Paranoid About The Government

Beautiful paranoid white woman wearing pink top

Schizophrenia In The Elderly

Imagine having no family history of mental illness and being highly functional for the first thirty years of your life. Imagine being very pretty and all the guys chasing you, replacing boyfriends left and right. Imagine meeting a handsome man who not only is a physician, but is employed by John’s Hopkins. Imagine everything falling in its place and not knowing what else to ask for in life, until your husband decides to get a divorce and schizophrenia decides to enter your life.

Environmental hits such as divorces may be strong enough to induce schizophrenia in those who are genetically prone. The problem is that we do not know who is genetically prone. After your husband slaps you with a divorce tag and schizophrenia parks itself in your mind, imagine becoming paranoid and delusional, believing that there is a government conspiracy at play.

You start to believe that the government has either recruited your husband or that he was in it all along. You then start experiencing auditory hallucinations of male government figures whispering random things in your mind. You also start to believe that your apartment is being gassed by the government, prompting you to frequently leave your place at random times.

When you finally get admitted into a psychiatric unit for stabilization and care, imagine starting to believe that the medications are altered by the government, the evidence being the different numbers engrained on the pills. Imagine believing that these altered medications are designed to harm you, when in fact they’re the best shot at getting you well again.

Imagine turning against yourself but it’s not really you turning against yourself; your mental illness is doing it to you. This is called paranoia and delusional thinking and it’s worse when it’s directed toward yourself, such as not taking medications. Without medications, how can the schizophrenia ever be treated? It can’t. So the cycle repeats itself and you end up being hospitalized numerous times, sometimes resulting in the delusions going away and you accepting the medications.

But without consistent medication compliance, the delusions often return, reigniting the same cycle experienced for the last thirty to forty years. By this time, you’re already a senior citizen somewhere in an adult home, desiring to “escape this mess.” What I have just described above is one version of a psychiatric patient’s life experienced from childhood to elderly.

There are thousands of different versions of psychotic states of mind. Each person in this world has a different story when it comes to mental illness. That’s why it’s important that we listen carefully to each other every single day!

Are you listening?

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Thought Blocked By Psychosis

Psychotic person holding hands on head with mouth open

When Schizophrenia Chips Away At Your Sanity

Just because a patient was diagnosed with schizophrenia over ten years ago does not mean that symptoms will never return. There are many factors at play as to why symptoms may reoccur but one big factor is medication noncompliance. Many psychiatric patients have a strong desire to eventually stop medications. If you’ve ever been on psychiatric medications, then you most likely know what I’m talking about!

When I used to be on Prozac, I used to think to myself if there would ever be a day when I could stop the medication. After many months on Prozac, panic attacks eventually vanished; they weren’t part of my life any longer. So I thought to myself, “Thank God! I can live again. But now how much longer do I have to be on Prozac?” There is no right answer when it comes to continuing psychiatric medications.

For patients who have experienced more than one episode of psychosis, the answer likely is “lifetime.” That’s because each episode of psychosis increases the chances of experiencing a future episode. Even if you are experiencing a strong desire to stop your medications, never do so on your own; always talk with your doctor before making any changes to your medications.

Believe it or not, there are many schizophrenics who continue to take medications and still experience auditory hallucinations at random times, requiring an inpatient psychiatric admission. These patients may appear as thought blocked: in the middle of a sentence, they suddenly stop and can no longer find their words or they make take a little longer to form a sentence in the first place.

Can you imagine trying to have a normal conversation with someone and not be able to find the right words, as if someone or something is holding your tongue back in place? Can you imagine how depressing it must be to not be able to speak freely because of your psychosis? Do you understand why many people suffering from a mental illness also experience suicidal ideations?

There is no cure for schizophrenia or any mental illness; only remission. Remission is when a patient stops experiencing symptoms but this does not mean that the disease is no longer present. It just means that it’s controlled by therapy, medications or both. Psychiatric medications do not cure a mental illness in the same way that high blood pressure medications or insulin do not cure hypertension or diabetes.

We must continue to remind ourselves that there is nothing wrong with being on psychiatric medications. The end goal is to live a normal life without allowing a mental illness to control your sanity and wellbeing. If this means that you must continue medications until 97, then so be it. You’ll be much better off free of symptoms while on medications than stopping them and relapsing; some people don’t ever recover from a relapse.

Don’t take that chance. Maintain a strong alliance with your psychiatrist and always come up with a plan together.

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Trapped By Schizophrenia

Schizophrenic woman with curly red hair holding small round mirror

When Mental Illness Robs Your Sanity

Mental illness affects everyone differently. While some people with schizophrenia remain functional in society, others end up in a state hospital for even years at a time. There are many factors at play when it comes to how a person handles their psychotic symptoms: it depends on their personality, the severity of their symptoms, the duration of their illness, their support system, their compliance with medications and whether they abuse any substances.

It’s no surprise that many patients who suffer from psychosis are trapped by schizophrenia. They are so affected by “negative symptoms” such as blunting of affect, poverty of speech and thought, apathy, anhedonia, reduced social drive, loss of motivation, lack of social interest and inattention to social or cognitive input, that they can be talking to you without any facial expressions despite suffering on the inside. They might even complain to you, “I don’t want to feel like this” and look like they are trying to cry, but cannot find the tears to do so, as if they are trapped within their own body.

It’s very sad to witness a patient suffering from psychosis. Keep in mind that not everyone who does is responding to internal stimuli, performing odd and extreme behaviors or are being physically aggressive. For some schizophrenics, if you were to see them on the street, you would never think twice of them having a mental illness. They can present as calm, cooperative and pleasant, but it’s not until you actually observe their behavior that you start to notice the differences in their speech and thought process.

They may even admit to experiencing auditory hallucinations of voices degrading them, “Shut the fuck up, you’re not good for anything! Go kill yourself, why are you still alive? Kill that bitch!” Can you imagine how difficult it must be to hear voices in your head on a daily basis? Schizophrenics are also prone to depression because of these experiences. Some even experience ideas of reference, such as believing that others can place thoughts into their mind or even be able to read their mind.

But medications do work and that’s the beauty of psychiatry; it just takes time, patience and compliance. The other beauty of psychiatry is forming an alliance with a patient and guiding them through their psychiatric experience; you can be there for them from the day they became psychotic to the day that they recognize that it was all a big delusion. It can be quite rewarding to see psychotic patients rebound on the bright side and recover from their illness.

This is a great time to be part of the mental health world and by coming together to share our experiences, we are contributing to the end of mental health stigma and the normalization of mental illness and the suffering that comes with it. Only through an open and honest worldwide community will we be able to achieve the three goals of The DSM Ready Community:

1) End mental health stigma and normalize mental health
2) Provide a safe and nonjudgmental place to share thoughts, feelings and advice about mental health
3) Maximize happiness and well-being 😎

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Mind Stolen By Marijuana

Teenage boy wearing black hoodie smoking marijuana joint

Marijuana Turned Me Into A Schizophrenic

In the field of psychiatry, you see it all when it comes to mental illness and the various factors that contribute to it. Marijuana affecting mental health should be no surprise, despite the media not really talking much about it. Why is that? Because there’s an agenda to legalize it. I am not against legalization but it’s important that humanity is educated on the influence of marijuana on mental health.

Many teens and young adults have experienced their mind stolen by marijuana. What does this mean? Some of the stories you’ll hear is that they started smoking weed in high school and fell in love with it; their usage escalated beyond smoking joints on social occasions to smoking bowls multiple times a day by themselves at home.

Some of these patients identified as being introverted in high school to begin with. They are not afraid to admit that once they started using marijuana, they became more introverted, spending more time by themselves in isolation, lost in the internal world that marijuana dug out for them.

At some point in time, whether under the influence or not, they slowly began to feel different in regards to the way they thought and interpreted the world. Their families would clearly notice a change in behavior, eventually calling EMS to take them to the emergency room. Not all patients can pinpoint the details of the changes brought upon by marijuana.

But some of the changes noticed by family and friends is amotivation, apathy, odd beliefs, self-isolation and even responding to internal stimuli. What once was a fairly normal kid attending science class was now a socially awkward, disheveled kid who struggled to express himself; it’s very sad!

It’s not known whether the high concentration of THC in modern strains of marijuana causes schizophrenia or just helps accelerate it in predisposed individuals with a family history and genetic loading. Even if a user doesn’t become schizophrenic, transient psychosis is quite common with modern day strains; people either consume an edible or smoke too much and cannot handle the high for those 2-3 hours, eventually losing their mind in the process.

Some return back to reality after they come back down from the high and after receiving a dose of an antipsychotic, while some have permanently become schizophrenic. For those who have become schizophrenic, their lives have now entirely changed just because they chose to consume marijuana. It’s very important to find out if you have a family history of mental illness before you try marijuana.

As a psychiatrist, I want my patients to be as physically and mentally healthy as possible and this involves no consumption of marijuana or other drugs. Even drinking is dangerous and should be done in moderation! At the end of the day, education is important and remember that just because you’re witnessing legalization of marijuana in a lot of states and around the world, does not mean that it can’t harm your mental health!

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Schizophrenia Gone Wild

Schizophrenic woman wearing face mask staring out the window

Coronavirus Affecting Stabilized Psychotic Patients

Many psychotic patients who were previously stabilized on their medications are beginning to decompensate from the coronavirus. It’s not necessarily that they are becoming exposed to it. It has more to do with them watching the news at home which is causing them to become worried and paranoid that they will get it. Some actually develop symptoms of COVID-19 and stop taking their medications, wrongfully concluding that their medications are causing the symptoms. This is schizophrenia gone wild.

Psychotic patients have a very fragile line of stability that they often walk on. Things such as stopping medications, environmental stressors, changes in their lifestyle or relationship disputes can be enough to put them over the edge and cause them to decompensate. When they do decompensate, it’s very obvious to family members; this is not a small and irrelevant change in behavior.

They will start to display odd or unusual behavior such as:

  • Believing that their deceased parents are calling them from the window
  • Shouting and arguing with loved ones
  • Making verbal and even physical threats
  • Calling random people at 2 am
  • Becoming catatonic and remaining mute for long periods of time

. . . and the list goes on. These are not behaviors that all patients experience; it was just a list provided for you to get an idea. When a schizophrenic patient decompensates, it doesn’t mean that they necessarily start to hear voices in their head or see things that aren’t there. It can simply mean that their behavior and thought process are disorganized. They may continuously shift positions in bed, flop their hands, ask if the apple juice on the table is alright in that position and even claim that it’s hot outside at the beginning of April in New York City.

It’s really sad to observe and talk to decompensated schizophrenics because you get a glimpse into their world and how much different their behavior is compared to people who don’t have a mental illness. Perhaps in their eyes they are not suffering but in ours they clearly are; they cannot function in society when they are decompensated. That’s why they’re in the hospital in the first place!

But keep in mind that even though a schizophrenic may not be currently at their baseline, does not mean that they cannot hold a conversation with you. Many can hold fairly normal conversations but they may make odd remarks. They’ll usually be able to answer all of your questions and many remain calm and pleasant during an interview. Just because a person has the diagnosis of “schizophrenia” does not mean that they cannot hold a normal conversation with you.

Schizophrenics are actually pretty cool!

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Thoughts Stolen By Psychosis

Red and white Do Not Enter street sign with drawing of demon between words

Outsiders Stay Away

In the realm of psychosis, logic, rules and regulations no longer stand ground; they dissipate as one’s sun falls off the end of the Earth and dark clouds slowly swarm in. When psychosis sets up a campground in your mind, believe the fact that it may remain there for a few days, months, years or even a lifetime. Thoughts stolen by psychosis is something that many people experience all around the world.

When people try to help those suffering from psychosis, their minds often respond with the message, “outsiders stay away!” This is the psychosis telling the patient, “keep these people away from you. They’re only here to disturb our plans.” The psychosis is attempting to form an alliance with the patient. Depending on the severity of the psychosis, this message can resonate with the patient to the point of inducing violence and murder.

When your thoughts are stolen by psychosis, many things can happen with your expression of language. One common thought process is called “thought blocking.” This is when a patient struggles to come up with words because the illness has interrupted the formation of their thoughts; they cannot put words together for self-expression.

When thought blocking is present, a patient can sit there for a few minutes or more before finally responding to your question. Thought blocking is an example of your thoughts being stolen by psychosis. Another example is the expression of bizarre beliefs based on auditory hallucinations.

Psychotic voices in one’s mind may inform the patient of anything under the sun. The patient can literally sit there, inappropriately smiling, while ignoring your questions. During these states, they are most likely actively hallucinating. The severity of their illness is very bad if a patient cannot even respond to you.

Depression while being stuck in a suicide forest is awful, but do not discount the severity of psychotic breaks. At least with depression, you can still maintain your sanity to a certain extent, unless you’re suffering from major depressive disorder with psychotic features. But with psychosis, sanity is often robbed from you. All you have left is your soul traveling in darkness, surrounded by evil clouds.

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Schizophrenia and the Evolution of the Human Brain — Dr. Elliott Gruen — HeartyPsych

An experienced psychiatrist, Dr. Elliot Gruen currently practices in Maine. Dr. Elliot Gruen draws on experience with a range of psychiatric conditions, including an in-depth familiarity with schizophrenia and its development. Schizophrenia is a complex mental illness that affects approximately 1 percent of the population. It causes abnormal activity in many different areas of […] via […]

Schizophrenia and the Evolution of the Human Brain — Dr. Elliott Gruen — HeartyPsych

World Dominated By Hallucinations

Bokeh photography of young woman experiencing colorful hallucinations

Altered Environmental Perceptions

There are many types of hallucinations and each may result from a completely different reason. No matter how unrealistic the description of a hallucination may sound to you, it is very real for the individual who is experiencing it. It is also very tempting for people who don’t experience them, to discount others’ hallucinatory experiences.

We must remember that even though hallucinations are not real, we should not put someone who experiences them in a position of shame or embarrassment. Since hallucinations are powerful to begin with, the last thing that you want to do is to further destabilize their state of mind with insecurity and uncertainty.

Schizophrenics usually experience auditory hallucinations. These are typically voices which are heard coming from the inside of their head. Most will tell you that the voices sound like as if a real person were talking to them! The voices may alternate between male and female, young and old and sometimes even converse among each other.

The voices can be commanding in nature, telling them to do harmful things to themselves or to others. When not controlled by antipsychotics, many people can do quite harmful and terrifying things secondary to command hallucinations. The voices can also be pleasant, demeaning or neutral, either telling them nice things, making fun of them or stating things that are neither harmful nor pleasant.

Schizophrenics usually don’t experience visual hallucinations, but they can! These are mostly experienced when an organic pathology is at play, such as a brain tumor, a traumatic-brain injury or viral infection of the central nervous system. Visual hallucinations are also experienced in people who use drugs such as psychedelics, deliriants, ecstasy and more.

Schizophrenics may also experience olfactory hallucinations or hallucinations of smell. They may complain of smelling dead people! Others with a seizure disorder may smell burning rubber prior to the onset of their seizure. Olfactory hallucinations are not as disturbing, but can still be quite uncomfortable.

Schizophrenics may experience tactile hallucinations or hallucinations of touch. The classic tactile hallucinations experienced by cocaine users is called formication, or bugs crawling on top of their skin. The experience may by very frightening, often causing them to vigorously scratch at their skin or even use more of the drug, with the hope of making the sensation go away.

While hallucinations are just altered perceptions of one’s environment, they feel very real to those who experience them. The best approach to adopt when talking to someone who is experiencing hallucinations, is to compassionately listen to their description and understand where they are coming from. By developing a therapeutic alliance, you are putting yourself in a much better position to potentially guide and help them come back to reality.

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Does DMT Cause Schizophrenia?

Purple psychedelic silhouette of person standing

The Mystery Of The Pineal Gland

The pineal gland is a small endocrine gland in the human brain that produces melatonin; the hormone responsible for regulating sleep. It is believed by some in the medical and scientific communities that the pineal gland may also secrete DMT, a chemical compound responsible for altered states of consciousness, intense hallucinations and mystical experiences.

DMT has been discovered in the human brain in extremely small concentrations. At these concentrations, no altered states of consciousness are experienced. It is also believed that the pineal gland may contain anti-DMT enzymes that constantly break down the compound, preventing us from hallucinating.

The question becomes: are anti-DMT enzymes malfunctioning in patients with schizophrenia, resulting in too much release of DMT that may be responsible for auditory and visual hallucinations? It is believed that DMT may be released at birth, during dreams, during very traumatic experiences and death.

It would be quite difficult to measure DMT in the human brain during any of the scenarios listed above. But since we do not know what causes psychosis, besides the possibility of too much dopamine, it may be possible that DMT is uncontrollably released due to malfunctioning anti-DMT enzymes.

When DMT is used for recreational purposes, users describe a very intense psychedelic experience of vivid hallucinations, a universal consciousness and detachment from the body. These descriptions sound similar to people who have gone through near-death experiences.

In addition, it has been observed in small DMT clinical trials that participants did not experience tolerance to DMT after receiving multiple doses. Tolerance is classic after multiple, consistent doses of LSD, psilocybin and mescaline are received. If the human brain does not experience tolerance to DMT, can this be part of the reason why some schizophrenic patients hallucinate indefinitely?

The next reasonable question to ask is why would the human brain create an endogenous substance responsible for making humans hallucinate? The same question can be asked as to why the human brain contains cannabinoid receptors and a compound called anandamide.

The human brain also produces endogenous natural pain killers such as endorphins and enkephalins, which are released when a person experiences pain. The pattern seems to be quite clear: the human brain contains receptors and endogenous chemical compounds that help with pain relief, pleasure, eating and sleeping.

If DMT is produced by the pineal gland, is it possible that it may be responsible for causing schizophrenia and other psychotic illnesses in millions of people worldwide?

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Struck By Catatonia

Young man in a catatonic stupor looking down at ground

A State Of Trance

Catatonia is a state of abnormal movement and behavior arising from a disturbed mental state, typically from schizophrenia. But catatonia can also occur independently of schizophrenia. When a patient is in a catatonic state, it is very obvious. They may demonstrate mutism, negativism, resistance to passive movement or repetitive and purposeless movement.

Some patients who are catatonic urinate and defecate on themselves. They have no logical explanation as to why they do it. They may say that they “didn’t have enough time to get to the bathroom.” That being said, you would think that they would at least clean up after themselves. Wrong. Catatonic patients can remain soiled in feces for hours at a time if undetected by staff or family.

You may repeatedly instruct a catatonic patient to shower because they are soiled in feces, but they will not react. They may enter the bathroom and just stand there, giving no logical reason as to why they are refusing to shower. Often, Ativan 2 mg IM must be given to catatonic patients; it helps them to snap out of it.

Some catatonic patients can be observed to be non-responsive in bed for hours at a time. You can ask them how they are doing and try to help them get out of bed, but they will just stare back at you with an expressionless face as if they just had a stroke. But no stroke has occurred. They are just in a mental state called catatonia.

Catatonia can occur unexpectedly. One minute a patient is sitting in a chair and talking with you, and the next minute he or she is down on the floor unresponsive. Patients with catatonia will continue to blink, but they’ll appear expressionless; you’ll call their name and attempt to comfort them, but they won’t budge.

It is important to remain patient with catatonic patients and to not lose your composure. It can become frustrating to have a catatonic patient not react to your verbal commands, but just be cognizant of the fact that catatonia is a mental illness. Many patients cannot even explain to you what catatonia feels like.

It just happens. So do your best to remain composed, professional and supportive. We are all in this together!

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