Guest Author - Bonnie Sayers
Surviving Schizophrenia: A Manual for Families, Consumers, and Providers is the product of thousands of conversations with families. The author states "the fate of these patients has been worsened by our propensity to misunderstand, our failure to provide adequate treatment and rehabilitation, our meager research efforts. A disease which should be found, in the phrase of T.S. Eliot, in the “frigid purgatorial fires” has become through our ignorance and neglect a living hell.."
E. Fuller Torrey, M.D. is also the author of The Death of Psychiatry, Schizophrenia and Civilization, Nowhere to go: The Tragic Odyssey of the Homeless Mentally Ill. His sister is afflicted with schizophrenia.
My ex husband has Paranoid Schizophrenia. There is a 50% chance that one or both of my children on the Autism Spectrum will develop Schizophrenia as a young adult, which is the reason for my reading Surviving Schizophrenia.
The manual is broken down into eleven chapters, four appendixes, a listing of courses on Schizophrenia, listing of addresses for provider training programs, listing of groups and activities and a listing of the best journals covering Schizophrenia.
There is a notes section at the back that goes into detail for each chapter the references from recent summary articles. Lastly is a twenty-page index to assist in searching for specific information.
The book starts with a preface to the third and first editions and a page showing where illustrations can be found within the manual. The first line in the preface to the first edition explains the fear many are faced when receiving the diagnosis of Schizophrenia.
“Oh, my god, anything but that,” she replied. “Why couldn’t she have leukemia or some other disease instead?” In the words of the author, “If this book contributes just a little toward bringing schizophrenia out of the Slough of Despond and into the mainstream of American medicine then it will have accomplished its purpose.”
Chapter one Dimensions of the disaster lists eight, with many of them ones I can relate to within my experience having lived with a person afflicted with this disease.
There are as many individuals with schizophrenia homeless and living on the streets as there are in all hospitals.
There are as many individuals with schizophrenia in jails and prisons as there are in all hospitals.
There are increasing episodes of violence committed by individuals with schizophrenia who are not being treated.
Many individuals with schizophrenia revolve between hospitals, jails and shelters.
Schizophrenia is remarkably neglected by mental health professionals.
My children's father is somewhere in San Francisco living in homeless shelters and comes back to Los Angeles every few months. Prior to my son Matthew being prescribed Risperdal I had experience observing their father on the same med. Neither are on it anymore. The first medication my ex husband started on was Haldol, the same medication Andrea Yates was on prior to drowning her children.
Regular schizophrenia is not a separate entity in the DSM-IV. Many appear to shift in their symptoms over time. Listed in chapter four is the discussion of what schizophrenia is not, such as mental retardation, manic-depressive disorder or a split personality, such as the movie Sybil. They also refer to infantile autism.
I know from experience having two children who are autistic that many professionals confuse autism with childhood schizophrenia. This was the thinking of long ago and not true. By reading the manual you will learn there are differences between males and females that are diagnosed Schizophrenic.
Chapter five discussed the prognosis of Schizophrenia and then chapter six has theories of what causes schizophrenia. It is established that individuals with schizophrenia die at a younger age plus suicide is the largest factor to the mortality rate. It is noted that they suffer more accidents, which might have to do with their delusions and distraction by auditory hallucinations. Individuals with schizophrenia have more infections and type II diabetes plus heart disease, with females breast cancer is higher. My almost ex has mentioned he has hepatitis C and was bulemic many years ago plus has heart problems.
It is mentioned that the younger the diagnosis the better the outcome as the individual gets older and females fare better. Under the street drug psychosis section the question is discussed on whether drug use can cause schizophrenia. There is now evidence that repeated use of mind-altering drugs can damage the brain but no concrete evidence that it causes schizophrenia.
Psychosis can also follow a severe head injury but both are common in young adults so it could be coincidental. My ex suffered some sort of injury around this time when he was a furniture mover in a warehouse. He also spent many years utilizing mind-altering drugs.
The description listed under Paranoid Personality Disorder seem to be describing my ex husband to a tee. Always suspicious of others, question loyalty of others, rigid, argumentative, few tender feelings, disdain weak people, lack any sense of humor and believe that others are trying to trick or harm them.
To meet the criteria for the diagnosis of Schizophrenia under the DSM-IV at least five of the items listed below should be met:
A. ideas of reference, meaning that the person frequently thinks that other people are talking about him/her
B. odd beliefs or magical thinking that influence behavior and are inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense:; in children and adolescents, bizarre fantasies or preoccupations)
C. unusual perceptual experiences, including bodily illusions
D. odd thinking and speech (e.g. vague, circumstantial, metaphorical, overelaborate, or stereotyped)
E. suspiciousness or paranoid ideation
F. inappropriate or constricted affect
G. behavior or appearance that is odd, eccentric, or peculiar
H. lacks close friends or confidants other than first-degree relatives
I. excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgements about self
Chapter seven is on the treatment of schizophrenia covering lithium, thorazine and haldol. This chapter also discusses hospitalization, non -psychotic drugs, the addiction aspect of the drugs and the various dosing needed for the degrees of schizophrenic behavior.
Chapter eight goes into detail on the rehabilitation of schizophrenia with medication, counseling, employment and housing issues. There is information on how to develop friendships and obtain medical care. Chapter nine is the major problems consisting of cigarettes, coffee, alcohol and street drugs, sex, pregnancy and AIDS.
They mention the importance of coffee and cigarettes to those afflicted with schizophrenia. The section on pregnancy was geared more towards a female who would be pregnant
Chapter ten is devoted to questions from families and consumers, such as the following:
"What will happen when the parents die?
Should you tell people that you have schizophrenia?
How can relapses be reduced?
Does schizophrenia change the underlying personality?
Should people with schizophrenia drive motor vehicles?"
Chapter eleven focuses on advocacy for research, how to decrease the stigma and improve services. Appendix A is the 15 best and worst books on schizophrenia, B is the videotapes and C is useful resources. Appendix D is the contacts for the Alliance for the Mentally Ill by State.
This is a useful reference manual for anyone who knows of a schizophrenic individual or is preparing to work in the mental health field. I even suggest family law specialists to peruse this manual for research in how to deal with those who are schizophrenic.