Quote:
Originally Posted by paulycoll
I'll tell you my understanding of a sz dx.
The person has transient positive symptoms exceeding 6months.
The person can no longer function practically or convincingly without intervention.
I assume that the people who get better without med intervention were less effected by the disorder and had less severe symptoms. Is that fair?
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Sure its fair.
My transient positive symptoms lasted about a year and a half but they were infrequent and seemed to be based on stress. After the initial 3 months on risperidone I had no more than 2 hallucinations in any given month though. This actually put me below the SIPS/SOPS rating they use for dxing kids in their prodrome so they just didn't count it as enough for any sort of sz dx. I was at an academic center so they are less likely to want to give you a sz diagnosis. My psychologist went with schizophreniform for me and my pdoc never told me anything other than psychosis but he said he didn't know if I had sz because he would have to take me off the meds to find out and that was unethical. Also I had 2 hallucinations coming off the meds and that's 2.5 years out but I hadn't had any at all in the year before that. So its not that I don't have hallucinations ever they are just way down as they never stopped when I was sick---it was constant voices---also had hallucinations with every sense, smell touch taste...
I was on risperidone or abilify for the whole period of 2.5 years after the first 1.5 months. Now was I functional during those 1.5 months? Well I kept showing up at work but I don't have a lot of supervision so the fact that I would randomly take a train downtown during the day to try and escape the voice transmitters by random walking wasn't really noticed. I mean basically I am the supervisor so who is going to rat me out you know. A couple of times I thought I was terribly ill(because the voices told me I was or due to hallucinations of pain) so I skipped work and went to the ER, one of those times was what got my coworkers to take me to the pdoc the first time. I also just walked out of the restaurant without eating one time I was out with my friends from work for lunch---I just walked out and went home and never went back to work that day. Any other job I would have been fired for sure. I started getting weird ideas about the experiments I had done in the past so I repeated them rather than doing the new work I was supposed to be doing. I stopped being able to remember if I had done a step in an experiment or not even though I had just done it so I had to write down everything I was doing as I was doing it. So things had pretty much gotten to the point where I wasn't functioning well at all but people had no idea until I told the police I had been raped by a former coworker---this guy was in Boston several states away and had just gotten engaged. One of my friends had even talked to him the night before---this made no sense to anyone and that's how I finally got caught and put on meds. So for me meds were critical but they worked right away as in within the week 98% of the voices were gone---then I got cbt and that helped me develop my own techniques to get rid of the rest. I tried getting off the meds after a year but it didn't work out at all I could not stand the way I felt at all after only 2 weeks on a reduced dose...was I going to relapse...didn't want to take the chance went back on. Honestly I think without the meds I would have died...I mean I almost gave my entire life savings to the food bank, I wanted to break out all my teeth to get out the supposed transmitter. I wanted to rip up my home to find the cameras and recorders. I was supposed to crush my bird who would be reborn as a mini-dragon who would filter the voices for me. Wanted to kill this dude at Harvard. So basically I was sick enough that eventually I could have done something irreversible and the only question was whether that first encounter was going to be with doctors or cops. It was a downhill slide that was only getting worse till I got the meds. But here is the thing if you're on meds before the first 6 months are up and they fully control your symptoms how will you ever know if you have sz or not----that is why my pdoc never gave me a dx---he really didn't know and neither do I. He did say I was high functioning though which is why I didn't actually do those horrible things...
Are the people who recover without meds milder...I don't think Nash was mild he had a lot of intervention ECT/meds etc but my understanding is he didn't recover until off the meds. I know that Vonnegut had meds initially at least but he never mentions whether or when he went off them. Sacks is still on meds. Personally I think you would have to be masochistic to try this without the meds once you realize you're sick (which I had no idea of while sick). I mean even for a cold you don't have to take a decongestant but why wouldn't you---I mean why feel sick if you don't need to?
So I'm 3 months off the meds so far and I see it as experimental for at least the first year. Still hoping for the best. I'm still not sure I meet your criteria for a dx of sz because the meds were so effective and I have no idea if I will relapse in the future (there is a roughly 5 year period of higher risk after an initial break). If you want to ask me anything I'm open to questions though---oh and in that 2.5 year period of meds I was absolutely rigid---I missed one pill once and that is it out of what a 1,000. Still I don't think the meds cured me but blocked my symptoms until I could get better on my own but then I have no way of knowing, anything could be true. That was kind of why I asked what you actually want to know because like I said the concept that I would know how I got better is at this point as as unintelligible as the idea that I would understand why I got sick in the first place...