is demeaning, irrelevent, and puerile.

Regarding the substance of your argument - I would point out that there is a substantive difference between a chipped or infected tooth and schizophrenia, at least as AHunter presents it. (I hasten to add that I myself know very little of schizophrenia.) Severe, chronic pain - as with a chipped tooth - can make it near-impossible to function normally. AHunter's position seems to be that his condition is not so incapacitating, and that treatment might be - *if* that is the case, then a schizophrenic declining to seek treatment doesn't seem to be behaving irrationally - he's just doing cost/benefit analysis.

It should also be mentioned that people routinely make decisions that are "bad" for them medically. For example, I probably drink to excess more often than I should when I'm at college. I also eat very poorly there - much of my diet is very high in fats and sugars. Arguably, I am risking serious liver and heart disease - would you propose, then, that I not be allowed to eat pizza and drink beer? Your position is that medically unwise decisions are sufficiently non-rational that the state should become involved in them (though perhaps, as you've made clear, not through surgery or imprisonment). So, when shall I expect the men in white suits to take me away? Would a Tuesday be good for them?

[GorillaMan]

Another point about treatment for schizophrenia - beyond mere sedation, which I think we can all agree is necessary where somebody is showing an immediate danger to themselves or others, treatments cannot operate without the willingness and cooperation of the patient. Without a full understanding of the particulars of the psychosis, the correct application of anti-psychotics is not possible. Therefore, it's impossible to effectively 'treat' a non-willing schizophrenic back to 'normality'.

[laigle]

AHunter's position seems to be that his condition is not so incapacitating, and that treatment might be - *if* that is the case, then a schizophrenic declining to seek treatment doesn't seem to be behaving irrationally - he's just doing cost/benefit analysis.

I strongly disagree. The CBA is biased by the fact that the costs of the mental illness are predominantly borne by others, whereas the benefits of not taking the medicine are primarily gained by the schizophrenic. That's not a good basis for a comparison. It's also not a valid decision to leave in the hands of only one individual effected by the outcome.

It's like asking people if they would like taxes reduced to 0% and let future generations pay off their social spending. A lot of people are going to say yes, especially if you specifiy the payoff will probably be several generations down the line and not with any relatives they'll ever know. But I suspect that if you got input from the eventual billees, you might get a different response.

[ultrafilter]

...the costs of the mental illness are predominantly borne by others....

This statement makes it obvious that you've done absolutely zero research on this topic, and are just spouting whatever sounds good to support your position.

If you'd like to actually learn something, I suggest you go here (http://dir.yahoo.com/Health/Diseases_and_Conditions/Schizophrenia/Personal_Experience/) and start reading.

[Lamia]

Really? You have a disease which makes you a danger to others and you have not been medicated, quarantined, or had the health department checking up on you to see that you are being treated?Nope, I just have an endocrine disorder. That makes me ill. You did say "I want to treat him like someone who is ill. Period." Not "like someone who is ill with a contagious disease" or "like someone who is ill and poses a health risk to others". "Ill" was the specific and unqualified term you used. So either you think all ill people should have medication forced upon them and be locked away if they try to resist, regardless of the type or severity of their disease, or you don't actually want to treat schizophrenics like other ill people.


Maybe you just need glasses, so you could read the word "all" in the quote. Oh, wait, you could, and now you're just purposefully ignoring the fact that I was referring to other posters in the thread in order to make a quip. :rolleyes:You do know what the word "all" means, don't you? It means "everyone", not "everyone except the person who actually wrote the post I am replying to". You might find communication easier if you could try to remember that words don't just mean whatever you want them to mean at the moment.


Bullshit. His psychiatrist diagnosed him with a medical condition that requires treatment. You have subsequently plugged up your ears and started the traditional "nu uh, not happening" routine in reference to the fact that he is ill.How do you know that it's a fact that he's ill? AHunter3 has given me no reason to doubt his honesty, but I haven't seen his medical records and it's possible that his account of events is not entirely accurate. Or perhaps the psychiatrist who made the original diagnosis was in error. I'm not willing to play doctor or start telling strangers what treatment they must undergo based solely on their limited remarks on the Internet about their past medical history. If you are, you're more a threat to public health than the average schizophrenic.


You are willing to lie, slander, and doubletalk to deny the horrible recourse I've proposedI am? Funny, I hadn't noticed. Are you sure you aren't suffering from paranoid delusions again?


He needs to take some medicine which will improve his quality of life, and they should be provided by the public if necessary.From my first post in this thread:

Personally, I think it's stupid and irresponsible for a schizophrenic to refuse medication that would help them. The key phrase being "that would help them". If the medication does not in fact improve their quality of life, I cannot see much justification for forcing it upon them.
Prove that medication will improve AHunter3's quality of life, and I'll agree that he should take it. I may not agree that it should be forced on him for his own good, but I'll certainly agree that taking it would be the right thing for him to do. But you can't prove any such thing, can you? You don't have any idea what the best course of treatment would be in this particular case, or if any treatment is necessary at all. You simply do not have the information or expertise needed to make that call.

[Qadgop the Mercotan]

laigle, your statements here demonstrate a profound ignorance of the principles of medicine in general and psychiatry in specific.

In medicine, the principle is "first, do no harm". We determine if the severity of the illness merits treatment, as treatment has a potential for harm also. This is done individually, on a case by case basis.

Forcing all people to have treatment based merely on a diagnosis violates this first principle.

QtM, MD

[laigle]

Well, since it's become more fun to troll at me instead of to discuss the topic, I'm bowing out. Do have fun.

[AHunter3]

Guinastasia, astro, and others reading this thread:

As I have already said, I can't ever get a lab test and prove I was misdiagnosed. There is no such thing as a psychiatric clean bill of health. At best I might obtain a diagnosis of "schizophrenia in remission". Mind you, I am most definitely not claiming that I was misdiagnosed, but supposing for the moment, for the sake of argument, that I was -- is there any meaningful way for me to differentiate that circumstance from that of a person who, as I'm certain laigle would put it, and as literally dozens of mental health professionals have put it to me and others with a similar diagnostic history, "are too sick to see how sick they are, and their lack of insight into their own sickness just goes to demonstrate the extent of their divorce from reality:?

Can't. The attitude and statements of laigle are entirely commonplace and accorded an enormous amount of legitimacy within the mental health system. Right now, if I were to act in a fashion that distressed people and provoked even momentary consideration of the barest possibility that I was having some kind of mental breakdown, and police or psychiatric professionals became involved and had access to the fact that I have a psychiatric history -- bang, I'm a "mentally ill person who is too sick to know that he needs psychiatric treatment and on that basis alone is a danger to himself and/or other people and therefore needs to be involuntarily detained and medicated".

Do you see that? Do you understand how futile and useless and ineffective it is and would be for me to try to draw any attention to any of these issues from a starting point of "I'm not really mentally ill, they misdiagnosed me and all this terrible shit happened to me, and I'm at risk of being revictimized" -- ??

But even if you grant all that, even if you're nodding by this point, perhaps you are thinking, "Yeah, but AHunter3, surely most of the people who get a psych diagnosis are, you know, out of touch with reality and unable to do abstract reasoning and do things like posit the possiblity that they are nuts long enough to argue that they aren't, and therefore what applies to you doesn't necessarily apply to the genuinely psychotic paranoid schizophrenic mentally ill, or at least doesn't apply in the same way."

Um. Well, I don't know if this makes the whole deal more Kafkaesque or less so, but the truth of the matter is that on the occasions when I've been on the locked ward as an involuntary resident, the other people there weren't dramatically different from me. A continuum, sure, but plenty of folks who could sign up for and participate on this board and not stand out as unusually nutty or unfocused. Plenty of folks who could attend Dopefests in person with the same results. Plenty of folks who could work at your place of employment or attend and participate in your college courses and not strike you as being wrong-in-the-head. Which means, inversely, that it could happen to you. Yes, you. Don't kid yourself that it couldn't.

They don't have to find schizophrenerase proteins in your bloodstream or discover paranotic breakdown products in your urine. All that has to happen is that a psychiatrist, in an institution at risk of bad publicity and possible lawsuits if they say you're OK and release you only to have you do something violent, decides that your behavior -- as reported by people who could be your neighbors, employers, coworkers, ex-spouses, parents, children, dorm supervisors, private condominium security chiefs, or whatever -- is sufficiently similar to what he or she thinks of as "symptomatic of mental illness", or sufficiently troubling in and of themselves, to warrant holding you and writing something on the line for diagnostic criterion. They aren't required to observe any of these troubling behaviors themselves. (But your reaction to being held can sure be added to the list as confirmation. I'm not sure what reaction they think of as "how a non-psychotic person would react to being held as mentallly ill and dangerous", but it isn't freaking out and it isn't being calm and accepting it, I can tell you that much.)

If "you are mentally ill" is viewed as a fact, then anything you do to challenge it is an illustration that you deny facts. Ain't that convenient and cute?

No need to bust liagle's chops. Not for demonstrating right here in front of you the very reason we feel the need for a political civil rights movement for lunatics. If you're inclined to dislike what you hear from liagle, come join us in confronting the psychiatric establishment for embodying the very same attitudes and implementing them in their policies.

[Guinastasia]

I'm not saying you aren't schizophrenic, or that you are, even. Just that you seem to cope very well, or else it doesn't seem to affect you as badly. Maybe it's just we all hear the horror stories of people with schizophrenia who aren't on meds and such. (I think I've watched enough ER and Law & Order to give me that impression!)

Again, I want to ask, is there research being done, to try and find treatment that would NOT result in being drugged up, as it seems currently? Because I have an anxiety disorder (of course, neurosis is different from a psychosis), and am on meds, and all they allow me to do is function as I would WITHOUT my anxiety disorder.

So, will there, someday, perhaps be away to do this with schizophrenia-a person could live without the horrible symptoms of this disorder?

[Zagadka]

I'm not saying you aren't schizophrenic, or that you are, even. Just that you seem to cope very well, or else it doesn't seem to affect you as badly.
A schizophrenic can sit here and type on a computer pretty freely. You have time to collect your thoughts, the paranoia isn't (always) there. I actually feel quite safe locked in my room. The thing about schizophrenia is that you can seem OK some of the time.

For me, I am only affected when I'm around people.


Maybe it's just we all hear the horror stories of people with schizophrenia who aren't on meds and such. (I think I've watched enough ER and Law & Order to give me that impression!)
Because TV dramas are a good source for psychological education. :rolleyes:


Again, I want to ask, is there research being done, to try and find treatment that would NOT result in being drugged up, as it seems currently?
Of course, but it seems that schizophrenia is a disorder in the brain, so drugs will probably be the only option.


So, will there, someday, perhaps be away to do this with schizophrenia-a person could live without the horrible symptoms of this disorder?
Sure, right after they cure cancer and AIDS.

[AHunter3]

Thanks, Guin :)

Let's say that one day you were on the worst day of misery after a really bad breakup and went out drinking with your friends to cheer up; one of your friends was a bit sillier and inclined towards juvenile mischief than you usually are but in your mood of the time it felt liberating to act out and feel like you just don't give a fuck anymore, ya know? So when your silly friend describes a time in high school when they put Fab detergent in the public fountain you decide the bunch of you is gonna do so tonight, and she goes in with you and y'all buy the soap and put it in the fountain, and then you jump in the fountain and talk about how they do these bubble parties somewhere that you're read about, and hey your other friends start making like wet blankets and won't join in and after awhile, leave; and you get a but sulky but stay splashing in the fountain in the soap suds when the cops show up. And at the police station your friend manages to make sense but you alternate between giddy/silly and crying about your boyfriend and you sass the cops some in your giddier moments.

Now pretend that was a decade and a half ago, you were in the mental bin for only two months and except for when you hang out with your friends and reminisce you don't think about it much. You get written up in the Regional News for the contract work you've done on the Chamber of Commerce and the reporter asks you for a brief bio. You gonna put down that you are a former mental patient?

But if you go berserk and take a rifle to the elementary school and shoot holes in random faculty members after your proposal to the School Board gets voted down, will it make the papers that an untreated mental patient just mowed down a bunch of schoolteachers? If the record is in any fashion available to the press's investigations, or that of the police looking into things, it will be.

That's a big part of the reason y'all don't have much experience with together-sounding schizophrenics. Those of us who manage to dig out and get the lines to meet at right angles again don't generally advertise this aspect of our past. Furthermore, those of us who can "pass" tend to put a hell of a lot more energy into poise and distinctively recognizable self-control and calculated rational thinking and detachments from seeing and describing only the viewpoints we think are valid, at the expense of ways of thinking and being in this world which were harmless and also more "us", at least until the nuthouse shit happened to us. Being locked up for being fervent and emphatic and wrapped up in your own strongly-felt but very unusual views will sure as hell teach you the tactical value of stepping outside yourself and planning how you're going to come across. Especially if you're going to wear a sign that says, in essence, "Hi, I'm a crazy fucker, an escaped paranoid schizophrenic". For all I know, someone like laigle is going to decide it's his civic duty to trace my real identity and call the cops cuz there's a maniac on the loose at <my home address>". So I play it cold like I have to be an attorney arguing for AHunter3 instead of just being AHunter3.

Research...

There's a fair amount of research but most of us in the movement feel like the effort and money goes to the big dogs that bark up what we think of as the same old wrong trees: pharmaceutical trials and other narrowly-conceptualized medical-model projects that still assume the constellation of feelings and perceptions and externally observable behaviors we call schizophrenia are a single disease, physiological and monocausal in nature.

What we think works, and therefore where we'd like to see the research and pilot-project money go, is into creating "safe homes" such as Zuzu's Place in Boston and the Vancouver Emotional Emergency Center of old in Vancouver -- places where you can check in and devote your attention to sorting out your head without worrying for the time being about stability or how you appear to others. Places where no one is trying to get you to take psych meds. Places where you aren't assumed to lack competency and decision-making authority. In practice, that has always meant user-run self-help centers, and while we do get funding for "day centers" / "outreach centers" such as Boston's Ruby Rogers Advocacy and Drop-in Center, the most significant unmet need for us is safe places to go when we think we're going nuts, to be in an environment of other kindred spirits who know what it's like and who know how to be supportive without being intrusive. (Other successful user-run projects include Howie the Harp's "All-the-Way Housing" project for homeless folks with psych histories in California and a similar one somewhere in Florida that activist Sally Zinman was involved in). Upstate in New York, George Ebert is doing some cool stuff with the Mental Health Alliance group, and David Oaks has a coalition group in Oregon with some self-help initiatives.

The most meaningful research I've run across seems to indicate that all other things being equal, the factor most likely to result in a patient's staying out of psych hospitals permanently and becoming self-supporting in the community is getting off psych meds and staying off them and having no further contact with the mental health system. Now, that's a finding that should provoke a lot of initial skepticism, since if some third factor causes someone to get well to the point they don't need psych meds, then both the absense of psych meds and the lowered rate of subsequent psych hospitalizations and/or system dependency would be explained by that third factor, rather than the absence of psych meds explaining the lower hospitalization and dependency rate. Still, for people who think of the meds as the answer, or as the best answer we've got, it should prompt at least a moment's pause. Me, I think it means exactly what it purports to mean. When you stay on schizophrenia meds, your capacities are impaired and you are brought into regular ongoing contact with the mental health system, and you internalize more of a sense of yourself as a sick and limited person as well as having that identity thrust more upon you by others. If, on the other hand, you successfully wean off them, and steer clear of the psychiatric system, you'll at least some of the time, in some cases, learn to deal with who you are and how you are different, and how you have to cope with the world as a consequence.

If those skills are picked up by us on our own individually at least some of the time, as seems to be the case, it seems to me that the smart money is on us helping each other as a community and serving as each other's extended care and support system.

And that's the therapy they should be researching.

[AHunter3]

Zagadka, I just expect less of people-contact and relationships.

I don't know if I've got missing pieces and stuff or not, and I do get piercingly lonely at times -- yes I will admit that it bothers me that I can be on this board since 1997 and somone will pop up out of nowhere and post prolific and soon they are popular and people care about them personally, and I will just not have that effect on them, or vice versa, and will always be experienced in a more mono-dimensional way, and it's not just here on this board it is everywhere and always, I will never ever be part of any group, really, and will always have times of feeling like I only thought I was at the party and in real life was just standing outside in the garden in the dark looking in the window pretending -- but other times I feel like everyone else is dancing the same few limited and worn-out set of thought-dances and experience-dances, sleepwalking through life just believing what everyone else around them believes, most of them long since having stopped trying to figure out anything if they ever did and instead just adopting and adapting and fitting in so they won't have to worry about being wrong and being thought wrong, and then I feel like I'm the lucky one, the free one. And a lot of the time I am not lonely because I feel emotionally self-sufficient. As long as I have some human contact and companionship some of the time, it doesn't greatly matter with whom I have it or if there is a great deal of continuity there.

How is it for you, the "other people thing"?

I hate the psych drugs. Brain-rape. Rather be dead. I totally support your right to take them if they help you, just as I totally support your right not to if you don't want to.

Do you socialize with other schizzies in your area? Any in the rights movement? Curious, want any contacts?

[Guinastasia]

Zagadka, you don't have to be so hostile. My point was, I don't know a lot about schizophrenia, and common perception seems to make it worse.

I wasn't suggesting a cure-I was saying maybe they'll find a drug that will be able to TREAT it as there are drugs to treat various anxiety disorders and depression.

[GorillaMan]

I wasn't suggesting a cure-I was saying maybe they'll find a drug that will be able to TREAT it as there are drugs to treat various anxiety disorders and depression.
Pharmacalogical treatment of anxiety and depression is little simpler than for schizophrenia.

[Lamia]

I wasn't suggesting a cure-I was saying maybe they'll find a drug that will be able to TREAT it as there are drugs to treat various anxiety disorders and depression.Given what little I know about psychiatric drugs and drug developent in general, I think it's reasonable to expect that the future will bring antipsychotics with fewer side effects. Drugs that would do a better job of treating the actual symptoms of schizophrenia are probably a long way off, though. The causes of schizophrenia still aren't well understood, and there may be factors involved that wouldn't respond to drug treatment at all.

I don't know the current research on schizophrenia, but I do know that many people suffering from other mental illnesses or even serious cognitive disabilities have benefited greatly from behavioral therapy and other non-pharmaceutical treatments. As AHunter3 mentioned, it is sometimes possible for people with mental health issues to learn how to better function in society and interact "normally" with others. This is true even with people suffering from disorders associated with aggressive, unpredictable behavior that might pose a threat to others. Of course medication may also be helpful, but pills alone are often not enough.

[GorillaMan]

The causes of most mental illnesses and disorders are little-understood. In many cases, such as with depressive illnesses (lumping it all under 'depression' is misleading in this context), there is a complex combination of genetic, behavioural, habitual and chemical causes. In some cases pharmaceuticals are enough my themselves; in other cases behavioural therapies work, in yet others psychotherapy. However, sometimes no solution can be found.

In some ways, schizophrenia should be simpler. There is more evidence that it is a result of specific abnormalities in brain function, perhaps more comparable to something like epilepsy. At the moment, drugs only treat the symptoms. And with a definite physiological cause, behavioural and psychological therapies are unlikely to be able to do much good by themselves.

[Lamia]

In some ways, schizophrenia should be simpler. There is more evidence that it is a result of specific abnormalities in brain function, perhaps more comparable to something like epilepsy. At the moment, drugs only treat the symptoms. And with a definite physiological cause, behavioural and psychological therapies are unlikely to be able to do much good by themselves.I'm not sure this is the case. It may be so with schizophrenia, I don't know, but it's not true of all disorders with a physiological cause. For instance, Fragile X Syndrome is caused by an abnormality on the X chromosome (hence the name) that leads to low levels of a particular protein needed by nerve cells in the brain. Someday there might be a form of gene therapy that could truly cure this condition, but although their condition has a physiological cause people with FXS can and do benefit from behavioral therapy -- in some cases dramatically. Similarly, the only established treatments for autism are non-pharmaceutical.

Medication may be used to treat problems associated with both FXS and autism, but there's not anything available that really helps with the core disorders. If medications could be found that would help then combination therapy would probably be more effective than non-pharmaceutical treatment alone, but in the meantime well-implemented behavioral therapy can do a lot of people a lot of good. The brain is a truly amazing organ with great potential to adapt and grow. Behavioral therapy can actually encourage it to change in beneficial ways. This is especially true in children, but it can work with adults too. Some people don't show much improvement even with therapy, but that doesn't mean they couldn't potentially be helped by new and improved methods.