Schizophrenia Understood

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Understanding the World of the Schizophrenic

Schizophrenia is a chronic, severe, and disabling brain disorder that has affected people throughout history. About 1 percent of Americans have this illness. People with the disorder may hear voices other people don’t hear. They may believe other people are reading their minds, controlling their thoughts, or plotting to harm them. This can terrify people with the illness and make them withdrawn or extremely agitated.

People with schizophrenia may not make sense when they talk. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking. Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help.

Treatment helps relieve many symptoms of schizophrenia, but most people who have the disorder cope with symptoms throughout their lives. However, many people with schizophrenia can lead rewarding and meaningful lives in their communities. Researchers are developing more effective medications and using new research tools to understand the causes of schizophrenia. In the years to come, this work may help prevent and better treat the illness.

The symptoms of schizophrenia fall into three broad categories:

  1. positive symptoms,
  2. negative symptoms, and
  3. cognitive symptoms.

Positive symptoms

Positive symptoms are psychotic behaviors not seen in healthy people. People with positive symptoms often “lose touch” with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following:

Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. “Voices” are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.

Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.

Delusions are false beliefs that are not part of the person’s culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical.

People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called “delusions of persecution.”

Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called “disorganized thinking.” This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called “thought blocking.” This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or “neologisms.”

Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available. “Voices” are the most common type of hallucination in schizophrenia.

Negative symptoms

Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:

  • “Flat affect” (a person’s face does not move or he or she talks in a dull or monotonous voice)
  • Lack of pleasure in everyday life
  • Lack of ability to begin and sustain planned activities
  • Speaking little, even when forced to interact.

People with negative symptoms need help with everyday tasks. They often neglect basic personal hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.

Cognitive symptoms

Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when other tests are performed. Cognitive symptoms include the following:

  • Poor “executive functioning” (the ability to understand information and use it to make decisions)
  • Trouble focusing or paying attention
  • Problems with “working memory” (the ability to use information immediately after learning it).

Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress.

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Much of this article came from an outside source. I’m just the errand boy on this post.

The Test of a Profound Silence, [Extreme Faith]

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But Jesus gave her no reply, not even a word. Then his disciples urged him to send her away. “Tell her to go away,” they said. “She is bothering us with all her begging.”

Matthew 15:23, NLT

This is exceptional.  Jesus is always engaging people around him.  He teaches and preaches, fully energized by the Holy Spirit.  He is a veritable hurricane of goodness and love.  He heard every request, and healed every disease.  But yet.  On this occasion he is completely silent.

The woman’s piteous crying, and begging was seemingly ignored.  “If Jesus won’t respond to me, I will go to his followers.”  She presses, and cajoles.  She falls on her knees.  Have you ever seen a person truly beg?  It is a very disconcerting experience.  Yet, Jesus does nothing, in spite of being able to do all things.

She is a Canaanite; a pagan widow, and her daughter was demonized.  Curiously, there was a large heathen temple to Eshmun, the Canaanite god of healing, was just three miles down the road.  But her desperate cry was for something real.  Something authentic and real that would heal her daughter’s affliction.  Only Jesus has what she needs.

Jesus is astonishingly silent.  He stands and sees, he hears her cries.  She is sobbing, clutching at the disciples robes, disheveled and distressed.  It was a desperate scene. Very ugly and very sad.

Jesus responds to his disciple’s plea.  Then there is something that seems like a negotiation.  A protracted conversation with a ‘seemingly’ reluctant Messiah.  It is somewhat disturbing as we listen.  Jesus seems to treat her callously.  I have always been mystified by this, troubled by his behavior. I can only conclude that what he did was necessary in some way.

But the Son of God sees through this. 

And then she makes an incredible statement.  Jesus is suddenly amazed at her faith in him.  This faith is what he has been waiting to see. She may have known despair, but that isn’t enough. Jesus leads her from the edge. Until she moved to a position of belief, nothing will change. Faith seems to change everything.  This is key.  It isn’t her words that alters things– it is her heart!  At that moment, Jesus declares a healing for her daughter.  She is now free from the demon’s grip.

So often I have also felt the pressure from the darkness.  I am often embattled and driven into a despair that seems to cripple me.  But Jesus is waiting for me, to come to him through an unflinching faith.  My good works can never, ever be enough.  I’m just like a dog, waiting for food under the table.  I have little, if any, decorum or sophistication.  There is nothing at all, to commend me to him. Nothing at all.

“Our Lord sometimes yet seems to be silent to His people when they cry to Him. To all their earnest supplications He answers not a word. Is His silence a refusal? By no means. Ofttimes, at least, it is meant only to make the suppliants more earnest, and to prepare their hearts to receive richer and greater blessings. So when Christ is silent to our prayers, it is that we may be brought down in deeper humility at His feet, and that our hearts may be made more fit to receive heaven’s gifts and blessings.”

–J.R. Miller

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The Awful Pain of Job

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“Oh, why give light to those in misery,
    and life to those who are bitter?
21 They long for death, and it won’t come.
    They search for death more eagerly than for hidden treasure.
22 They’re filled with joy when they finally die,
    and rejoice when they find the grave.
2Why is life given to those with no future,
    those God has surrounded with difficulties?”

Job 3:20-23, NLT

Job begins to curse his existence and his words are saturated with frustration. He grieves for all of his dead children and is sickened by his afflictions. Job is a man pushed beyond the edge.

Job is the “poster child” of human suffering. He is completely without pretense as he openly grieves. He voices exactly what is in his heart.

Let us be clear about this; He is devastated, ravaged by Satan’s grim ministry. Job to his credit, is oblivious to Satan’s wager with the Almighty God. He has no clue that he has been chosen by God in this matter. The Lord keeps His secrets.

All Job knows is the pain, and there is the endless grief that even his tears can’t help.

In Job’s first speech he asks some basic questions:

  • Why is light given to those who are full of pain?
  • Why does life unfold to the one who rather not live anymore?

Death has a powerful influence in this three verses, He wants to die, and end the charade. He wishes for non-existence and laments that he can not die fast enough.

People with disabilities and chronic pain can understand Job’s desire for release. Once they were “whole” people. Death was something to be avoided at all costs. But now it is seen as an escape.

Hurting people will often turn to drinking and drugging as a way of coping. We’ll try anything to numb our thinking. It’s what gets us through the day. Oblivion has become my best friend.

For Job (the patron saint of pain) finds that nothing will fix him. His friends have come, but they seem to only accuse and confuse job. Honestly he is better when they just sat with him in silence.

“God wants us to choose to love him freely, even when that choice involves pain, because we are committed to him, not to our own good feelings and rewards. He wants us to cleave to him, as Job did, even when we have every reason to deny him hotly.”

–Philip Yancey

“Come quickly, Lord, and answer me, for my depression deepens. Don’t turn away from me, or I will die. Let me hear of your unfailing love each morning, for I am trusting you. Show me where to walk, for I give myself to you.”

Psalm 143:7-8

ybic, Bryan

 

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A Day in the Life of a Mental Hospital Patient

6:30 am. “Rise and shine,” but this is debatable– you simply just breathe and walk, in this kind of a desperate mental fog,  (Simply put, ‘there will be no sunshine for you today.’) But, this only just seems to really matter to us, who have no hope.  You exchange brief greetings with your roommate, which only just seems proper, even at this level.  We are given “ratty” old surgical scrubs to wear through out the day.

We head down ‘en mass’ to the cafeteria.  I see the servers on the line, I notice that they avert their eyes from us as we form a hungry queue.  Sometimes, they will give us choices: “bacon or sausage?”  To a mental patient, this can be a Gordian Knot of complexity.  So the line moves slowly, as we try to sort out this conundrum.

There is no coffee for us, as patients.  It has been two weeks for me, and I dream of a cup of hot coffee, with cream.  Some of the attendants drink Pepsi, although it is done hiddenly, but we all know it.  We resent their liberty, especially when we have none.  There is a question of equity, with us, which has been violated.

8:40 am.  We are all race to be the first in line for our morning meds.  It almost seems we are afraid they are suddenly going to run out.  I get my Seroquil, my lithium, my Zoloft.  Additionally, because I am ‘post-op’ brain tumor, I am given a mild stimulant called Provigil to help me think clearly.  I have no idea if it works, or not. (I rather have a cup of coffee.)

We then gather into a day room full of clunky and ugly furniture.  It is big, and the chairs encircle a grimy tile floor to make a large open space.  This is not an orderly place, as people are wandering about, some stare at the wall or at a fake plant in the corner.  It is noisy, some even shout.  Others just “rock” back and forth to a song that only they can hear.  A few of us lie in “fetal position” of hiddenness, just wanting to disappear.

The thought occurred to me one day, of a ‘giant aquarium.’  It was constantly moving, swirling about.  If you stopped moving, it meant that you were dead.  Everyone was moving, and oblivious to the others who were also moving.  This seems to explain much.  (You will need to accept the ‘aquarium’ idea if you really want to process the moment.)

On one of my stays, weeks went by before I realized that this particular meeting actually existed, but I was very confused and seriously beyond any correction.  I was really struggling with clinical depression, so meals and meds was all I could manage.  When I finally figured this out, I quickly joined the fish bowl.  It was both good and bad.  But mostly good. Finally as bleak as it was, I started accepting reality.

11:00 am.  One thing you do notice is a lot of disjointed conversations.  You would speak to someone and 10 minutes later they would answer.  And for the most part, conversations would be muted, whispered to people.  As if there was a conspiracy involved, and a certain appropriateness must be taken. We were a paranoid bunch.

Sometimes an attendant would turn on the TV.  I can remember watching cartoons and just maybe I would think that they were communicating to me in code.  We did have a VCR for movies, but because one guy urinated into the machine, it shorted it out.  So, alas, no more movies.

During one stay (and there were several) I was suicidal.  The staff watched me like a hawk, sitting at my door out in the hallway. But I was desperate to cut my wrists, so I stood up in a chair.  I took down a clock and wrapped it in a blanket, to muffle the sound of breaking glass.  I managed to slash my wrists deeply and often, before the nurse came in my room.  For a moment, I brought an excitement to the staff.  And perhaps a certain meaning to me.

When you’re in a psych ward your days are beyond tedious.  One day is like the next.  The psychiatrist comes to see you for 10 minutes, and it is a high point of your day.  You discover that any new explanations, or treatment plans are done solely by the doctor.  That is one of the first cardinal rules on the ward.  Ask a nurse or an aide, and they invariably dodge.  But the psychiatrist “rules the roost.” Everyone follows his decision. This is useful to know.

1:00 pm.   Suddenly a young teen girl with schizophrenia, screaming and pounding her head against the wall has now becomes the focus.  Every couple of days this happens, and in a twisted way punctuates the drabness of the day.  She is artfully restrained by the staff and taken to “the padded cell.”  We are all told it is for her own protection,  but we as patients, we all rally behind her fight.  When she makes a break from the nurses we all cheer her effort and want her to escape.

The second cardinal rule of the floor is that you don’t “stick out” in any way. Creating an issue is never tolerated, whatsoever.  Demanding more TV time, or coffee, or a newspaper will hardly ever go over well.  Just before Thanksgiving, 2003, I timed my meeting with the pdoc to raise an issue of a fresh cup of coffee.  There was a nurse present at our meeting, and she had to respond to the doctor’s order that I was to be given coffee on Thanksgiving morning.  The next morning the coffee was delivered, but the nurse insisted that she would set in a chair next to me until I finished.  Nevertheless, it was a glorious moment.

3:00 pm.  I soon developed auditory hallucinations.  First, I kept hearing a CB radio, squawking constantly.  A few days later, I started to hear a telegraph, “dit-dot-dash.”  They both were very loud and insisting that I pay attention.  Also, I would have 3 or 4 moments of seeing black and hairy spiders climbing at me.  They were so real, and even volitionally know they were not real, I still panicked.

4:30 pm.  They’re other issues as well.  I basically hated phone calls from family.  When they did come they always seemed intrusive and seemed to work against the thinking on the ward.  When a few friends did visit, I would be abrasive and rude.  Wishing they hadn’t made the effort.  I imagined their hearts processing me and my need to be there, and it disturbed me.  Since I lived about 300 miles from the hospital, it took effort on their part to try to see me.  Looking back though, I wish I had been nicer.

8:48  pm.  Getting ready for bed.  It seems that is what I have waited for this all day.  These are moments I have started to live for.  Sleep = oblivion.  I fade to black, and life is paused.  There isn’t any issues for me to figure out.  For eight hours, I find peace,  Sleep is a deep mercy, a gift given to us from the Father.  Those of us, who struggle hard against the dark, understand the “gift” of grace in the form of sleep.  Depressives very often crave sleep. We often want to hide into it, as if doing so would solve our problems and issues. For me, sleep was the only time I was free from the ward.

I want to sleep, to close my eyes and to be gone.  I suppose that is true, for all of us who want to “commit suicide by sleep.”  We seek oblivion, and long for the moment when we can “check out.”  We want to be forgotten and overlooked. We deeply want to be erased, and move directly into forgottenness.

When we have been committed to the ward as patients, we will probably be shaken to our core.  Our insertion into a diverse floor of mental illness, will always introduce us to deep desperation. We are jolted that there is a darkness that is pursing us far beyond what seems is right.  We must call out to Him who can save us.

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kyrie elesion, Bryan

 

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