Are you ready to #SchizoChat, our weekly series where we spout fun facts about schizo-type illnesses, ask questions, and generate conversation to help #EndTheStigma?
Last week we discussed treating schizo-type illnesses with antipsychotic medication. If you missed that #SchizoChat check it out here (in html format): threadreaderapp.com/thread/1184604…
Or this thread:
Or this thread:
And if you missed our first #SchizoChat (“what is schizo?”) you can check it out here (html): threadreaderapp.com/thread/1182068… or the thread below. Every SchizoChat will be tagged in my pinned thread (go to my profile, click “show this thread”)
Since we focused on antipsychotics (the primary treatment for schizo-type disorders) last week, this #SchizoChat will be all about other methods that folks used to treat #schizophrenia and #schizoaffective disorders.
Usual caveats: I’m not a doctor or expert of schizo-type diseases, I’m just a scientist who happens to have schizoaffective disorder and wants to share some cool facts. Make sure you talk to a real doctor! #SchizoChat
As I’m not an expert, if you notice any of my facts are incorrect please let me know and I’ll fix it! #SchizoChat
And please engage so I’m tweeting into the void! Comment on the posts, send me DMs, participate in the polls—anything to get folks talking about schizo-type illnesses! In the non-stigma way, obviously. #SchizoChat
I’ll answer your questions/comments/DMs as soon as I can—I’m behind today so I’m writing these tweets as I go. #SchizoChat
I’ll be trying to tweet in this thread at least every 5 minutes so keep check in as I go (and I post the completed chats in my pinned thread each week and retweet the juiciest bits throughout the week if you are interested but don’t want to check Twitter all night). #SchizoChat
If you recall from last week, some patients with schizo-type illnesses (~10%) will never respond to antipsychotic medications. For others, the side effects are too great or the costs are too steep. What then? #SchizoChat
All treatment options should ideally be made through a dialogue between the patient and their psychiatrist (and potentially other parties, like family members assuming they have the patient’s best interests in mind). #SchizoChat
For the vast majority of patients, schizo-type illnesses are a lifetime struggle. We will need various types and amounts of treatment/support at various stages of our life, and this is not often predictable. #SchizoChat
If patients don’t respond to antipsychotic medications (or don’t respond to them as well as needed to lead their lives), psychiatrists may prescribe other drugs either instead of or in addition to antipsychotics. #SchizoChat
These medications may include antidepressants, mood stabilizers, anti-anxiety meds… basically any medication that you can think of that can help alleviate the accompanying depression, anxiety, mood swings, etc. #SchizoChat
I am personally taking an antipsychotic (Latuda) but I’m also on an anti-depressant (Wellbutrin), a mood stabilizer (lamotrigine), and an anti-anxiety medication (buspirone) as well! #SchizoChat
Check it out—many patients are on these sort of medication “cocktails” #SchizoChat
At the time of tweeting, 100% of participants say they take meds in addition to their antipsychotics!
At the time of tweeting, 100% of participants say they take meds in addition to their antipsychotics!
In addition, many patients will take medications to help alleviate the side effects of the antipsychotics themselves. For a while I took a medication that reduced the likelihood of night terrors, as that was a crushing side effect of an antipsychotic #SchizoChat
There are many people who take multiple medications to treat all sorts of mental illnesses and mental health issues! #SchizoChat
It’s hard to find the right dose/type of antipsychotic! As you can imagine, finding the right medications to complement the antipsychotic can at times seem like a herculean task! #SchizoChat
I meet with my psychiatrist regularly (as regularly as I can afford, basically) to make sure that all of the medications are working in the right ways and to balance all the associated side effects. It’s exhausting! #SchizoChat
Again, though, not everyone will respond to *any* medication, the costs (financial and personal) may too be great, and/or you might need additional support. What does that look like? #SchizoChat
Some patients respond to other types of medical intervention, such as the so-called “convulsive therapies” frequently used in the mid-20th century. These sound terrifying, but what are they exactly? #SchizoChat
These convulsive therapies (cardiazol, insulin shock, and electroconvulsive) were mostly replaced by antipsychotic and other medications, but I’ll go into them a bit anyway. #SchizoChat
Convulsion therapies were initially an attempt to induce seizures, which doctors thought treated major mental health problems like depression, schizo-type disorders, bipolar, etc. #SchizoChat
Insulin shock therapy (also known as insulin coma therapy) was used in the mid-20th century to treat a variety of psychiatric disorders including schizo-type illnesses. #SchizoChat
Patients that underwent insulin shock therapy were generally those that were physical fit and had a “good prognosis.” Why? It was intense! #SchizoChat
Patients undergoing insulin shock therapy were given injections of insulin until they went into a coma. This was done six days a week for two months or even up to two years! #SchizoChat
Physicians claimed that insulin shock therapy blocked nerve cells, leading to the recovery of the patient by “jolting” them out of their mental illness #SchizoChat
Curious about what this looks like? Nobel Laureate (and schizophrenic) John Nash underwent insulin shock therapy. It’s shown on screen in the biographical film A Beautiful Mind. #SchizoChat
Physicians who were proponents of insulin shock theory claimed it cured 80% of patients, but if those patients already had a good prognosis they may have just gone into remission. #SchizoChat
As you can imagine, the side effects from insulin shock therapy could be awful. Patients would have seizures, uncontrollable weight gain, twitching, spasming, “aftershocks,”… the list goes on and on. #SchizoChat
Insulin shock therapy was ended mostly because of the introduction of antipsychotics, but also because Dr. Harold Bourne published a paper called “The Insulin Myth” arguing that it wasn’t helpful at all anyway #SchizoChat
A similar therapy was called “cardiazol therapy.” It was similar—patients were injected with a drug used as a circulatory stimulant. It may have helped depression but it caused uncontrollable seizures and was halted in 1982. #SchizoChat
Perhaps the most famous “convulsive therapy” is electroconvulsive therapy, formerly known as “electroshock therapy.” Patients (who now have to give informed consent) have electrodes placed on their head, which deliver electricity #SchizoChat
Electroshock therapy may seem like a thing of the past but it is still widely used to treat patients who don’t respond to drugs—but only with their consent! Current estimates suggest 1 MILLION people are treated this way annually. #SchizoChat
I forgot to launch this poll earlier, but please let me know if you or anyone you know has undergone electroshock therapy recently! I am intrigued. #SchizoChat
How does electroshock therapy work? In short, we don’t really know. We do know that it can help treat depression and other mental illnesses but we don’t exactly know why (but remember we don’t really know how the drugs do either) #SchizoChat
Side effects of electroshock therapy can include seizures, memory loss (temporary and permanent), muscle soreness, heart arrythmia, and more #SchizoChat
Intriguingly, electroshock therapy can be administered during all three trimesters of pregnancy! #SchizoChat
Side note: antipsychotics are often not recommended during pregnancy/breastfeeding, although patients and psychiatrists may continue the medications if the benefits of antipsychotics outweigh the risks to parent and baby #SchizoChat
Extra side note: I'll probably do a #SchizoChat about parenthood and schizo-type illnesses later on because I'm hoping to be a parent at some point so I read a LOT about it.
Many famous folks underwent electroshock therapy including Ernest Hemingway (who died right after a session), Robert Pirsig (who wrote Zen and the Art of Motorcycle Maintenance), David Foster Wallace…#SchizoChat
In addition to convulsive therapies, patients were sometimes treated with “deep sleep therapy.” They would be given drugs to make them sleep for days to weeks at a time to “treat” everything from schizo-type illnesses to obesity to addiction. #SchizoChat
Deep sleep therapy led to some deaths (including a large scandal exposed by the 60 Minutes program) and was not used as frequently as convulsive therapies. #SchizoChat
Healthy sleep can help your mental health, pass it on! #SchizoChat
Another popular therapy of the 20th century was psychosurgery. This involved the literal removal or destruction of part of the brain by radiation, freezing, or cutting. #SchizoChat
The most famous type of psychosurgery is the lobotomy, which brain parts (the prefrontal lobes, for you nerds) are separated by putting holes in the skull. This could be done with an icepick. #SchizoChat
In the 1940s 5000 people received lobotomies annually in the United States. #SchizoChat
The main proponent/discoverer of lobotomies was a US neurosurgeon named Walter Freeman. He drove a “lobotomobile” around the country to advocate for the procedure. #SchizoChat
And when I say discoverer I mean modern Western discoverer—putting holes in skulls has been a thing since 5100 BC apparently. #SchizoChat
Lobotomies are not the only type of psychosurgery though! Some procedures target brain parts like the amygdala, hippocampus, hypothalamus, prefrontal cortex, and cingulate gyrus… all brain parts that regulate emotion. #SchizoChat
As you can imagine, chopping up the brain can lead to death, severe loss of function, memory loss, and a slew of other problems. It’s been said that psychosurgery benefited the family members who had to “deal with” the patients more than it benefited the patients. #SchizoChat
Other brain-altering therapies include deep brain stimulation (DBS), where a “brain pacemaker” neurostimulator is placed in the brain. This can help with a variety of mental illnesses apparently. #SchizoChat
Deep brain stimulation has many possible side effects, of course, like personality changes, hallucinations, cognitive dysfunction, etc. etc. We have no idea how this works either. #SchizoChat
Another similar brain-altering therapy is transcranial magnetic stimulation (TMS) in which repeated magnetic pulses are sent through the brain. It is still used today to treat mental illnesses like depression #SchizoChat
One of my good friends is undergoing transcranial magnetic stimulation at the moment because she’s never responded to antidepressants and she says it is working well. I’m intrigued. #SchizoChat
Of course transcranial magnetic stimulation is not without side effects, including headaches, twitching, seizures, mania, and hearing loss. #SchizoChat
So, physicians have found a variety of ways to safely and not-so-safely stimulate the brain in an attempt to treat mental illnesses like schizo. But there are other less-medical options for treatment as well! #SchizoChat
Finding support systems may in itself be very useful for patients—we often need help taking care of ourselves, learning about schizo, relaxing, focusing on goals, staying upbeat, etc. #SchizoChat
These support systems may be family members, in-person support groups, and online support groups (looking at you, my Twitter support family) #SchizoChat
Patients may also benefit, in extreme cases, by living in hospital “psych wards” or institutions. I’ll go into the history and continued use of these techniques in next week’s spooky #SchizoChat!
Other forms of support therapy may come from professional individuals like counselors, licensed therapists, and psychologists. #SchizoChat
We often use the terms “counselor,” “psychiatrist,” “therapist,” and “psychologist,” interchangeably, but there are differences between the professions and their techniques. #SchizoChat
What is the difference between counseling and psychotherapy? #SchizoChat
Counseling focuses on specific issues in order to treat a particular problem. Patients undergoing counseling ideally learn specific techniques to help them cope with and avoid problems. #SchizoChat
Counseling is often short-term, as the patients would ideally find the solution to their particular problems. #SchizoChat
As you can imagine, though, dealing with a lifelong mental illness may not require such a short-term solution. #SchizoChat
I’ve run into this with university counseling services. They ask “what do you want to solve” and want you to solve it in a few sessions. They don’t like it when my answer is “finding support for a lifelong illness.” #SchizoChat
That isn’t to say that counseling is not helpful for many schizo-type patients! Oftentimes learning specific coping skills and problem solutions may make life easier and deal with specific schizo-related problems #SchizoChat
Psychotherapy is different from counseling! It is more long-term and covers a wider range of the problems associated with mental illness. #SchizoChat
The basic idea of psychotherapy is that patterns of thinking and behavior can impact the way patients interact with their illness and the world around them. This long-term care will help the patients alter these interactions. #SchizoChat
Examples of the goals of therapy include focusing on understanding the illness/symptoms, managing symptoms, reaching personal goals, having more satisfying relationships, regulating responses to stimuli, etc. #SchizoChat
There are multiple classes of psychotherapy that are useful for different types of people. Folks trained to perform psychotherapy (more on this later) often have specific classes on which they focus. #SchizoChat
Humanistic therapies focus on the client, assuming that they are the authority on themselves, and allow them to make rational choices to develop into their potential #SchizoChat
Psychoanalytic therapies focus on the unconscious issues/conflicts that result in the symptoms the patients want to address. This often includes the classic “what happened in your childhood” and dream analysis approaches. #SchizoChat
Behavioral therapies focus on changing unhealthy behavioral patterns by helping patients learn new reward/punishment associations or by exposing them to triggers (such as treating fear with phobia exposure). #SchizoChat
Integrative/Holistic therapies combine these different approaches in order to best treat a client. A well-known example of this is cognitive behavioral therapy, which seeks to address thought and behavior. #SchizoChat
My new therapist is a cognitive behavioral psychologist who focuses on #schizophrenia—hopefully she will be able to help me in addition to my medication!
Counselors can provide the short-term problem-solving counseling, but who provides these long-term in-depth psychotherapies? There are a few different titles/degree programs who can #SchizoChat
Psychiatric/mental health nurses are nurses who have received additional training and certification. They can diagnose mental illness, provide psychotherapy, and (in some states) prescribe medication. #SchizoChat
Clinical social workers need a master’s degree in social work. They evaluate and treat mental illness, provide case management and hospital discharge planning, and advocate for patients and families. #SchizoChat
Licensed mental health counselors hold master’s degrees in psychology, counseling, or other related fields, and they need two years’ experience working with a professional after graduate school. #SchizoChat
Licensed mental health counselors are certified to provide counseling and psychotherapy. #SchizoChat
In my experience, the local counselors, psychiatric nurses, clinical social workers, and licensed mental health counselors were not comfortable treating someone with a schizo-type disorder. That left me with the last class of therapists: psychologists. #SchizoChat
Psychologists have a PhD, PsyD, or ED degree. They are doctors of the study of the mind and behaviors. They go to graduate school and do an internship for 2-3 years afterwards #SchizoChat
Licensed psychologists are certified to do counseling, psychotherapy, psychological testing/diagnosis, and provide treatment but they are (with a few exceptions) not able to write prescriptions for psychological medications #SchizoChat
Because psychologists and other mental health professionals often do not have the ability to write prescriptions, they will turn patients over to psychiatrists #SchizoChat
Psychiatrists are medical doctors (with M.D.s or D.O. degrees) who specialize in preventing, diagnosing, and treating mental illness. They go to medical school for four years, an internship for one year, and at least three years of special training. #SchizoChat
Psychiatrists differentiate mental health problems from other conditions, monitor mental illness, and prescribe medication for those mental illnesses. #SchizoChat
Because psychiatrists prescribe medication they are often quite focused on medication as a treatment. But we know that medications don’t always help! #SchizoChat
Some psychiatrists may also provide psychotherapy themselves, but most refer patients to counselors, therapists, or psychologists that do. #SchizoChat
In practice, this often means that patients see both a psychiatrist and a licensed therapist of some sort. We talked about the extreme cost of psychiatry last week, but therapy/psychology can be equally expensive! Check out this #SchizoChat poll:
With my previous therapist I was paying $30/session copays, or $120 a month. Not sure what my new psychologist will be, but hopefully not more expensive! It works out to >$500/month between the meds, psychiatry, and therapy. #SchizoChat
Psychology, support systems, psychiatry, and other medical interventions are the general treatment plan for treating schizo-type disorders. #SchizoChat
Some patients will also swear by home remedies, know as “alternative treatments” or “herbal remedies.” #SchizoChat
Some of these home remedies have some scientific basis. Vitamins like B12, fish oil, folic acid and more may treat some of the symptoms or schizophrenia. Maybe. Remember we still don't really know what causes schizo-type disorders. #SchizoChat
In other cases, vitamins may make things worse. In general, we get most of the vitamins we need from our diet so we don’t really need supplemental vitamins. But talking with a psychiatrist about vitamins may be useful! #SchizoChat
Side note: I’ll talk about this more in a later #SchizoChat about schizo on TV, but a character on Criminal Minds who is worried about developing schizophrenia mentions taking B12 and fish oil. He never says it is for schizo, but that’s my guess. #SchizoChat
Just an Easter egg for schizo folks out there I guess.
No Criminal Minds spoilers please, I'm only on season 10. #SchizoChat
No Criminal Minds spoilers please, I'm only on season 10. #SchizoChat
There’s other dietary options to help with schizo-type illnesses as well. A very small number of schizophrenic patients (<5%) may be experiencing their symptoms due to an undiagnosed gluten intolerance! #SchizoChat
Because of this, some professionals (including my university psychiatrist) recommend cutting back on gluten or cutting it out altogether. It didn’t help me because I’m not in that <5% but it has helped some folks! #SchizoChat
Many folks self-medicate with other drugs. You may hear that marijuana can help treat schizo-type illnesses, but as you can imagine, taking a drug that induces hallucinations and paranoia in neurotypical brains is not recommended #SchizoChat
Many many schizo-type patients use nicotine products (more than 9 out of 10 are heavy smokers). There may actually be a link between schizo symptoms and nicotine receptors in the brain! medicalnewstoday.com/articles/31544…
That’s not to say that doctors recommend the use of nicotine products! Tobacco products are notoriously unhealthy and it sure looks like vaping products are also bad news. Nicotine itself (in patches or gum) is not healthy either #SchizoChat
That being said, none of my psychiatrists have ever tried to get me to break my nicotine habit because they know that I feel better and (think that) I think more clearly while using nicotine patches/gum. #SchizoChat
This whole #SchizoChat (and all the others) has a big skew towards Western medicine because I live and research in the United States. That’s not to say that other cultures’ medications don’t help schizo-type folks, I just don’t know much about them
I’d love to learn more about traditional medicine (in general and related to schizo-type illnesses). If you have any recommendations/sources please pass them on! I’d love to do a #SchizoChat about them too.
I did find a cool scientific study that shows that traditional Chinese medicine (TCM in medical literature) can help alleviate the symptoms of #schizophrenia when used in addition to antipsychotics! cochrane.org/CD003444/SCHIZ…
Lots of folks also swear by wellness exercises in general. Meditation, music, religion/spirituality, petting your dog, exercising… all of these things contribute to positive mental health and can definitely help folks deal with schizo-type disorders! #SchizoChat
Here’s my dog, in case you were wondering. #SchizoChat 
She is a very good dog who helps me get home when I am disassociating, brings me comfort when I’m freaking out, and helps me determine if my hallucinations are real or not (she’s react if the monster was really there after all). #SchizoChat
Funny side note: I was looking for dogs because my therapist told me too and I found her on a pet site states away from where I was living. I had this intense delusion/compulsion that told me I absolutely had to have her. Absolutely worked out! #SchizoChat
In general these home-remedies/herbal remedies may not have scientifically proven results, but they may help you! And that is okay #SchizoChat
I’m a skeptical scientist, so I tend to think a lot of home remedies are placebo effects (they don’t actually do anything but we think they do so we think they are helping). But hey, if it helps it helps! #SchizoChat
I definitely wouldn’t recommend using any of them instead of psychiatry and psychotherapy, but then again I’m not your parent, do whatever you want! Haha #SchizoChat
In general try to be compassionate towards folks regardless of the type of help they’re seeking. Unless they’re asking for advice the best practice is to not give it to them! #SchizoChat
In conclusion, there are a lot of ways to treat schizo-type disorders in addition to antipsychotics! They are often really helpful if used alongside those antipsychotics. #SchizoChat
If you appreciated any part of this #SchizoChat please share it (or the whole thing!). I want to get as many folks involved with #SchizoChat as possible to help #EndTheStigma.
Last week I asked y’all about different awareness-raising merch! In general folks thought bracelets, pins, stickers, and t-shirts would be great. I’ll launch a website soon with merch to purchase and other resources. #SchizoChat
Next week’s #SchizoChat will be spooky themed because it’ll be the day before Halloween. I’ll be chatting about asylums/institutionalization—its history, current use, portrayal in media/Halloween costumes, and controversy. See you then!
Hey @threadreaderapp can you unroll this for me please?
she'd* react whoops
therapist told me to* I can grammar I swear
Here's the html if you prefer reading it in this format: threadreaderapp.com/thread/1187141…
so I'm not tweeting into the void! words are hard
Correction: luckily @Jack_ElHai pointed out that the term lobotomobile is a myth made up my biographers!
