Family and Caregiver Schizophrenia Discussion Forum

Excellent Explanation of Schizophrenia (given by a board certified psychiatrist)

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Overall a good introduction, I’d be interested in the rest of the series, if it’s available.

Some minor quibbles: first I found the varied pronunciations of schizophrenia distracting. Second, the psychiatrist uses the word, schizophrenic, at one point which is generally not how people with schizophrenia prefer to be called. Psychiatrists in general, and especially doctors who work in hospital environments tend to objectify patients and use language to match, although it may be unintentional, it projects a sense of detachment and depersonalization of people with the disease which can spill over to how they speak to caregivers.

Third I disagree that it’s near impossible to navigate, work, school and family life with psychosis. This is how “highly functioning” people with SZ navigate the world. He presents an inconsistent narrative, where SZ psychosis is effectively constant and not episodic, and people can live effective lives with SZ, yet somehow they do this by doing something he says is ‘impossible’. It’s difficult to do without medication, yes, but some people do it. He also says that medication helps with symptoms, but never fully suppresses them. To me the bulk of recovery is learning coping mechanisms to deal with residual psychotic symptoms.

Fourth, he gives very little attention to caregivers in this discussion. I’m hoping he devotes more attention to them in later videos.

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Personally, I think this is a very good explanation of schizophrenia. So much of what he describes exactly applies to what I went through with my daughter when she was unmedicated and undiagnosed. I would have loved to have someone explain it to me like this during her first hospitalization. During that first hospitalization, the doctor would only say “unspecified psychosis” which just didn’t explain anything to me. What did that mean?

Thank you @Catherine for posting it. I will recommend it to others. I can see @Maggotbrane that it may not fit every instance, but nothing else I’ve seen puts such a great deal of education into a short easy to absorb form for people who have no idea what schizophrenia truly is.

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@oldladyblue, I agree. I have a tendency to look at things with an overly critical eye, and I’m often painfully aware my situation is unique. My quibbles are likely addressed more fully in the rest of the series.

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I found this particular video on a You Tube channel called “MedCircle”, I clicked on “playlists” and this video was there, not sure how much of a “series” it is just an informational video, I think it’s just meant to broadly explain the illness to the “average Joe” who’s not familiar at all with it. Many people that come here to this forum are just being introduced to schizophrenia for the first time and are not as well versed in it as some of us are after many years of dealing with it either personally or through care giving. Glad you found it helpful @oldladyblue As for the “critical eye” @Maggotbrane I too contend with that in every day life, I understand.

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So I sent this video to our friends and family so that they can understand Schizophrenia. I’ve explained it like this, but of course you have those that think she needs to exercise more. :neutral_face:
Catheryn is the healthiest person physically. She works out everyday, does yoga, swims and eats healthy.
Anyway you know how it is. Helpful video for sure. :+1:

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@Catherine, thanks again. Medcircle popped up in my feed recently with umpteen videos about narcissism. Maybe the algorithm is trying to tell me something🙂. Seriously, my sister is always going on about narcissism in ways I consider reaching, so maybe it picked this up subliminally (there were times in my life when this might have driven paranoid delusions).

The video you cite was uploaded a month ago, but they mention a series on SZ. There are other videos related to SZ on the channel, but none with similar quality or continuity, so I’m going to assume there’s more to come. I’ll check periodically and post additional links if/when available. The playlists and the channel itself seem a bit haphazard, so it may be helpful to cherry-pick and organize.

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I watched the video and thought it was good. One thing that I am really starting to question is that they are saying people who are suffering from schizophrenia are not more violent than anyone else. If that is the case why is the mental health ward in a hospital locked? Why are staff assaulted by patients receiving care for mental health? Why are police officers trained to deal with people suffer from mental illness? There is another video on this board where the speaker says the narrative needs to change so that services can be more readily available in the community.

And yes, I’m one breath the psychiatrist in the video said it’s impossible to lead a normal life and then later said a person can lead a normal life.

Hopefully, they will have more videos in the future.

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@Feelingalone untreated people with mental illness can be violent, but the effectively treated ones less so. They often shun society which gives them fewer opportunities for conflict. Whether this fully balances the equation is unclear.

There’s a sizable population of mentally ill people incarcerated in the US initially for minor crimes, but from experience with my brother continuing or resuming needed treatment is tough, because it’s difficult to get prescribed medications into jails and prisons so folks go untreated or receive poor care. Close conditions and other factors unfavorable to mental health exacerbate situations that lead to violence which in turn can lead to longer stays, rinse, wash and repeat. There’s also the problem of true criminals malingering, hoping for transfers to mental health facilities for better treatment and access to free psychotropic drugs they can use or sell, raising opportunities for violent or exploitative criminals to invade mental wards, ala Jack Nicholson’s famous depiction of Patrick Murphy.

After visiting several psych wards and being hospitalized one time, my observations are doors are often locked to limit exit paths and control traffic flow, but wards and individual rooms aren’t fully locked. Usually main doors are supervised, but not locked. From my experience, being admitted to a mental ward can be bewildering and disorienting and I found I was prone to getting lost. I tend to pace when anxious or agitated and I remember bemused titters when I took a wrong turn and wandered into staff offices. Some patients are suicide risks and as such should not be allowed to wander off unsupervised for their own protection. When I was first admitted I was put on a program called “special checks” where a nurse would hunt me down wherever I wandered to, note my location and periodically check my blood pressure. Over time, I became aware of the rules and scrupulously followed them, because I knew it would shorten my stay. I wasn’t sure exactly what the purpose of the checks were, but it may have something to do with assessing my acclimation and possible suicide risk.

There’s also logistical challenges that come with supervising patients with varied cognitive and emotional deficits. Meals need to be served on schedule, outdoor recreation needs to be supervised, “activities” like exercise, musical and art therapy, or group sessions attended, even simple things like shaving in the morning were challenging, because razors were kept locked up and doled out and shaving supervised. Add to this the logistical nightmare of getting the many addicted smokers and vapers to designated smoking areas, and you could see why locking a few doors and controlling access might be necessary. My stay was before smoke free environments existed, so I can only imagine what a nightmare this must be now, and I’m sure precautions for stemming transmission of the current pandemic only make this harder. My take on this is it’s no more restrictive than a nursing home and less so than a “memory care facility”.

I’m curious where you are getting your information about violence and the locking of hospital doors and such. Is it from personal experience, or various media? I can assure you that most if not all media depictions of mental wards and facilities are outdated and inaccurate. Troupes of escaped mental patients and spooky, poorly lit mental wards or “asylums” abound, yet because of stigma and privacy concerns the public rarely see mental wards or hospitals, so these troupes persist and imaginations of production designers run wild.

Per training of police to handle mental health situations, I should think that recent protests around the world should make the value of this clear for all health situations including and especially mental illnesses. In many cases police are the only ones with legal authority to take people to mental care facilities against their will by legal means. Often by the time mentally ill people encounter the police they are disruptive, uncooperative, mouthy and confused and can behave and speak unpredictably and bizarrely due to psychosis. These signs can be misinterpreted as violent or provoking violence and can lead to resistance that can turn violent or deadly— most likely with the police prevailing. There should be more of this training, not less, because its purpose is to deescalate tensions and avoid violence rather than unwittingly provoke it. Because current laws in the states often have a bar of “harm to self and others” as a prerequisite to psychiatric holds and the police often are the only ones with authority to transfer people to mental health facilities, it’s a recipe for possible violent conflict if officers aren’t properly trained. There is a transition to properly trained multidisciplinary crisis teams to handle these situations, and if anything good is to come from the poorly articulated “defund the police” movement, it would be to make these sorts of teams more consistent and prevalent.

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I agree with your assessment. This was the only video I found worthy to share.

The wards aren’t locked just because of the possibility of violence. They are locked because delusions can cause patients to wander and engage in activities that could endanger themselves without meaning to. In addition, many wards are understaffed and hospital insurance policies would require that wards helping people not in control of their own faculties be locked. In fact violence is not as common in mentally ill patients as the media would have you think. Other factors can be at play as well such as being on the wrong medication or engaging in other forms of self medication that can greatly negatively impact the illness.

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Hi @Feelingalone , those are all very good questions. From my own experience: The wards are sometimes keeping people out who don’t belong in there or aren’t welcome, I was kept out when my daughter was refusing to see me. It upset me, but another time when I was in there, I saw the terrible reaction a person had to a visitor that they didn’t want. Staff have to deal with people who think they are are being followed by aliens, or FBI agents or beings with special powers. A person with severe delusions and hallucinations can lash out at their tormentors (who aren’t the hospital staff) or who they “see” as their tormentors. The police need to be trained to understand mental illness. So many mentally ill get arrested for odd things, just like my daughter did who was running in and out of traffic on a busy street and wouldn’t stop. She doesn’t even remember the incident correctly now that she is no longer in psychosis, she only remembers standing on the sidewalk reading a book at the people going into the building that she was in front of.

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Another really good point @oldladyblue about locking the wards to keep people out that don’t belong there. My son had an abusive girlfriend when he was very ill and I had to constantly worry about her finding a way to get to him and then she’d give him illegal drugs as well. I can’t believe I forgot that.

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I like that he is a real doctor who deals hands on with smi patients and their families in a hospital environment. I like that he wasn’t afraid to touch the third rail and said the word “crazy” which is how scz is perceived by the uninformed public. The doctor may hate it, we are all stuck working from where we are in our families and in society. Once my husband understood more about scz - it took a while- we now use “irrational”. As in “don’t try to be rational in your mind with irrational thinking in his”. My son uses the word “crazy” in conversation a good deal. A few weeks back he showed me a news clip and asked “is this crazy or what?” I am glad that “crazy” has returned to its common language usage in our family. I was happy to look at the clip and agree with him, “Yes, that is way crazy”.

As was taught in my Family to Family class, I get that we shouldn’t label people by the name of their illnesses. They are people with an illness, they shouldn’t be defined by their illness. Last I knew they were also pushing for brain disorder instead of scz. My son has schizophrenia, anyone who tries to label him as a schizophrenic is denying his personhood. Thanks NAMI for the heads up. Its been a long journey for our family and hopefully there is an even longer journey ahead.

I love the idea of an entire country that has trained crisis intervention people answering our calls for assistance. I don’t want frightened people trying to help me or my son.

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Yes, it was clear to me when some police came to my house that they were themselves afraid to handle my daughter. It is much better when the police have completed their Crisis Intervention Training. Being able to ask for a CIT trained officer when calling for police help helps lessen the worry on everyone’s part.

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I agree @hope and I loved the Family to Family class when I took it, it helped me so much.

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Me too Catherine, me too. Best wishes.

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We recently had a situation in my area in which an active shooter killed and injured others and ultimately was killed himself by the police.

His parents described him as having schizophrenia, which I had been suspecting from some of the details of how things had transpired.

His parents eventually were interviewed by the media added some additional information that I thought was very interesting. Specifically, although their son had suffered from symptoms of schizophrenia for years, was on and off medications, and could be volatile, he had never been violent or threatening in any way until he was jailed for a period of time a couple of years ago for a non-violent offense.

As his parents described it, he emerged from this period of incarceration with a very visceral sense that other people were dangerous and wanting to cause him harm. He had also learned to respond to limit setting with anger and threats to the point that his parents continued to do whatever they could to assist him, but would no longer allow him to live with them.

After the shootings (during which he primarily targeted law enforcement), his parents blamed the mental health system for failing their son, and this makes sense to me.

It makes total sense to me that if you take someone already prone to paranoid delusions and put them in a situation (such as jail) where their sense of threat is high and the behaviors of others towards them are frequently unkind, then they would emerge from that situation in a worse way than when they entered it.

Add a lot of societal instability and anger that happens to coincide with some of his negative experiences, and you end up with someone who initially had a basically positive attitude about other people but who ends up becoming dangerous to others and (ultimately) to himself.

Tragic and probably preventable.

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