What is Schizophrenia? Trouble Arises From Ignoring It

Having lived as a diagnosed schizophrenic since the summer of 2001 (technically having been bearing the actual affliction since birth), I feel that my position provides me with a unique perspective on a widely-misunderstood disease that many view only through the disinterested disdain of the media: the raving lunatic on the streets, shouting at passer-bys, the “problem child” (the one in the institution) nobody in the family talks about in polite company, Anthony Hopkins tearing off a cop’s face (in a movie, I hope). In fact, among the general population of those afflicted, less than 1% exhibit violence related to the disease, and fewer than 10% require institutionalization at any point during their lives.

But what is schizophrenia really, if not the stylized madness portrayed in popular film and television? Schizophrenia is not so much a ‘disease,’ really, as a ‘syndrome,’ in that it is an aggregate of lesser, separately-diagnosable mental conditions. The most common component diagnoses include manic depression, anhedonia (inability to experience joy), alogia (tendency to contribute little to conversation), and a variety of hallucination-related disorders that are so numerous they are generally uncharacterized outside of the broader category of schizophrenia.

Is it possible to live a normal life with schizophrenia? Yes, it is, in fact, within 30 years of diagnosis, 25% of those afflicted exhibit signs of a full recovery, and another 35% are able to live a normal life with the assistance of only a minimal amount of oral medication. But then again, 15% are dead of suicide, mostly as a result of the fact that, as far as diseases go, schizophrenia is not exactly a popular fundraiser.

It is not uncommon for the medical industry to shun that which is does not and cannot understand: remember until less than a hundred years ago, some trained doctors were still diagnosing certain diseases as demonic possession. To try to understand how this tendency applies to schizophrenia, think of some of the popularized diseases you’ve heard of, the ones that really rack up the cash in the fundraisers: Alzheimer’s, multiple sclerosis, diabetes, muscular dystrophy, HIV.

For a perspective, consider that for every one American with muscular dystrophy, there are sixty with schizophrenia. For every with diabetes, there are six with schizophrenia. For every with MS, there are five with schizophrenia. For every one with Alzheimer’s, there are two schizophrenics feeling very, very left out of the medical research funding aspect of things. For an HIV perspective, consider that there are 800,000 living with this disease in America, earning a total of $1.792 billion in annual research funding. Yet there are more than three times as many with schizophrenia (2.6 million, in the United States), generating a scant $196 million in medical research annually. Proportionally, this means that the diseases with the better PR are getting, in sum, trillions more dollars in research than a disease which affects many more, and in some cases, much more seriously curtails their lifespan and their quality of living.

But statistics never convinced anyone, because this is America: the facts are not so important as their presentation. So, let me share with you what it means to me that schizophrenia only receives $196 million annually with which to search for a cure.

When it came down to diagnosis time, I experienced something common among most with this disease: anosognosia, or, in Fraudian (or, Freudian, take your pick, you repressed penis-envier, you) terms, “denial.” This is not to suggest any truth to the old joke about the guy whose psychiatrist tells him he’s in denial, and he says “No I’m not!” and the doctor goes “see?” Anosognosia is when, even when presented with overwhelming evidence, the heart of the matter is continually denied. Confronted with hallucinations both auditory and visual, delusions of varying degrees of absurdity, and occasionally even lapsing into the identity of a separate individual, I refused to accept that there could be something wrong with me.

Let me take this time to remind you that schizophrenia is not the same as “multiple-personality disorder.” That disorder is, by consensus of the medical community at large, probably not actually real.

Eventually I came out of it and realized that it is uncommon and irregular for a person to see things that aren’t actually there and hear things that aren’t actually being said, so, I began regular treatment with a popular antipsychotic medication called Abilify, chemical name ariproprazol. The purpose of this medication is not to prevent hallucinations, either auditory or visual, because it is almost entirely unknown to medical science what parts of the brain are responsible for hallucination, much less how to correct those faulty parts, but instead to combat the variety of neurological symptoms related to the disease, the delusions and such.

I remember there was a period of about a year when I thought that somebody was secretly publishing my stories and poems in magazines around the country behind my back. This malevolent plagiarist was collecting big bucks off of work that I perceived to be mine, and I remember standing at the magazine aisle in Borders sometimes and flipping with maddening speed through magazines like the Writer’s Digest and such and jotting down the names of writers that I believed to simply be pseudonyms of that bastard who stole my notes, even the hand-written ones, right out of my room while I slept. That never really panned out or resolved, instead it metamorphosed into a larger delusion that I, being a liberal, was an enemy of the state and as such, the government was injecting these visions and madnesses into my brain with advanced radio technology from a secret base underneath Alaska so as to discredit me in the eyes of whatever audience I perceived to be hanging on to my every word.

But what the medication does nothing for is the occurrence of the “psychotic episode.” Having had one of these when I was thirteen or so, let me try to tell you what it’s sort of like, without going into the particulars: If you were under eighteen, I would liken it to the game “Jenga,” when you pull out an unstable block: everything falls apart.
If you were over eighteen, I would ask you to momentarily imagine, if you’d be so kind, the darkest and most dire pages of the Book of Revelations, to imagine the nightmarish beasts said to overrun the Earth in the last days of mankind, and then, for comparison, turn them all into small, cooing doves. Now take what would be, in this new analogy, the new demons of Revelation. Those are the things that happen to you in a psychotic episode. That was the only time I ever spent in a mental institution.

Among those afflicted with schizophrenia, 22% will experience only one episode and be unimpaired after recovery, a further 35% will experience multiple episodes throughout their lives but will be unimpaired during their normal lives after recovery from each episode. However, due to insufficient research into what causes these episodes as a result of lack of appropriate funding leads to the “on the other hand” statistics that read that say that 8% of those affected never return to reality after the onset of the initial episode, and another 35% grow increasingly impaired over several episodes and never return to full normality.

That is the cost of living for some people: complete detachment from reality, an utter loss of ability to function or contribute to society. An estimated 200,000 homeless Americans, constituting fully one-third of the homeless population, suffer from schizophrenia. Another 250,000 live in permanent hospitalization, costing millions to billions in government and family money. The drain is greater for those living in nursing homes or living with family members out of necessity. Dr. Richard Wyatt totals the economic fallout at $65 billion, of which only about one-third results from direct treatment and the rest is that lost from lost work time for patients, care-givers, and the criminal justice system.
Which is to say, even if one takes the coldest possible outlook at medicine (which is, the cost-benefit analysis), curing schizophrenia is simply a more profitable enterprise than nearly any other disease. Only diseases such as cancer and chronic respiratory illness drain more from the coffers of society than schizophrenia.

The only way to prevent a problem such as this is to allot time to its discussion: you know that family member you don’t talk about around polite company, the one in “the institution?” Maybe it’s time to talk about him. Instead of taking the approach taken by all but those affected, either as patients or care-givers, in which those affected are dismissed to the far back of society, never to be seen again, it is simply more reasonable, more profitable, and more humane to eliminate the problem once and for all, with roundly effective cures, instead of the fractionally effective medications in use today that leave thousands homeless, and thousands dead.

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