Living with Schizophrenia

by Brian Benjamin Carter

Good day to all of you,
I read your schizophrenia article ("Schizophrenia and Oriental Medicine") and I'm really happy because of your information. I am Rafie from the Philippines, my ever beloved girlfriend is suffering the disease called Schizophrenia. I really feel bad about her situation. I'm grateful that she hasn't become delinquent. But still I am affected. She is under psychiatric treatment. May I ask you a favor if you could give me the information on this matter:

Can it be treated - will she be back to her previous personality, the way she talks, dresses, etc.?
How long is it for the recovery?
Are there any physical effects that may arise due to her mental disease or may it complicate from mental ailment to physical?
What are to be avoided -anything that may worsen her disease; foods, environment, etc.?

Ralph
Taiwan

Dear Ralph,
I'm sorry to hear about your situation! I can't imagine it's easy to deal with. I hope that my answers can help you both and ease your suffering a bit.

The short answers to your questions are yes, maybe, it depends, yes, and it depends. Ok, I'll amplify that. Let me take these questions one at a time.

Can Schizophrenia Be Treated?
Schizophrenia has been pretty effectively managed with antipsychotic prescription medications and most schizophrenics can return to a fairly normal life. 25% return completely to normal. 20-50% of them can lead normal active lives with some symptoms. Research in China has demonstrated beyond doubt that acupuncture helps schizophrenics recover. They've found that acupuncture can be utilized as the primary treatment in any mental disorder. That conclusion was made way back in 1987 when Michael Jackson was still cool. Yeah, a long time ago! :)

Schizophrenic Personality Changes
Schizophrenics experience interpersonal difficulties due to what has been described as a "disconnectedness from common sense." They have trouble understanding others' states of mind. They experience "schizophrenic vulnerability" which can be divided into three categories: Sensory disorders: Incorrect views of self, body, and world. Conceptualization disorders: Attributing the wrong meanings and intentions to people and situtations. Attitudinal disorders: Holding strange values and beliefs while distrusting conventional knowledge.

Female Schizophrenics
Schizophrenia affects women differently than men: They have more emotional symptoms. They are more likely to hear things that aren't there (auditory hallucinations), and to believe people are persecuting them. They respond more quickly to antipsychotics, but have more side effects than men do.

Factors that Influence Recovery
Your girlfriend has a good chance of returning to her previous self. There are a number of factors that influence these chances. She will do better if:
There is a known trauma, either physical or emotional, that triggered the first episode
The onset of schizophrenia was late (later than teens or early twenties)
The onset was sudden rather than gradual
There was good social functioning before the onset
Treatment is begun early in the course of illness
She combines multiple types of treatment; antipsychotics, cognitive behavioral therapy, acupuncture, the right herbal medicine, proper nutrition and exercise
She avoids stress and instability in work, personal relations, and home

She must do these things not just to get better faster, but for her own safety as well. Schizophrenics are at risk for both suicide and life-threatening disease. I don't mean to alarm you; I only want to emphasize that doing everything she can will ensure her return to active, normal and long life.

Antioxidants for Schizophrenics
Interestingly, schizophrenics do better in developing countries. It's not clear why this is, but patients in developed countries have more lipid peroxidation and lower levels of membrane phospholipids. This implies greater oxidative stress. You've heard all the hype about antioxidants? Schizophrenics appear to do much better when given antioxidants (e.g., vitamins E, C and A; beta-carotene, Q-enzyme, flavons, etc.) and essential polyunsaturated fatty acids (EPUFAs). Schizophrenics' lifestyles are often very oxidative; they smoke, drink, eat high calorie foods, but do not exercise. For this reason, antioxidants and EPUFAs are very important.

Antipsychotic Effectiveness and Side Effects
Antipsychotic medications clearly work. They get rid of the hallucinations and delusions. However, the side effects cause problems and slow down or stop recovery. The side effects are: weight gain
endocrine disturbances
sedation
anticholinergic effects
hypotension
seizures
extrapyramidal symptoms (potentially painful and disfiguring abnormalities of body movement... even parkinsonism)

One of the biggest problems is the weight gain. For patients who are already susceptible to weight gain, gaining 50 pounds or so can have a horrible effect on self-image and mood, and the patient may decide to stop taking the antipsychotics. It's as if they're saying, "I'd rather be a skinny crazy-woman than a sane overweight one."

Alternatives to antipsychotic-only treatment are:
Acupuncture and herbal medicine as primary treatment with a lower dose of antipsychotics (there is research in China to back this up), or Antipsychotic primary treatment combined with acupuncture and herbs to manage the side effects.

More on Schizophrenic Weight Gain Management
Your girlfriend may not have a great understanding of nutrition (a lot of people don't!). She may also not be able to afford healthy foods (who can?)... just avoiding the wrong foods can be a cheap way to make progress. In Chinese Medicine, the foods to avoid would depend upon her pattern diagnosis. If she can see a Chinese Medicine herbalist/nutritionist, she should! Weight management isn't just about looking good; it's a matter of life and death! Statistics show that life-threatening diseases come from obesity and smoking combined with poor diet, lack of exercise, and pharmaceutical side effects.

Schizophrenics Must Avoid...
These things put schizophrenics at risk for suicide or disease. They should at least cut down on them, if not avoid them entirely. Smoking. It makes sense that schizophrenics love to smoke; research shows nicotine improves attention and memory tasks. It's better if they use a nicotine patch. Ear acupuncture helps here, not only for reducing the mental obsession associated with addiction, but also in restoring the nervous system and reducing desire (and perhaps need) for nicotinic agonists. High calorie diets and inactivity. This increases oxidative stress. Oxidative stress on neurons in the brain may be responsible for schizophrenics' mental problems. Changing their dosage and medications themselves, prescribing themselves herbs. They should be advised by medical professionals (psychiatrists, CM doctors, etc.). Not following medical advice can lead to relapse, degeneration, and longer recovery times. Stress and Sensory Overload. Schizophrenics have been known to improve dramatically in natural environments. This may be due to the lower sensory stimulation. That means she should avoid much of our high-energy, stressed-out, fast-paced modern lifestyle (I'd love to do that too). If she can get out and walk around in nature, great, because she's exercising at the same time. Full water immersion is another way to decrease sensory input. Have her take baths and go fully underwater every once in a while. Hopefully, she is functioning well enough to be safe in a bathtub. If not, she may need to be watched. This is also a great maintenance therapy during remission.

I think I hit all your questions there, Ralph. Hope that helps!
Brian Carter

References
(All available on PubMed with the exception of #4):

1. Vulnerability to schizophrenia and lack of common sense.
2. Sex differences in schizophrenia, a review of the literature.
3. National Schizophrenia Fellowship. (UK)
4. Soothing the Troubled Mind (1987), translated from the Chinese by Thomas Dey, 1999.
5. The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches.
6. Culture and schizophrenia and other psychotic disorders.
7. Iatrogenic disorders associated with conventional vs. atypical antipsychotics.
8. Schizophrenia, a neurodegenerative disorder with neurodevelopmental antecedents.
9. Oxidative stress and role of antioxidant and omega-3 essential fatty acid supplementation in schizophrenia.
10. Antipsychotic-associated weight gain and clinical outcome parameters.
11. Management of weight gain in patients with schizophrenia.
12. Improving the physical health of patients with schizophrenia: therapeutic nihilism or realism?
13. Integrating pharmacological and psychosocial treatments for schizophrenia.
14. Cognitive effects of nicotine.
15. Patient compliance with drug therapy in schizophrenia. Economic and clinical issues.
16. Some adverse effects of antipsychotics: prevention and treatment.
17. Extrapyramidal symptoms (EPS)

Source:

Brian Benjamin Carter Editor, The Pulse of Oriental Medicine "Alternative Medicine You Can Understand" The #1 Layperson's Guide to Chinese Medicine since 1999... 3 Years, 8 Experts, 100+ Articles, 25,000+ readers. Our free e-zine BEING WELL keeps you up to date with the latest greatest new articles on the Pulse website. SIGN UP now. Send a blank email to: beingwellnewsletter-subscribe@topica.com