Recovery from "schizophrenia" and other "psychotic disorders"

A recent, easy to read article on stress, titled “Brain is a co-conspirator in a vicious stress loop” it is pointed out that when we are chronically stressed, our brain rewires itself in ways that sometimes perpetuate stress.

What happens is that the parts of our brains which just do habitual behavior get stronger, while the parts of the brain that are good at making wise executive decisions get weaker. (The article uses the example of rats that keep pressing a lever to get food, even though they aren’t hungry.)  Such reversion to strong habits may be helpful in some emergencies, which may be why our brains work that way, but this tends to be very unhelpful in chronic stress situations. Instead, we find ourselves carrying out habits that may not make any good sense, while we have a hard time thinking up new things to try or bringing any kind of wisdom or cunning to our decision making.

So that’s how stress can make us stupid. A further point, not covered in the article mentioned above, is how stressing about these changes can amplify the stress and make us truly crazy! More »

In the attempt to convince people to take medications, the hazards of such medications are often minimized or overlooked. While many people may truly be better off taking some medications, at least for awhile, the danger in hiding the hazards of the drugs is that rational decisions about how long to stay on medications, at what dosage, and how hard to try to find alternatives, become impossible. Instead, an illusion is created that the only rational approach is to stay on medications indefinitely, because only an irrational person would risk the return of a destructive psychosis.

If we really allowed ourselves to face all the facts however, we would see that these decisions are much more complex. For example, while the effects of being caught up in psychosis can be terrible, the effects of the antipsychotic medications can be terrible as well. These medications significantly increase the risk of death, due to causing things like heart problems, metabolic syndrome, obesity, diabetes etc. And, while most of psychiatry is still in denial about it, it appears that antipsychotic medications have a tendency to shrink brains. (For those of you unfamiliar with the evidence for this effect, I include some references and other information at the end of this post.)

Some people might think that if antipsychotic medications will shrink the consumer’s brain and then possibly kill them, then the obvious decision is to just get off the medications as quickly as possible. However, the problem is that it appears that uncontrolled psychosis, and its associated distress, will also shrink a person’s brain and very possibly kill them (besides making a total mess of their life in other ways.) More »

A lot of efforts to transform an often oppressive mental health have focused on “recovery” and making the mental health system more “recovery focused.” Many agencies have integrated the notion of recovery into their practice, and if the use of this word were a measure of progress, we would be well on our way to system transformation! Unfortunately, what seems to be happening is that as the word “recovery” is used more and more, it seems to mean less and less. I know someone for example who is on heavy doses of an antipsychotic as well as other medications, lives in a foster care home, and spends most of his daytime hours in a mental health day treatment program, yet is assured by his case managers that he is “recovered.”

More at this recovery page.

Changing focus is a key part of recovery: to recover from a “symptom” it is often necessary to quit focusing on trying to get rid of the symptom, at least in any direct way!

This is true of a great many kinds of mental health “symptoms.” The problem is that the things people do to control the “symptom” in the short run usually make both the “symptom” and the person’s life worse in the long run.

Let’s look at “anxiety” as one example. A man may perceive himself as having “too much” anxiety. In response, he avoids doing or thinking anything that creates more anxiety. As a result, he fails to learn that he could actually survive doing or thinking those things, and as a result of avoidance and hiding, he feels smaller and weaker and of course, more anxious. Also, because he is focused on reducing anxiety rather than getting on with his life, he becomes hypervigilant for more signs of anxiety, so he notices anxiety more often and it seems to get worse, etc. He may even take pills to avoid feeling the anxiety: this may work briefly, but when the pills wear off anxiety is even higher, plus as a result of using pills to manage the anxiety, he feels even less competent to manage the anxiety without the pills.

“Depression” is another example, it works much the same way. More »