11 ms·

The concept of schizophrenia is dying

118 points by LiweiZ 9y ago

tcj_phx 9y ago
I think a good case can be made that many of these "mental disorders" are actually metabolic problems. There are many causes behind an individual's metabolic problem that leads to schizophrenia/dementia/psychosis/(edit3: depression)/etc... Sometimes people are malnourished. The B-vitamins are important cofactors for metabolic activity. An old/new treatment for "schizophrenia" is Vitamin B3 [0]. My girlfriend's treatment provider did a genetic test this past summer and found that she's a poor methylator. This means that she doesn't convert folic acid (synthetic Vitamin B-9) into folate very well. They've put her on prescription folate [1], and she's doing much better than when she was just double-tranquilized. I asked the biochemist about this issue, and he said that when on a good diet with folate-rich foods (liver, etc), even 'mutants' get plenty of folate. [0] https://www.madinamerica.com/2017/06/schizophrenia-deconstructed/ https://www.madinamerica.com/2017/06/schizophrenia-deconstru... [1] https://en.wikipedia.org/wiki/Levomefolic_acid https://en.wikipedia.org/wiki/Levomefolic_acid The street pharmacy's stimulants (cocaine/meth) shred the mitochondria. These are known causes of substance-induce psychotic disorders. People who drink heavily train their nervous system to become insulin-resistant and run on acetate (one of the breakdown products of ethanol). I think it's well-established that excess alcohol is inflammatory, which is also associated with psychosis. So... Cute anecdote from today. I called two attorneys because I've hit a wall in my efforts to convince my girlfriend's treatment provider that she's been misdiagnosed and is not actually benefiting from the palliative maintenance medications (anti-psychotic/etc) they're still forcing her to take. The first attorney listened to me, confirmed that it was within my legal rights to file pro-se petitions with the court, said that rural judges don't want to cause problems for their community's treatment provider, and said he couldn't help me because he'd already done some work for my girlfriend's treatment provider. He gave me the number for the second attorney. It later occurred to me that the treatment provider certainly consulted him about my suit against them. (minor edits) edit2: physical injuries and inescapable/emotional stress are drains on the body's energy-producing capacity too. My other friend's father gradually became "schizophrenic" after he broke his back falling out of a tree.
- gscott 9y ago
  Doctors are only allowed to give medications that treat a certain disorder. Experimental herbal treatments are not going to resolve a real mental disorder... you can try some vitamins but no medical professional is going to stake their medical license on it. Both of my parents had schizophrenia and it was a real hell.
  - AstralStorm 9y ago
    Well, methylation disorders have both a genetic and plain old specific blood test. Ado a good doctor can stake their license on it.
  - LyndsySimon 9y ago
    > Doctors are only allowed to give medications that treat a certain disorder. Is this true, particularly in the US? My understanding is that a doctor can prescribe basically whatever they want as long as they believe that "in their professional opinion" the potential benefit outweighs the potential harm. It's certainly common for doctors to prescribe medication "off-label" to treat conditions for which the medication is not approved by the FDA. I don't see how prescribing a specific vitamin in an attempt to impact a mental disorder is any different from, say, prescribing modafinil for ADHD?
    - gscott 9y ago
      It is true a Dr could in theory do what they want to but there are treatment guidelines and if they vary off that too much then the medical board could get after them. This happens I know a Doctor who wanted to treat lymes disease for patients and the medical board didn't like that it seems she was experimenting with what would work to treat it (this was about 15 years ago when it was pretty new).
SolaceQuantum 9y ago
I would argue that the indications of schizophrenia being associated with weed is ascribing a causative effect to a correlation. Weed doesn’t increase your chances of schizophrenia unless you already had something that would tilt you in that direction in the first place, from my experience. I would say I do agree that schizophrenia probably needs to be broken up; it was merely a collection of symptoms to begin with that couldn’t be explained by other means. Now we have explanations. I am curious how this may affect schzioaffective, schizoid, and schizotypal disorders. That they’re not mentioned st all in this article is rather disappointing.
- jwdunne 9y ago
  There exists cannabis psychosis. Naturally, more psychosis will exacerbate a psychotic illness. It usually brings it on earlier and heavier in severity i.e typically schizophrenia presents later but cannabis usage in adolescents seems to trigger it. The same is true for amphetamine. Interestingly, amphetamine has been hypothesised as a chemical model for schizophrenia. Amphetamine psychosis is extremely similar to the positive symptoms of schizophrenia. In fact, many of the treatments used for psychotic illnesses repress dopamine activity in certain receptors (the newer ones, the typical antipsychotics, are less 'targeted' than newer ones leading to Parkinsonian side effects).
  - LyndsySimon 9y ago
    > There exists cannabis psychosis. As far as I can tell, this is not generally accepted as true. At best, there is a statistical association between cannabis use in children/young adults and the later development of psychoses. As we all know, "correlation is not causation" - it may well be that those who are more likely to develop psychosis are also more likely to use cannabis and other psychoactive substances to excess.
- maxscam 9y ago
  I was diagnosed schizoid because I was a smartass and said I could "hear things that others couldn't".
Aloha 9y ago
Schizophrenia is one of those disorders that medicine has, that is likely not one discrete condition, its likely a multitude of different psychological illnesses all flying under one banner, even if the underlying psychology and physiology are quite different for different people. As we get better with medicine, we find more illnesses - for example, its part of why I think cancer is found so much more often now, while there is undoubtedly more cancer (we're living longer, as it turns out, old age is a fellow traveler of cancer), we're also much better at finding it.
- bencollier49 9y ago
  Like Asthma.
deleted 9y ago
[deleted]
vacri 9y ago
Way back in the 90s when I was doing my neurophysiology degree, one lecturer who worked with schizophrenia said that it was such a difficult disease to work with because it wasn't one disease. Traditionally, if they didn't know what was wrong with you, they just threw you in the 'one-size-fits-all' schizophrenia bucket. One example of this was that the most frequent symptom (hearing voices) was present in only 69% of cases, and all other symptoms dropped off fairly quickly from there. At the time, he thought that schizophrenia would break up into four basic groups, based on positive/negative affect (does an episode have the person doing extra activity or withdrawing) and, I think, whether or not the person has hallucinations. I haven't really kept in touch with the literature to see how his 4-way prediction went, but I have never seen anything to counter the idea that schizophrenia is more than a single disease. And, of course, classification of disease is a key element of treating it, so if schizophrenia is not being properly classified...
RHSman2 9y ago
I’d suggest that not taking a drug (weed/lsd/mushrooms) that alter ones perceptions of our very existence is a good way of staying mentally sound. If you take ten 16 yr olds, allow them to experiment, 1-2 will drop off the world, 2-3 will have major, life changing changes to the way they view life (border line changes in said spectrum) and the rest handle it fine although with a significant change in lifestyle. As someone who has had a close call with the boundaries of perception I believe weed is of significant concern. It has a ‘benign’ perception but for those it effects it can take their heads off to places which are not healthy for fitting into normal, standard life. Aka the general ‘schizophrenic’ term
- adammunich 9y ago
  How do you mean? Most folks I know who regularly use marijuana aren't close to anything I'd call schizoaffective. Those who I know whom have gone off the deep end so to say, seem to have had other troubles in life which compounded to become too much to handle for them.
  - mercer 9y ago
    It's probably a bit of column A and a bit of column B.
  - chris_wot 9y ago
    The plural of anecdote is not data.
    - Mikushi 9y ago
      Same can be said about the original comment. Nothing in there of value except some dubious extrapolations.
      - mercer 9y ago
        Yes. countering it with another anecdote doesn't really help though.
  - 9y ago
kosma 9y ago
A significant chunk of schizophrenia-diagnosed patients have already been chipped away; it turned to be autism spectrum disorder instead. I wouldn't be surprised if other such corrected diagnoses followed, gradually dismantling the schizophrenia itself altogether.
- mercer 9y ago
  On top of that I would be surprised if autism doesn't (again) split up into separate (sub-)disorders as we find out more. Sooner rather than later, I hope.
MichailP 9y ago
I love this snippet from Dr Gabor Mate [1], where he talks about "the myth of normal". If you haven't seen this, please take a look, it is truly wonderful. [1] https://www.youtube.com/watch?v=8_j5mmBa4mw https://www.youtube.com/watch?v=8_j5mmBa4mw
thanatropism 9y ago
There's something important the article seems to be getting wrong: psychosis is a symptom, not a disease. There are such things as psychotic depression and post-partum depression; psychosis is a symptom of severe bipolar mania, etc. By the way, the concept of schizophrenia first comes up in Emil Kraepelin's realization that bipolar disorder (manic-depression) and schizophrenia ("precocious dementia") are distinct pathologies -- even though they may have similar presentations at times. With this, Kraepelin also inaugurates the idea of differential diagnosis. Similar in spirit (but less compatible with our contemporary understanding) is Freud's distinction between neurosis and "psychosis", the former being amenable to analysis. I.e. schizophrenia has always been a diagnosis of exclusion. If people are actually being able to open up schizophrenia into further detail -- well, that's good. But there will always be a diagnosis of exclusion, we'll just euphemize it as "psychotic disorder NOS" or some such.
- Pica_soO 9y ago
  Freud is dead. Dead and gone. We moved on. Really, i know he founded the field and made for a nice soap opera gossip generator when discussing other peoples problems sources (generating alot of unnecessary drama, to people who already had drama, like having the genes for schizophrenia in the family)- so please could we stop mentioning him, when discussing modern neurology. Its like a tribe on a pacific island had discovered boolean algebra first, and every time somebody tried to discuss comp science ever after - out of nowhere someone yells "This calls for a ritual, sacrifice the chicken, you cant discuss booleans, without being ridden by baron samedi."
  - ivkustov 9y ago
    We actually shouldn't. The psychoanalysis is contempted and forgotten however psychoanalysis is something like a computer language, the language of human inner world. Some kind of lisp with probably terrible interpreter. The modern neuroscience is of course something like an assembler. So lisp or assembler? If you want to write modern OS, then you know the answer. The Freud, Jung, Lacan theory is related to psychotherapeutic work is like automata theory relationships to writing modern enterprise applications. I don't believe there is something 'true' or 'objective' in psychoanalysis - deep inside is some ocean, some chaos of different introjections, emotions and feelings. But the psychoanalysis helps to create structure there, to look and make sense out of the ocean. There is no substitude for psychoanalysis except really good prose probably or poetry. And of course Freud was a genius.
DanBC 9y ago
The UK British Psychological Society recently released an update to their Understanding Psychosis and Schizophrenia report. People may be interested in it. http://www.bps.org.uk/networks-and-communities/member-microsite/division-clinical-psychology/understanding-psychosis-and-schizophrenia http://www.bps.org.uk/networks-and-communities/member-micros... It's had some criticism: it includes a bunch of people who probably aren't psychotic (auditory hallucinations are common, and not always a sign of illness, for example), and it appears to exclude a bunch of people who have severe forms of illness. Here are two blog posts that give a thorough, evidence based, review: https://www.nationalelfservice.net/publication-types/report/understanding-psychosis-and-schizophrenia-a-critique-by-laws-langford-and-huda/ https://www.nationalelfservice.net/publication-types/report/... https://www.nationalelfservice.net/mental-health/psychosis/understandingpsychosis/ https://www.nationalelfservice.net/mental-health/psychosis/u...
bane 9y ago
I grew up with a close uncle who suffered for decades from this disease. The tales of his brilliant youth, on track as a naval nuclear engineer, are only more tragic to the shattered shell of a man I knew. Most of his treatment involved a cocktail mix of a dozen or so "medicines" who's primary purpose appeared to be to keep him sedated for long stretches of the day. He was absolutely unable to hold a job, or even a coherent conversation, and was in and out of half-way houses and treatment programs. At times he would get violent to himself or others as various psychotic fantasies moved him to be. He famously assaulted my sister one day before my father sent him away to stay with my mother's family (of which he was a sibling)...when he remembered the event at all he insisted he was trying to save her from one of a variety of fantastic and impossible sequences of events. Often in tears trying to explain what he had been trying to do, the family eventually concluded that in his mind he was trying to do a good thing and help against some imaginary evil, but his reality was so distorted it had turned into harm and that we simply couldn't risk his presence any further. Drugs of various levels of legality were a constant feature of his life. It was well known that he ended up dropping out of the Navy as a pot head that morphed into a serious cocaine and lsd user. Much of his treatment in his later years was trying to get him to stop self-medicating and to let the professionals provide the legal stuff. He made it to his 60s before a tumble in the bathroom knocked him unconscious and sent him into a hospital bed where he never woke up. Another Uncle, the guardian of his estate, made the decision to take him off of life support and hope his next chance turned out better than this one. His autopsy wasn't revealing, his system was basically a mobile pharmacy and narcotics evidence locker combined, but it still devastated the siblings who had tried to help him find his way back to the brilliant 20 year old they last remember.
- deleted 9y ago
  [deleted]
- I_am_tiberius 9y ago
  I know somebody who was brilliant (I mean brilliant as hell) as well until the age of about 20. He started suffering from bipolar disorder later on (at about 23). Between that age he was registered at university but was not attending it. Instead he was partying all the time. I noticed him acting odd first when he came back from a trip to the other side of the world - my impression was that the jet-lag in combination with alcohol consumption and the realization that other people made a lot of progress during the years he was partying helped initiating the illness. I think summarized the factors were lack of sleep, alcohol, stress and high vulnerability due to inheritance. Therefore I think the best way to prevent this illness is: - Avoid stress, especially in your 20's - Try to have an ordered life - Get enough sleep - Avoid too much alcohol consumption - Do sports (rarely a mistake I assume) - Take jet-lags seriously I am not sure if drugs (from the trip to the other side of the world) were involved. It is possible but I doubt it.

118 points by LiweiZ 9y ago

I think a good case can be made that many of these "mental disorders" are actually metabolic problems. There are many causes behind an individual's metabolic problem that leads to schizophrenia/dementia/psychosis/(edit3: depression)/etc... Sometimes people are malnourished. The B-vitamins are important cofactors for metabolic activity. An old/new treatment for "schizophrenia" is Vitamin B3 [0]. My girlfriend's treatment provider did a genetic test this past summer and found that she's a poor methylator. This means that she doesn't convert folic acid (synthetic Vitamin B-9) into folate very well. They've put her on prescription folate [1], and she's doing much better than when she was just double-tranquilized. I asked the biochemist about this issue, and he said that when on a good diet with folate-rich foods (liver, etc), even 'mutants' get plenty of folate. [0] https://www.madinamerica.com/2017/06/schizophrenia-deconstructed/ https://www.madinamerica.com/2017/06/schizophrenia-deconstru... [1] https://en.wikipedia.org/wiki/Levomefolic_acid https://en.wikipedia.org/wiki/Levomefolic_acid The street pharmacy's stimulants (cocaine/meth) shred the mitochondria. These are known causes of substance-induce psychotic disorders. People who drink heavily train their nervous system to become insulin-resistant and run on acetate (one of the breakdown products of ethanol). I think it's well-established that excess alcohol is inflammatory, which is also associated with psychosis. So... Cute anecdote from today. I called two attorneys because I've hit a wall in my efforts to convince my girlfriend's treatment provider that she's been misdiagnosed and is not actually benefiting from the palliative maintenance medications (anti-psychotic/etc) they're still forcing her to take. The first attorney listened to me, confirmed that it was within my legal rights to file pro-se petitions with the court, said that rural judges don't want to cause problems for their community's treatment provider, and said he couldn't help me because he'd already done some work for my girlfriend's treatment provider. He gave me the number for the second attorney. It later occurred to me that the treatment provider certainly consulted him about my suit against them. (minor edits) edit2: physical injuries and inescapable/emotional stress are drains on the body's energy-producing capacity too. My other friend's father gradually became "schizophrenic" after he broke his back falling out of a tree.

gscott 9y ago
Doctors are only allowed to give medications that treat a certain disorder. Experimental herbal treatments are not going to resolve a real mental disorder... you can try some vitamins but no medical professional is going to stake their medical license on it. Both of my parents had schizophrenia and it was a real hell.
- AstralStorm 9y ago
  Well, methylation disorders have both a genetic and plain old specific blood test. Ado a good doctor can stake their license on it.
- LyndsySimon 9y ago
  > Doctors are only allowed to give medications that treat a certain disorder. Is this true, particularly in the US? My understanding is that a doctor can prescribe basically whatever they want as long as they believe that "in their professional opinion" the potential benefit outweighs the potential harm. It's certainly common for doctors to prescribe medication "off-label" to treat conditions for which the medication is not approved by the FDA. I don't see how prescribing a specific vitamin in an attempt to impact a mental disorder is any different from, say, prescribing modafinil for ADHD?
  - gscott 9y ago
    It is true a Dr could in theory do what they want to but there are treatment guidelines and if they vary off that too much then the medical board could get after them. This happens I know a Doctor who wanted to treat lymes disease for patients and the medical board didn't like that it seems she was experimenting with what would work to treat it (this was about 15 years ago when it was pretty new).

SolaceQuantum 9y ago

I would argue that the indications of schizophrenia being associated with weed is ascribing a causative effect to a correlation. Weed doesn’t increase your chances of schizophrenia unless you already had something that would tilt you in that direction in the first place, from my experience. I would say I do agree that schizophrenia probably needs to be broken up; it was merely a collection of symptoms to begin with that couldn’t be explained by other means. Now we have explanations. I am curious how this may affect schzioaffective, schizoid, and schizotypal disorders. That they’re not mentioned st all in this article is rather disappointing.

jwdunne 9y ago
There exists cannabis psychosis. Naturally, more psychosis will exacerbate a psychotic illness. It usually brings it on earlier and heavier in severity i.e typically schizophrenia presents later but cannabis usage in adolescents seems to trigger it. The same is true for amphetamine. Interestingly, amphetamine has been hypothesised as a chemical model for schizophrenia. Amphetamine psychosis is extremely similar to the positive symptoms of schizophrenia. In fact, many of the treatments used for psychotic illnesses repress dopamine activity in certain receptors (the newer ones, the typical antipsychotics, are less 'targeted' than newer ones leading to Parkinsonian side effects).
- LyndsySimon 9y ago
  > There exists cannabis psychosis. As far as I can tell, this is not generally accepted as true. At best, there is a statistical association between cannabis use in children/young adults and the later development of psychoses. As we all know, "correlation is not causation" - it may well be that those who are more likely to develop psychosis are also more likely to use cannabis and other psychoactive substances to excess.
maxscam 9y ago
I was diagnosed schizoid because I was a smartass and said I could "hear things that others couldn't".

Aloha 9y ago

Schizophrenia is one of those disorders that medicine has, that is likely not one discrete condition, its likely a multitude of different psychological illnesses all flying under one banner, even if the underlying psychology and physiology are quite different for different people. As we get better with medicine, we find more illnesses - for example, its part of why I think cancer is found so much more often now, while there is undoubtedly more cancer (we're living longer, as it turns out, old age is a fellow traveler of cancer), we're also much better at finding it.

bencollier49 9y ago
Like Asthma.

deleted 9y ago

[deleted]

vacri 9y ago

Way back in the 90s when I was doing my neurophysiology degree, one lecturer who worked with schizophrenia said that it was such a difficult disease to work with because it wasn't one disease. Traditionally, if they didn't know what was wrong with you, they just threw you in the 'one-size-fits-all' schizophrenia bucket. One example of this was that the most frequent symptom (hearing voices) was present in only 69% of cases, and all other symptoms dropped off fairly quickly from there. At the time, he thought that schizophrenia would break up into four basic groups, based on positive/negative affect (does an episode have the person doing extra activity or withdrawing) and, I think, whether or not the person has hallucinations. I haven't really kept in touch with the literature to see how his 4-way prediction went, but I have never seen anything to counter the idea that schizophrenia is more than a single disease. And, of course, classification of disease is a key element of treating it, so if schizophrenia is not being properly classified...

RHSman2 9y ago

I’d suggest that not taking a drug (weed/lsd/mushrooms) that alter ones perceptions of our very existence is a good way of staying mentally sound. If you take ten 16 yr olds, allow them to experiment, 1-2 will drop off the world, 2-3 will have major, life changing changes to the way they view life (border line changes in said spectrum) and the rest handle it fine although with a significant change in lifestyle. As someone who has had a close call with the boundaries of perception I believe weed is of significant concern. It has a ‘benign’ perception but for those it effects it can take their heads off to places which are not healthy for fitting into normal, standard life. Aka the general ‘schizophrenic’ term

adammunich 9y ago
How do you mean? Most folks I know who regularly use marijuana aren't close to anything I'd call schizoaffective. Those who I know whom have gone off the deep end so to say, seem to have had other troubles in life which compounded to become too much to handle for them.
- mercer 9y ago
  It's probably a bit of column A and a bit of column B.
- chris_wot 9y ago
  The plural of anecdote is not data.
  - Mikushi 9y ago
    Same can be said about the original comment. Nothing in there of value except some dubious extrapolations.
    - mercer 9y ago
      Yes. countering it with another anecdote doesn't really help though.
- 9y ago

kosma 9y ago

A significant chunk of schizophrenia-diagnosed patients have already been chipped away; it turned to be autism spectrum disorder instead. I wouldn't be surprised if other such corrected diagnoses followed, gradually dismantling the schizophrenia itself altogether.

mercer 9y ago
On top of that I would be surprised if autism doesn't (again) split up into separate (sub-)disorders as we find out more. Sooner rather than later, I hope.

MichailP 9y ago

I love this snippet from Dr Gabor Mate [1], where he talks about "the myth of normal". If you haven't seen this, please take a look, it is truly wonderful. [1] https://www.youtube.com/watch?v=8_j5mmBa4mw https://www.youtube.com/watch?v=8_j5mmBa4mw

thanatropism 9y ago

There's something important the article seems to be getting wrong: psychosis is a symptom, not a disease. There are such things as psychotic depression and post-partum depression; psychosis is a symptom of severe bipolar mania, etc. By the way, the concept of schizophrenia first comes up in Emil Kraepelin's realization that bipolar disorder (manic-depression) and schizophrenia ("precocious dementia") are distinct pathologies -- even though they may have similar presentations at times. With this, Kraepelin also inaugurates the idea of differential diagnosis. Similar in spirit (but less compatible with our contemporary understanding) is Freud's distinction between neurosis and "psychosis", the former being amenable to analysis. I.e. schizophrenia has always been a diagnosis of exclusion. If people are actually being able to open up schizophrenia into further detail -- well, that's good. But there will always be a diagnosis of exclusion, we'll just euphemize it as "psychotic disorder NOS" or some such.

Pica_soO 9y ago
Freud is dead. Dead and gone. We moved on. Really, i know he founded the field and made for a nice soap opera gossip generator when discussing other peoples problems sources (generating alot of unnecessary drama, to people who already had drama, like having the genes for schizophrenia in the family)- so please could we stop mentioning him, when discussing modern neurology. Its like a tribe on a pacific island had discovered boolean algebra first, and every time somebody tried to discuss comp science ever after - out of nowhere someone yells "This calls for a ritual, sacrifice the chicken, you cant discuss booleans, without being ridden by baron samedi."
- ivkustov 9y ago
  We actually shouldn't. The psychoanalysis is contempted and forgotten however psychoanalysis is something like a computer language, the language of human inner world. Some kind of lisp with probably terrible interpreter. The modern neuroscience is of course something like an assembler. So lisp or assembler? If you want to write modern OS, then you know the answer. The Freud, Jung, Lacan theory is related to psychotherapeutic work is like automata theory relationships to writing modern enterprise applications. I don't believe there is something 'true' or 'objective' in psychoanalysis - deep inside is some ocean, some chaos of different introjections, emotions and feelings. But the psychoanalysis helps to create structure there, to look and make sense out of the ocean. There is no substitude for psychoanalysis except really good prose probably or poetry. And of course Freud was a genius.

DanBC 9y ago

The UK British Psychological Society recently released an update to their Understanding Psychosis and Schizophrenia report. People may be interested in it. http://www.bps.org.uk/networks-and-communities/member-microsite/division-clinical-psychology/understanding-psychosis-and-schizophrenia http://www.bps.org.uk/networks-and-communities/member-micros... It's had some criticism: it includes a bunch of people who probably aren't psychotic (auditory hallucinations are common, and not always a sign of illness, for example), and it appears to exclude a bunch of people who have severe forms of illness. Here are two blog posts that give a thorough, evidence based, review: https://www.nationalelfservice.net/publication-types/report/understanding-psychosis-and-schizophrenia-a-critique-by-laws-langford-and-huda/ https://www.nationalelfservice.net/publication-types/report/... https://www.nationalelfservice.net/mental-health/psychosis/understandingpsychosis/ https://www.nationalelfservice.net/mental-health/psychosis/u...

bane 9y ago

I grew up with a close uncle who suffered for decades from this disease. The tales of his brilliant youth, on track as a naval nuclear engineer, are only more tragic to the shattered shell of a man I knew. Most of his treatment involved a cocktail mix of a dozen or so "medicines" who's primary purpose appeared to be to keep him sedated for long stretches of the day. He was absolutely unable to hold a job, or even a coherent conversation, and was in and out of half-way houses and treatment programs. At times he would get violent to himself or others as various psychotic fantasies moved him to be. He famously assaulted my sister one day before my father sent him away to stay with my mother's family (of which he was a sibling)...when he remembered the event at all he insisted he was trying to save her from one of a variety of fantastic and impossible sequences of events. Often in tears trying to explain what he had been trying to do, the family eventually concluded that in his mind he was trying to do a good thing and help against some imaginary evil, but his reality was so distorted it had turned into harm and that we simply couldn't risk his presence any further. Drugs of various levels of legality were a constant feature of his life. It was well known that he ended up dropping out of the Navy as a pot head that morphed into a serious cocaine and lsd user. Much of his treatment in his later years was trying to get him to stop self-medicating and to let the professionals provide the legal stuff. He made it to his 60s before a tumble in the bathroom knocked him unconscious and sent him into a hospital bed where he never woke up. Another Uncle, the guardian of his estate, made the decision to take him off of life support and hope his next chance turned out better than this one. His autopsy wasn't revealing, his system was basically a mobile pharmacy and narcotics evidence locker combined, but it still devastated the siblings who had tried to help him find his way back to the brilliant 20 year old they last remember.

deleted 9y ago
[deleted]
I_am_tiberius 9y ago
I know somebody who was brilliant (I mean brilliant as hell) as well until the age of about 20. He started suffering from bipolar disorder later on (at about 23). Between that age he was registered at university but was not attending it. Instead he was partying all the time. I noticed him acting odd first when he came back from a trip to the other side of the world - my impression was that the jet-lag in combination with alcohol consumption and the realization that other people made a lot of progress during the years he was partying helped initiating the illness. I think summarized the factors were lack of sleep, alcohol, stress and high vulnerability due to inheritance. Therefore I think the best way to prevent this illness is: - Avoid stress, especially in your 20's - Try to have an ordered life - Get enough sleep - Avoid too much alcohol consumption - Do sports (rarely a mistake I assume) - Take jet-lags seriously I am not sure if drugs (from the trip to the other side of the world) were involved. It is possible but I doubt it.