i think that is part of the complications, rightly or wrongly; psychiatric medications cause physiological changes, neuroleptic drugs change brain structure, function & chemistry. If it wasn't a primarily biological condition to begin with, it does in part become one on medication.

Part of the confusion in my own case is that i used street drugs heavily from the ages of 15 to 28 - & i wonder how much that also exasperated things?

As far as i can personally conclude is that my own condition is a wide mixture of biological/psychological/social & spiritual factors, but it is an illness/condition, & the spiritual components i feel is now more from my own interests/practises rather than something necessarily intrinsic to the condition? i don't think that anyone really has the answers. Madness/psychosis i feel does very much still remain largely a mystery.