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mental health mondays :: a nut house divided

although the history of schizophrenia is not particularly long, it has already become exceedingly complex. in the late 1800s, german physician emil kraepelin invented the term "dementia praecox" to refer to cases of mental illness that occurred in younger people- those too young to be suffering from age-related dementia. in 1911, the term "schizophrenia" was coined by swiss psychiatrist eugen bleuler, in order to distinguish the disorder from proper dementia, which involved a deterioration of mental faculties. his work was crucial in determining the characteristics of what we now call schizophrenia, including the identification of both positive symptoms [things that schizophrenics do that the rest of us don't] and negative symptoms [things schizophrenics don't do that the rest of us do].

unfortunately, while various drugs to control schizophrenia have been developed and many, many studies done, the progress on understanding the disorder has been remarkably slow. various subtypes were added underneath the larger umbrella of schizophrenia, but with the publication of the dsm-v, field professionals decided that those had become cumbersome without being especially useful. so all of the subtypes were removed in 2013 and schizophrenia became just one very large restaurant with a large variety of crazy treats on the menu.

more recently, however, the results of a study of thousands of schizophrenia patients may have proved that schizophrenia, as we've conceived of it thus far, may not even exist. rather, what we call schizophrenia is actually a series of eight separate disorders which can be identified genetically and, to a great extent, predicted based on the presence or absence of certain other genes.

the fact that schizophrenia has hung around this long as a diagnostic term may be related to our own unwillingness to deal with mental illness. we don't assume that every symptom related to the lungs is lung cancer, because we know that the lungs can be affected by many different things. but there was a tendency among doctors to simply lump psychiatric symptoms together as equalling "schizophrenia". this new study indicates that different psychiatric symptoms- like hallucinations or disordered speech- are indicative of different disorders and that they are caused by different combinations of genes. so rather than being a disease on its own, schizophrenia is better understood as being a category, like "autoimmune disorder" or "heart disease".

the good news, of course, is that a better understanding should allow for the development of better treatments. medicine can move beyond using one type of approach for what is actually a lot of different diseases and instead focus on what will actually reduce the impact of the disorder on people's lives.

the bad news is that the study raises the possibility that genetics is a lot more important than we might have believed in the development of mental illness. that doesn't mean simply that schizophrenic disorders will run in families [although it may well], but that your own propensity to such a disorder is determined largely by which specific gene clusters you have. indeed, the study indicates that by looking at specific gene clusters, doctors can predict with a high degree of accuracy who will develop a schizophrenic condition at some point. and if you have those gene clusters, there is basically a little time bomb in your head that will someday explode and fuck everything up. [although hopefully not until after some new treatments exist.]

doctors have been arguing for years that schizophrenia has become a catch all term, encompassing too much to be meaningful. and indeed, this study seems to lend scientific credence to that; schizophrenia has developed multiple personalities.


L.P. said…
This is pretty big news. I got my MSW degree in 1989 (clinical mental health) and we spent a lot of time on schizophrenia- symptoms, diagnosis, treatment. I also worked quite a bit with people diagnosed as chronically mentally ill, and most of them had multiple diagnoses by different doctors. For a few years they'd be treated for a particular type of bipolar disorder, then when no progress was made it would they'd try, say, schizoaffective disorder. Schizophrenia often seemed to be the diagnosis when they had no place else to go. (I haven't worked in the field in years, just to be clear.)
Kate MacDonald said…
Thanks for the insight, LP! Most of the people I know who have been diagnosed have had multiple diagnoses from multiple doctors, so that they're never quite sure who they should believe. I'm curious to hear more about this.

as long as you're here, why not read more?

don't speak

you might think that it sounds dramatic, but linguistic genocide is something that happens. people in power will go to great lengths to eradicate certain languages, not just for the sheer joy of making the world a lesser place, but as a way of beating down the culture that's associated with it. language has a unique reciprocal bond with culture, and every group that has attempted to break down another has recognised that forbidding a cultural group from communicating in their own language is an extremely effective way to tear apart their culture.

there are lots [and lots and lots and lots] of examples of this sort of thing, some successful, some not, but far too many to cover in one blog post. however, i thought it was worth looking at some languages that have been the subjects of active repression, and what the political consequences of that have been.

devastation :: the native north american languages :: it should come as no surprise that the largest genocide in history [by a ma…


just a short time ago, i waxed prosaic about trump supporters who felt betrayed by their candidate pursuing in office the exact things that he said he would. short version: i have no sympathy.

today is a bit different. in the wake of america's bombing of a syrian air strip, in response to a chemical weapons attack by the syrian government, my facebook and twitter feeds were peppered with plaintive shades of "we believed you". these are the people who heard trump say that he wanted the united states to step back and focus on defending its own. indeed, trump did say such things, over and over; america cannot be the policeman of the world. even arch-liberal cynics like me had to admit that this was a refreshing argument to hear from someone outside the paul family, and, could easily have been turned into trump's greatest argument against hillary clinton. [he chose to go another way, which also worked.]

trump also said, repeatedly, that america needed to invest heavily …

long division

after the united states election last year, there were the usual calls for the country to unite behind the new president. that never happens anymore, because, since george w. bush scored a victory in 2004, having launched the country into a war in iraq for no reason, the people on the losing side of a presidential election have been pretty bloody angry about it. democrats hated bush 43. republicans really hated obama. democrats really hate trump.

it didn't help that trump didn't make the typical conciliatory gestures like including a couple of members of the opposite party in his cabinet, or encouraging his party to proceed slowly with contentious legislation. barack obama arguably wasted at least two and as many as six years of his tenure as president trying to play peacemaker before he felt sufficiently safe to just say "screw you guys" and start governing around the ridiculous congress he was forced to deal with. not-giving-a-shit obama was the best president in …