7 ms·

There's a really interesting line of research that suggests Schizophrenia is a spectrum, rather than a binary. Lots of people have personality traits that are s

There's a really interesting line of research that suggests Schizophrenia is a spectrum, rather than a binary. Lots of people have personality traits that are similar to schizophrenics or have genetic risk factors for the condition. Some of those people develop the full disorder, and some don't. There's evidence that the reason for the split is that psychosis is itself damaging. Once someone has a psychotic episode, they are much likelier to have more. But the earlier a psychotic episode is interrupted, by anti-psychotics or therapy, the better outcomes are. So the implication is that many people have some degree of vulnerability to schizophrenia, and only those who have psychotic breaks develop the full condition. That's a possible causal explanation for a link between marijuana and schizophrenia. Someone who's got some vulnerability to psychosis, but wouldn't otherwise have developed schizophrenia, might be pushed over the edge by heavy drug use. This jives also with anecdotal reports of people who've had really terrible reactions to other psychedelics. There's a fascinating account by a psychologist who's also schizophrenic. He didn't have his first psychotic break until he was 33, far later than average. He talks about the personality traits of schizophrenics, how he noticed something was off and got early therapy, and how he credits that with delaying a psychotic break and improving his outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632294/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632294/ Not a doctor or scientist, just regurgitating research I read for personal interest.

wahern 3y ago
> There's a really interesting line of research that suggests Schizophrenia is a spectrum, rather than a binary. I don't think it was ever considered binary. Rather, previously the variance was explained in terms of discrete subtypes and comorbidities. I guess now the field is moving toward a model that is more fluid and away from a rigid ontology, at least to the extent the ontology deigned to reflect distinct pathogeneses. I'm tempted to believe that there's an improved appreciation that progression isn't inevitable, and can be halted with management. But whatever assumptions the literature made on that score (and I'm not familiar with the literature), I'd bet most patient clinicians have always appreciated this. Understanding the why's and how's was always and still remains the problem.
kayodelycaon 3y ago
Psychosis can do a lot of damage. I had a 4-month-long psychotic break that eventually led to me being diagnosed bipolar. It several years to recover from but I think some of the damage is permanent. I feel like I've lost a lot of memory function but I can't remember what things were like before. And it's difficult to separate that out from medication side-effects at this point. What I do know is caffeine gives me panic attacks now (even decaf coffee is too much) and I can't function well enough to hold a job without medication.
- TN1ck 3y ago
  First person that I read about also having a problem with coffee and even with decaf. For me it started inducing anxiety like effects and gives me insomnia now if I accidentally eat a tiramisu or something containing a bit of it. Haven’t found anything that one can get an acquired caffeine sensitivity, but I guess there is not much research. I didn’t have an episode, but it did start during some more mentally challenging times.
  - ITB 3y ago
    Same
- naruhodo 3y ago
  > What I do know is caffeine gives me panic attacks now (even decaf coffee is too much) Coffee makes me jittery, but green tea gives me focused attention. I just don't enjoy the taste of green tea that much, so I drink coffee and take L-theanine (extract of green tea) pills to calm me down a bit.
  - kayodelycaon 3y ago
    L-theanine seems to be pretty good for a lot of people. :) My experiment with it went pretty badly as it took out my mood stabilizer. (Oops.) That took me for a wild ride for the next 3 weeks after I stopped it. After I mentioned this to my psychiatrist, she was rather insistent about not self-medicating. This included vitamins. A great number of things interact poorly with my medication mix. (e.i. Magnesium can interfere with absorption.) At this point, I treat anything available over the counter the same way I treat prescription medications. I do research and clear anything potentially psychoactive with my psychiatrist. I do use natural things like melatonin. I just need to make sure are safe to take.
muffles 3y ago
> Once someone has a psychotic episode, they are much likelier to have more. An anecdotal observation of this in media is when comedian Owen Benjamin took a "Stars of Death" edible on the Joey Diaz podcast. It was argued that this was the point his big break with reality occurred (delusions and conspiracy seen everywhere). Another interesting observation is that THC seems to intensify the effect of amphetamines like Adderall. With the increase in ADHD and the presumable fix of amphetamine style drugs like Adderall common marijuana usage could intensify the amphetamine high massively which can exacerbate delusions and psychosis even further. Owen himself was known to use Adderall before shows to maintain focus. Quite an interesting area of research.
- operatingthetan 3y ago
  Plus that combo gives guaranteed insomnia. The user wakes up from whatever sleep they did get, takes the speed again, and it's like nothing happened. This continued loss of sleep compounds over time and can contribute to psychosis.
  - copperx 3y ago
    You don't even need the combo. Just taking Adderall several days in a row can give you psychotic symptoms if it's hurting your sleep every day.
  - piperswe 3y ago
    For some with ADHD, stimulants can have a neutral or positive effect on sleep. I know I can have the best, calmest naps after I've taken Vyvanse. Therefore, I wouldn't say "guaranteed" insomnia. Once it wears off though, my sleep's not great. At least it's no worse than it was before starting medication, I've just never been able to sleep well.
    - operatingthetan 3y ago
      >For some with ADHD, stimulants can have a neutral or positive effect on sleep. I know I can have the best, calmest naps after I've taken Vyvanse. Therefore, I wouldn't say "guaranteed" insomnia. You're talking about half the the drug combo in question, I'm not sure that's a useful anecdote. As I said to others, I would not recommend adding weed to your vyvance though, unless you are interested in personally experiencing the topic of this thread.
deleted 3y ago
[deleted]
lostlogin 3y ago
This is easily the best link I’ve clicked on HN in a long time, thank you. In the context of medication and schizophrenia, the authors take is interesting: “The message is do not only change what is inside your head but that which your head is inside of… Recognizing the causes of the crisis as having been multifactorial made me also recognize that all ameliorative efforts had to be multilevel, impinging on everything from brain biochemistry to self-concept and social scenario.”
copperx 3y ago
> Schizophrenia is a spectrum, rather than a binary. Spectrum is not the opposite of binary. You probably mean gradient, from your context. This is more than just a pedantic observation. Autism spectrum disorder is often misconstrued by the general public as a gradient, which is not accurate.
- skissane 3y ago
  > Autism spectrum disorder is often misconstrued by the general public as a gradient, which is not accurate. If one accepts the dimensional model of psychiatric diagnosis, then almost all psychiatric disorders are "gradients" – ASD included. If you are calling the dimensional model "not accurate", I disagree I think the biggest thing where the general public misconstrues things is with "autism"="spectrum". The DSM-5 contains both the autism spectrum and the schizophrenia spectrum, although the former is conceptualised as a single disorder, the latter as a family of related disorders. There is also a brief mention of the concept of the "obsessive-compulsive spectrum", although that concept did not make it into the main body of the text. In the research literature, you'll find heaps more "spectrums" proposed – for example, the "disruptive behaviour disorder spectrum" (composed of ADHD, oppositional-defiant disorder, conduct disorder and antisocial personality disorder) and the "bipolar spectrum" (bipolar I, bipolar II, cyclothymia – some add other conditions such as disruptive mood dysregulation disorder)
beepbooptheory 3y ago
thanks for this link. Reminds me of Judge Schreber and his writings a little: https://en.m.wikipedia.org/wiki/Daniel_Paul_Schreber https://en.m.wikipedia.org/wiki/Daniel_Paul_Schreber
mise_en_place 3y ago
There is a high correlation between intelligence and mental illness. For example, John Nash also had paranoid schizophrenia. The way your mind encodes information seems to be correlated with perceptual disturbances.
- coffeebeqn 3y ago
  I wonder if that’ll be the case for AI?
  - mise_en_place 3y ago
    AI will never have qualia so no. The closest you’ll get is something like LLama-7B hallucinating output.
    - Zircom 3y ago
      Maybe they won't ever experience the same set of qualia humans do, but I don't think it's out of the question to say they won't have their own set of qualia that are just as inscrutable to humans as ours are to them.
Haga 3y ago
[dead]

wahern 3y ago

> There's a really interesting line of research that suggests Schizophrenia is a spectrum, rather than a binary. I don't think it was ever considered binary. Rather, previously the variance was explained in terms of discrete subtypes and comorbidities. I guess now the field is moving toward a model that is more fluid and away from a rigid ontology, at least to the extent the ontology deigned to reflect distinct pathogeneses. I'm tempted to believe that there's an improved appreciation that progression isn't inevitable, and can be halted with management. But whatever assumptions the literature made on that score (and I'm not familiar with the literature), I'd bet most patient clinicians have always appreciated this. Understanding the why's and how's was always and still remains the problem.

kayodelycaon 3y ago

Psychosis can do a lot of damage. I had a 4-month-long psychotic break that eventually led to me being diagnosed bipolar. It several years to recover from but I think some of the damage is permanent. I feel like I've lost a lot of memory function but I can't remember what things were like before. And it's difficult to separate that out from medication side-effects at this point. What I do know is caffeine gives me panic attacks now (even decaf coffee is too much) and I can't function well enough to hold a job without medication.

TN1ck 3y ago
First person that I read about also having a problem with coffee and even with decaf. For me it started inducing anxiety like effects and gives me insomnia now if I accidentally eat a tiramisu or something containing a bit of it. Haven’t found anything that one can get an acquired caffeine sensitivity, but I guess there is not much research. I didn’t have an episode, but it did start during some more mentally challenging times.
- ITB 3y ago
  Same
naruhodo 3y ago
> What I do know is caffeine gives me panic attacks now (even decaf coffee is too much) Coffee makes me jittery, but green tea gives me focused attention. I just don't enjoy the taste of green tea that much, so I drink coffee and take L-theanine (extract of green tea) pills to calm me down a bit.
- kayodelycaon 3y ago
  L-theanine seems to be pretty good for a lot of people. :) My experiment with it went pretty badly as it took out my mood stabilizer. (Oops.) That took me for a wild ride for the next 3 weeks after I stopped it. After I mentioned this to my psychiatrist, she was rather insistent about not self-medicating. This included vitamins. A great number of things interact poorly with my medication mix. (e.i. Magnesium can interfere with absorption.) At this point, I treat anything available over the counter the same way I treat prescription medications. I do research and clear anything potentially psychoactive with my psychiatrist. I do use natural things like melatonin. I just need to make sure are safe to take.

muffles 3y ago

> Once someone has a psychotic episode, they are much likelier to have more. An anecdotal observation of this in media is when comedian Owen Benjamin took a "Stars of Death" edible on the Joey Diaz podcast. It was argued that this was the point his big break with reality occurred (delusions and conspiracy seen everywhere). Another interesting observation is that THC seems to intensify the effect of amphetamines like Adderall. With the increase in ADHD and the presumable fix of amphetamine style drugs like Adderall common marijuana usage could intensify the amphetamine high massively which can exacerbate delusions and psychosis even further. Owen himself was known to use Adderall before shows to maintain focus. Quite an interesting area of research.

operatingthetan 3y ago
Plus that combo gives guaranteed insomnia. The user wakes up from whatever sleep they did get, takes the speed again, and it's like nothing happened. This continued loss of sleep compounds over time and can contribute to psychosis.
- copperx 3y ago
  You don't even need the combo. Just taking Adderall several days in a row can give you psychotic symptoms if it's hurting your sleep every day.
- piperswe 3y ago
  For some with ADHD, stimulants can have a neutral or positive effect on sleep. I know I can have the best, calmest naps after I've taken Vyvanse. Therefore, I wouldn't say "guaranteed" insomnia. Once it wears off though, my sleep's not great. At least it's no worse than it was before starting medication, I've just never been able to sleep well.
  - operatingthetan 3y ago
    >For some with ADHD, stimulants can have a neutral or positive effect on sleep. I know I can have the best, calmest naps after I've taken Vyvanse. Therefore, I wouldn't say "guaranteed" insomnia. You're talking about half the the drug combo in question, I'm not sure that's a useful anecdote. As I said to others, I would not recommend adding weed to your vyvance though, unless you are interested in personally experiencing the topic of this thread.

deleted 3y ago

[deleted]

lostlogin 3y ago

This is easily the best link I’ve clicked on HN in a long time, thank you. In the context of medication and schizophrenia, the authors take is interesting: “The message is do not only change what is inside your head but that which your head is inside of… Recognizing the causes of the crisis as having been multifactorial made me also recognize that all ameliorative efforts had to be multilevel, impinging on everything from brain biochemistry to self-concept and social scenario.”

copperx 3y ago

> Schizophrenia is a spectrum, rather than a binary. Spectrum is not the opposite of binary. You probably mean gradient, from your context. This is more than just a pedantic observation. Autism spectrum disorder is often misconstrued by the general public as a gradient, which is not accurate.

skissane 3y ago
> Autism spectrum disorder is often misconstrued by the general public as a gradient, which is not accurate. If one accepts the dimensional model of psychiatric diagnosis, then almost all psychiatric disorders are "gradients" – ASD included. If you are calling the dimensional model "not accurate", I disagree I think the biggest thing where the general public misconstrues things is with "autism"="spectrum". The DSM-5 contains both the autism spectrum and the schizophrenia spectrum, although the former is conceptualised as a single disorder, the latter as a family of related disorders. There is also a brief mention of the concept of the "obsessive-compulsive spectrum", although that concept did not make it into the main body of the text. In the research literature, you'll find heaps more "spectrums" proposed – for example, the "disruptive behaviour disorder spectrum" (composed of ADHD, oppositional-defiant disorder, conduct disorder and antisocial personality disorder) and the "bipolar spectrum" (bipolar I, bipolar II, cyclothymia – some add other conditions such as disruptive mood dysregulation disorder)

beepbooptheory 3y ago

thanks for this link. Reminds me of Judge Schreber and his writings a little: https://en.m.wikipedia.org/wiki/Daniel_Paul_Schreber https://en.m.wikipedia.org/wiki/Daniel_Paul_Schreber

mise_en_place 3y ago

There is a high correlation between intelligence and mental illness. For example, John Nash also had paranoid schizophrenia. The way your mind encodes information seems to be correlated with perceptual disturbances.

coffeebeqn 3y ago
I wonder if that’ll be the case for AI?
- mise_en_place 3y ago
  AI will never have qualia so no. The closest you’ll get is something like LLama-7B hallucinating output.
  - Zircom 3y ago
    Maybe they won't ever experience the same set of qualia humans do, but I don't think it's out of the question to say they won't have their own set of qualia that are just as inscrutable to humans as ours are to them.

Haga 3y ago

[dead]