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Rethinking Schizophrenia Treatment

By Christina Bruni, Health Guide Thursday, January 05, 2012
I want to spark a debate about schizophrenia treatment and get your feedback about your experiences. A number of people at the Mental Health Networking LinkedIn group have offered insight on the topic "To DSM or not DSM?"   This psychiatric bible is a tool for getting the right treatment when us...
Schizophrenia Recovery and Support Options
1/ 5/12 8:26pm
Thanks Chris for your wonderful comments. I differ slightly in my views, only in that I was sent to our voc rehab for many weeks early on, but was simply unable to cope with working at a job, even a part-time one. I had tried and tried before, but could not handle even 2 hours a day. Now, if I had been tested with Myers Briggs and also somehow provided with the financial means to write and perhaps allowed/ encouraged to go to art school that might have worked, but they tried to get me to take on a reporter's job when I was chronically psychotic...That said, the treatment providers at both the in-patient hospitals and the halfway facilities were more or less brutal, being at best into mostly coercion and control and at worst physical abuse. (see Wagblog for more on that). I most fervently agree that better treatment, in the sense not just of medical/psychiatric but social and human treatment of persons diagnosed with certain mental conditions is essential. I think frankly that fewer conditions should be immediately treated with medication, one, and two, that if we had facilities that provided a space for those with psychotic illnesses to take the time to heal without or with meds -- by choice not forced -- I think we could get back to those statistics that were once commonly cited for schizophrenia: one third recover completely after one episode or two, one third are intermittently ill, but function relatively well, and one third are chronically disabled. TOday, instead, all those with schizophrenia are given the identical life sentence: you must take meds the rest of your life...You will never get better. Period. It is the rare individual who dares to buck that advice and try seriously to survive without the meds, and withdraws from them slowly enough not to induce a rebound psychosis that brings on the usual I told you so! Anyhow, the subject brings up a great deal and is an excellent springboard for a long discussion and i hope you get many comments. I may even blog about it on my own site. Thanks !
1/ 5/12 8:39pm

Amen, Pam.  I echo your thinking.  Have you read Robert Whitaker's "Anatomy of an Epidemic"?  A lot of surprising and eye-opening statistics.  P.S. I love your poetry.

Christina Bruni, Health Guide
1/ 5/12 8:54pm

The "1/3 recover, 1/3 have intermittent hard times, and 1/3 have ongoing trouble" statistics were current as of 2002.

 

You can find these statistics in the Gale Research Group's Student Resource Center database entry on schizophrenia.

 

Christina

1/ 6/12 4:15am

In 1980 I was admitted to a prublic hospital for 28 days. Two weeks after the discharge I ended up in a state hospital. From 1980-1989 I spent months and weeks in and out of the state hospital system. After my first discharge in 1981 (I spent a year inpatient) I was put in a day program where we did arts, music, and exercise classes. I was placed in a Sheltered Workshop Program and got a job in a machine shop. I worked there for a year before returning to the work programs at the state.

 

In the 1990's I has several jobs, I worked as dishwasher, taxi driver, pizza driver, janitor. I worked at the state outpatient program also. In 1997 was offered a "real" state job as a cook/manager/mentor of a cafeteria. I worked there until 2007 where I was able to take a disability retirement due to my psychaitric diagnosis.

 

Since 1980 I have been inpatient at the state and the public hospitals over 30 times, twice last year alone.

 

Christina you mentioned the staff at hospitals. I want to come to their defense. While they are some that shouldn't be in that profession, I met some that have helped change my life. I've had employees that went out of their way to make me a better man. Even yesterday at the hopsital for my ECT, there were nurses who know me that came up to me and asked how I was doing. A tech in the ECT always jokes around with me. I agree that there needs to more employment training but there has been ALOT new therapy classes. I was able to go the state hospital to speak to the patients. It changed dramatically. The days of "quiet rooms" are gone. Tile floors are replaced with carpet. Shower stalls are private. Food is healthier. No straight jackets are used or belts to tie you in bed. I am grateful for the many employees that took the time to care for me when I couldn't.

 

David

1/ 9/12 9:10pm

Dear David,

 

I would advise you to take a look at my Wagblog.wordpress.com before you say that the days of quiet rooms, ie seclusion rooms and restraints are over. Not by a long shot! Search out Psychiatry and Authority in my blog for an earful of what I have been through just in the last three years!

 

Am glad that your experience has been better, but in Connecticut, one of the very few states that NAMI rated with a B, I have been brutalized in the very recent past. In fact, my treatmnet in the 2000s has been far worse than in the two decades leading up to them.

1/10/12 8:14am

Dear Ms. Wagner,

 

I am sorry that you had "bad treatment" in the 2000's. But it is my experience that what I wrote is true. We may not have had the same experiences but you cannot say that patients are being treated harshly everywhere. I will not debate this issue any further as I am not going to post or comment here any longer.

 

David

1/ 6/12 6:24am

Great topic Christina and I am one to write on it as although I was diagnosed as beint is g subseptible to developing sz at 15, My actual onset took place one week before my 23rd birthday and it was both observed and recorded and documented but those doctors did not diagnose or treat me despite all the evidence of psychosis. i was on active duty with the United States Marine Corps and these doctors recomended me for a bad conduct discharge because i had a psychotic break. I fought for and got a honorable discharge all while enduring a undiagnosed psychosis. All I say is thank God for being with me for the same undiagnosed psychosis sent me to prison and was the engine behind hurting a lot of people. Yes some people with untreated sz are violent and I was one. And the shameful part is my sz morphed into schizoaffect disorder at the time of my asnon-diagnosis and non treatment. i lived in hell for over 20 years. I was finally diagnosed in 2003 as psychotic disorder NOS and in 2008 as a schzoaffective disorder and being honest with myself, it is true and right. Accepting my dx and working towards recovery is such a greater feeling. At least i know i am sick and i need to work on it. I now have a good cocktail of meds, handle my own money, I am drug,alcohol and cigarette free, live by myself in my choice of community, volunteer at the VA hospital and i am back in college going very slowly. I even flunked one of my courses and i did not stress out over it. My advice to doctors is admit you know very little about sz and do not take it for granted nor your patients. Three words: John Forbes Nash. There is some of that in all of us. Thank you. Ysraal

Christina Bruni, Health Guide
1/ 6/12 9:00pm

Thank you for your service in defense of our great country!

 

I always look forward to hearing from you.  I wish you all the best fortune with school, where studies are not that easy for any of us with a dx.

 

I admire your positive outlook.

 

Best wishes,

Christina

1/ 8/12 6:53pm

Very nice topic, Christina. I was in a drug and alcohol rehab facility for 27 days back in December of 2005. My family checked in me in after I lost control of myself and hit my mom in a crystal meth induced psychotic frenzy.

 

After completing the rehab program, I was transferred into a halfway house that served as an aftercare facility. Upon admission, I learned that the majority of the residents were drug or alcohol addicts that were court ordered to complete the 9 month aftercare program (Prop 36). If not, they would be returned back to jail for a mandatory 3 years.

 

My first psychiatrist was assigned to me after being a resident in this facility for about a week and a half. I remember during my interview, I explained my symptoms to him and he eventually concluded that my diagnosis was psychotic disorder. I had been taking Zyprexa 2 weeks prior to entering the halfway house to relieve my positive symptoms. I was first given Zyprexa while I was under observation at an MHS facility that I was admitted into by the SDPD into after trying to check into a hotel as God. This is the only time that I have ever been admitted into a hospital type facility.

 

After being on Zyprexa for about 7 weeks into the aftercare program, my doctor decided to switch my medication from Zyprexa to Abilify and Wellbutrin even though this med was working well for me. He explained that he was making the change because of the adverse side effects of Zyprexa. I remember at that time, I was still somewhat delusional and still thought that I was God or "the Chosen One" but I was still able to handle the day-to-day activities of the aftercare program.

 

Those thoughts changed within about a week after being on the new cocktail. My delusional thoughts were replaced with extreme anxiety. Since we attended AA/NA meetings daily, I became extremely anxious anytime during a session. I eventually left the program after about 1.5 months because my anxiety was so intense and I could not deal with being around people.

 

I moved back home with my parents right after I left. I still can't believe my mom allowed me to move back in after what I did to her.

 

I started receiving SSDI benefits in May of 2007 and was referred to the Department of Rehabilitation by my therapist at MHS. I was assigned a job coach to help me slowly prepare for the transition back to work. The last time I had a job was in June of 2004. After being on SSDI for about 3 months, I just said the heck with it and started looking for a job on my own. I got called in for my first interview after sending out my resume to a few places. I can't believe I got hired and have been with this company for almost 5 years. I mean I even told the people that interviewed me that I didn't work for 3 years because I was in recovery for drugs and alcohol just so that they wouldn't hire me. In addition, my work history was horrible. I am very grateful that they saw something that they liked in me. I almost quit at one point because of my anxiety but I stuck it out and am so grateful that I did. I was given a diagnosis of schizo-affective disorder by my new pdoc in November of 2007.

 

I'm back in school now taking online business classes. My anxiety is still overwhelming at times, but my coping skills along with my new medication make everyday more bearable.

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By Christina Bruni, Health Guide— Last Modified: 02/02/12, First Published: 01/05/12