My diagnosis

I am 32 years old my official diagnosis Is psychosis NOS I have had professionals ask me what this is? It is listed in the DSM IV . THe NOS stands for not otherwise specified. There is no specific cause and no known cure.Only the symptoms can be treated and I refuse to take medication.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
mayanbard said:
Only the symptoms can be treated and I refuse to take medication.

</div></font></blockquote><font class="post">

I appologize for sounding curt mayanbard but it seems then that you road will be long...

But sharing here or anywhere for that matter can't hurt,,,so I hope we can at least be helpful in our empathy...

Lenny

> There is no specific cause and no known cure.Only the symptoms can be treated and I refuse to take medication.

That means only that the people saying this do not know what causes it or how to treat it. It does not mean that no one knows how to deal with it. Medications might help, but I don't think they are a cure and I do not blame you for resisting the idea that they are.

Keep posting here.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
pachyderm said:
Medications might help, but I don't think they are a cure and I do not blame you for resisting the idea that they are.


</div></font></blockquote><font class="post">

I hope I did not mislead you pachyderm or our new member. I didn't insinuate that medications are cures,,,there are very few chemicals that fill this wish (but there are some). I did subtly state that without medications his progress will be slow and it will probably be more painfull than with medical support.

I personally think that on a public forum it is in the best interest of the member to support what the professional community has or would suggest. In the specific case of psychosis there are a variety of prescription methodologies which mitigate many of the most severe symptoms and offer considerable relief to the patient. This is regardless of cause.

The halls of medical schools and hospitals are filled with horror stories of folks who leave their scripts behind.

IMHO.

Lenny

My reaction to medications is my due to my own experience and observations -- you did not influence me in that regard!

Also, I have a less sanguine view of the "professional [mental health] community" than you.

<blockquote>
Lenny: ...it is in the best interest of the member to support what the professional community has or would suggest. In the specific case of psychosis there are a variety of prescription methodologies which mitigate many of the most severe symptoms and offer considerable relief to the patient.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Ivan Tyrrell and Richard Bentall discuss patient-centred new approaches to the understanding and treatment of psychotic illness.

PROFESSOR RICHARD BENTALL holds the Chair in experimental clinical psychology at the University of Manchester.

IVAN TYRRELL is a psychotherapist, writer and lecturer who, with JOE GRIFFIN, developed the human givens approach.

Tyrrell: ... You say, in effect, that modern psychiatry has been based on two completely erroneous ideas.

Bentall: Yes. The orthodox approach, which I think is so wrong, is based on two false assumptions: first, that madness can be divided into a small number of diseases, for instance schizophrenia and manic depression; second, that the 'symptoms' of madness cannot be understood in terms of the psychology of the person who suffers from them.

The German psychiatrist Emil Kraepelin is really the man who set psychiatry off in this wrong direction — the Kraepelinian paradigm remains almost unchallenged within the mental health professions, even today. It is the organising principle for psychiatric practice and research. It was Kraepelin's idea that psychoses fell into a small number of discoverable types and that these could be independently identified by studying symptoms. Although his ideas were fiercely debated at the time, his system of diagnosis — on the basis of specific symptoms — was embraced by most clinicians.

Tyrrell: Interestingly, hints that the truth might lie elsewhere weren't followed up. For instance, you write about the Swiss psychiatrist, Eugen Bleuler, who took the same basic approach as Kraepelin but refined some of his ideas, and introduced the concept of schizophrenia. In 1867 he took over the psychiatric clinic on an island in the Rhine. When a typhoid epidemic broke out in the village, he recruited some of his patients as nurses. He noted that they performed extremely well, prompting him to suggest that, in a general crisis, mental illness, far from dominating the life of the patients, could retreat into the background.

This is actually a far-reaching insight which we are still struggling to get orthodox psychiatrists and psychodynamic psychotherapists to see today — directing people's attention outwards, off their own problems, helps break the cycle of their illness. Working as nurses gave people a sense of meaning and purpose, self respect, a degree of control, a chance to help others — all things which are crucial to mental health. But, alas, Bleuler didn't make these connections, and what became emphasised in psychiatry was symptom classification.

Bentall: And the system doesn't work. For a categorial system of diagnosis to work, patients must all fit the criteria for a particular diagnosis and not be able to fit the criteria for more than one disease, unless they are very unlucky indeed. That means more and more sub-categories are required, to try to accommodate everybody.

Tyrrell: Could you explain that a bit more?

Bentall: current Diagnostic and Statistical Manual — DSM-IV — there are five subtypes of schizophrenia; two milder forms of psychosis (schizophreniform disorder and brief psychotic disorder); schizo-affective disorder; delusional disorder; shared psychotic disorder; psychotic disorder due to a medical condition; substance-induced psychotic disorder; and, finally, the catch-all "psychotic disorder not otherwise specified"!

DSM-IV states that patients may not be diagnosed as suffering from schizophrenia if they also meet the criteria for schizoaffective disorder, major depression or mania.

Similarly, the criteria for bipolar disorder specify that the patient's symptoms shouldn't be better accounted for by schizoaffective disorder and must not be imposed on schizophrenia, schizophreniform disorder, delusional disorder or other psychotic disorders. But what researchers found when they tested the criteria was that 60 per cent of people who had met the criteria for one disorder had also met the criteria for at least one other at some time. They concluded that suffering from one disorder put people at greater risk of suffering from another.

Strangely, they didn't discuss the possibility that their findings might reflect the inadequacies of the neo-Kraepelinian system! The most likely explanation for the strong associations observed between schizophrenia, depression and mania is that these diagnoses do not describe separate disorders.

Tyrrell: Absolutely! One of the central planks of your book is that the problems involved in categorising and 'explaining' schizophrenia and manic depression and so forth disappear if we look at the circumstances behind, and meaning of, people's psychotic experiences. We need to listen to what they have to say about it themselves, and accept that there isn't such a huge divide between people who have psychotic experiences, such as hearing voices or delusions, and those who don't. ...

Tyrrell: That brings me on to my next point. Neuroleptics.

Bentall: What's striking about the story of the neuroleptics is that, in terms of efficacy in their effect on the so-called positive symptoms of schizophrenia (hallucinations and delusions), there has been no real improvement since the discovery of chlorpromazine, the first neuroleptic to be used on psychotic patients. There is no evidence that the new 'atypical' neuroleptics that are available today, and that have been pushed by drug companies at a huge expense to the British taxpayer, are any more effective than the older drugs.

Neuroleptics do have an effect on positive symptoms, and I believe that's been proven, given the amount of trial evidence available. But they have many negative effects, which are also well understood. The old fashioned, so-called typical, neuroleptics, for example, produce side effects that are really dreadful: the patients have parkinsonian symptoms; they have a terrible inner sense of restlessness and depression; they get muscle dystonias, which are muscle spasms. In some cases they get tardive dyskinesia — pronounced involuntary movements of, for instance, the tongue, the lips and mouth, which can be very debilitating to people.

And these drugs also appear to have an extremely negative effect on people's motivation, so that patients taking them often have what's been described as a neuroleptic-induced deficit syndrome. So, although users may experience fewer positive symptoms, they're also less able to achieve things in their lives.

Now, the new, or atypical, neuroleptics are being touted as much better because they don't produce these side effects, but the truth is that they produce lots of other side effects. For example, if you take a drug like olanzapine, which is probably the most widely used neuroleptic in this country at the moment, massive weight gain is a serious problem. At least 50 per cent of people have sexual dysfunction and there is also a high risk of diabetes, so these drugs have pretty nasty side effects.

Tyrrell: Clearly, any benefits need to be balanced against all those side effects.

Bentall: Ah, but you also have to take into account that maybe a third of patients don't get any benefits at all; they don't get a reduction in positive symptoms, although they are still given the drugs and so still get the horrible side effects.

Tyrrell: So why do they keep on being prescribed the drugs?

Bentall: Psychiatrists tend to think the drugs are the only thing there are, therefore they must be prescribed, even if the patient is not getting any obvious benefit. I think patients should be asked if they want to take these drugs. The benefits and the side effects should be explained, and, if they do want to take them, they should be given a low-dose typical neuroleptic like chlorpromazine for three months. At the end of that time, a detailed account should be taken of the costs and benefits, and then the patients should decide if they want to continue or to try another drug. If the costs seem to be outweighing the benefits, then it makes sense to try another drug. If that doesn't work after another three months, it makes sense to try an atypical neuroleptic. If that doesn't work, then step four is to give up on the drugs. But that never happens.

You find, in Britain, that probably under five per cent of psychotic patients are not given neuroleptic drugs and they're usually people who have been labelled as non-compliant: the people who have the guts to say firmly that they don't want to go down that route. And they're treated in a very pejorative way by the psychiatric establishment because of that. If taking a drug were based on an analysis of cost and benefits, you'd probably find just 50 per cent of patients would be on neuroleptic drugs.

Read the full article here: "What Was That You Said?" -- A New Look at Psychosis


</div></font></blockquote><font class="post">

See also:
- Dr. Ricahrd Bentall: Madness Explained: Psychosis &amp; Human Nature

- The Human Givens Institute

- Dr. Bertram Karon: Schizophrenia &amp; Psychotherapy

- Dr. Loren Mosher - Still Crazy After All These Years

- Chemical Warfare: An Interview With Robert Whitaker

[/b]

.

mayanbard: I am 32 years old my official diagnosis Is psychosis NOS I have had professionals ask me what this is? It is listed in the DSM IV . THe NOS stands for not otherwise specified. There is no specific cause and no known cure.Only the symptoms can be treated and I refuse to take medication.

Many people recover from psychosis and schizophrenia. Some of those people identify medication as being helpful to them; some of those people don't.

In addition or as an alternative to medication, talk therapies such as cognitive behavioral therapy (CBT), psychoanalysis (Jungian) and other forms of talk therapy such as Open Dialogue Treatment have been demonstrated to be helpful and effective forms of treatment. In many instances, these alternative treatments have been demonstrated to be as beneficial or more beneficial than treatment with medication.

If you are aiming for recovery without medication I would encourage you to first seek to understand what happened to you and why. This blog entry may provide you with a starting point in your explorations: Presumed Causes of Schizophrenia & Psychosis.

I would also encourage you to seek out the insights and opinions of physicians who share your perspective such as Richard Bentall, Bertam Karon, Jaako Seikkula, Loren Mosher, John Weir Perry, Maureen Roberts, David Lukoff, R.D. Laing, etc.

Lastly, I would encourage you to investigate alternative treatments that may be beneficial to you.

Best of luck to you mayanbard.

Hi Spiritual emergency...

As usual you do your homework.

It would fill our database here at PC if you and I would compare articles on this subject,,but since you added one perspective let me add another:

http://findarticles.com/p/articles/m...11/ai_n9314425

But if you truly read my response,,my point was not in the advantages or disadvantages of any specific protocol,,but in our limitations and responsibilites here at PC in advising anyone concerning the taking of professionally prescribed medications..

I personally believe it oversteps our access to information and qualifications,,thus jeopardizing the progress of therapy and potentially the safety of our member.

But again,,that is only my opinion.

Lenny

<blockquote>
Hi Spiritual emergency...

Hello Lenny

As usual you do your homework.

I think it's important when making these kind of decisions for ourselves, and sharing our discoveries and experiences with one another that we do our best to provide factual information. This is part and parcel of the reason I prefer to quote physicians as well as consumers.

I personally believe it oversteps our access to information and qualifications,,thus jeopardizing the progress of therapy and potentailly the safety of our member.

My opinion would differ Lenny. In this instance, we have a young man who has shared his diagnosis of psychosis and his desire to not take medication. In my opinion, he is seeking support so I can best support him by sharing some information related to recovery without medication. If I were to tell him, "Oh no, you shouldn't do that," or, "You should take whatever medication your doctor says you should take," I am no longer offering the support he requested. What's more, I couldn't possibly ignore the overwhelming evidence and my own experience that paints a very different picture of psychosis and successful treatment than that embraced by mainstream psychiatry in this culture.

As a general rule, when it comes to the issue of medication I believe that people are entitled to know the following...

- The risks and benefits of their prescribed medication.
- Alternative treatments that have been helpful to others and may be helpful to them.
- That others have recovered without medication.
- To make their own decisions regarding treatment as much as possible.

The truth of the matter is that some people identify medication as being helpful to them; some don't. Some people identify medication as being instrumental to their recovery; some don't. Some psychiatrists believe that medication is necessary in all instances; some don't. If we are to insist that we hold to professional opinions we will have to concede that the professional opinion on psychiatric medication is not set in stone. There is a huge deal of controversy, not only in regard to treatment but cause.

My personal belief is that people should avoid medication if at all possible and this is because we know that neuroleptic medication comes with some heavy duty side effects including but not limitied to, pulmonary complications (i.e., heart failure), metabolic disorders (i.e., diabetes), neurological damage (i.e., tardive dyskinesia) and death (i.e., neuroleptic malignant syndrome). Am I willing to insist that people take such medications if they do not wish to take those risks or do not find the medication to be helpful for them? No, I wouldn't feel comfortable doing so. At best, medication is a tool but it is not the only tool.

We also know that some cultures and settings that do not have the option of using neuroleptic drugs, nonetheless produce recovery rates substantially superior to those achieved in developed nations. We need to learn what we can from these alternative viewpoints so we can reduce the risks and enhance the possibility of recovery for all people -- including those who identify medication as personally helpful.

Clearly, the issue of medication is a complex one and if people wish to make an informed decision they will have to seek out reputable sources of information and expose themselves to a range of thought and opinion. Ultimately, they are probably in the best position to make that choice for themselves. For this reason, I am as opposed to forced medication as I am to forced non-medication. I am also opposed to the silencing of opinions. It's far better, in my estimation, that all voices and perspectives be heard and encouraged in any open dialogue. We can never know who is reading our words or who will find some helpful insight in them. There are many paths to recovery and the most successful form of treatment is always the one that works for that particular individual.
See also:
- Defining Anti-Psychiatry
- Schizophrenia &amp; Hope

Then you are willing to also accept the responsibility that the insurers of professionals underwrite..

Our host is no fool..I'm sure he knows his buisness and the administrating of public forums but it is a smart choice to have all "professionals" register as such,,and have their insurance companies aware,,and to insist whenever possible that opinions are only that and not to confuse these posts or threads in any way with medical advice.

I concede to your higher value...good for you,,may you do no harm...

Lenny

<blockquote>
Lenny: may you do no harm...

</font><blockquote><div id="quote"><font class="small">Quote:</font>

.... researchers in Ireland reported in 2003 that since the introduction of the atypical antipsychotics, the death rate among people with schizophrenia has doubled. They have done death rates of people treated with standard neuroleptics and then they compare that with death rates of people treated with atypical antipsychotics, and it doubles. It doubles! It didn't reduce harm. In fact, in their seven-year study, 25 of the 72 patients died.

Source: Chemical Warfare: An Interview With Robert Whitaker

==============================================================================

Most Frequent Suspect Drugs in Deaths

Oxycondone (Opiate): 5,548
Fentanyl (Opiate): 3,545
Clozapine (Anti-psychotic): 3,277
Morphine (Opiate): 1,616
Acetaminophen (Analgesiac): 1,393
Methadone (Opiate): 1,258
Infliximab (Anti-rheumatism): 1,228
Interferon beta (Immunomederator): 1,178
Risperidone (Anti-psychotic): 1,093
Etanercept (Anti-rheumatism): 1,034
Paclitaxel (Atineoplastic): 1,033
Olanzapine (Anti-psychotic): 1,005
Rofecoxib (Anti-inflammatory): 932
Paroxetine (Anti-depressant): 850

Source: Furious Seasons - FDA Report [PDF File]

==============================================================================

There is an excess of death from natural causes among people with schizophrenia. Aims Schizophrenia and its treatment with neuroleptics were studied for their prediction of mortality in a representative population sample ... During a 17-year follow-up, 39 of the 99 people with schizophrenia died. There is an urgent need to ascertain whether the high mortality in schizophrenia is attributable to the disorder itself or the antipsychotic medication.

Source: Neuroleptic Medication &amp; Mortality

==============================================================================

As for the abnormalities that researchers have found with brain scans, Mosher thinks the antischizophrenic medication accounts for much of this. He says, "The Germans, who invented neuropathology, looked at the brains of thousands of schizophrenics before there were any neuroleptics. And they were never able to find anything. They never reported increased ventricular volume, which at postmortem you can measure quite easily. And they also never reported any specific cellular pathology, and they studied many, many, many brains." He adds that "there are a whole lot of people who don't have schizophrenia and also have enlarged ventricles. And there are people who have other psychiatric conditions who have enlarged ventricles, and there are a number of known causes of enlarged ventricles that are not schizophrenia. So, yes, there is a statistical difference, but it is not specific."

"On the other hand," Mosher continues, "there are studies that have shown that people treated with neuroleptics have changes in brain structure that are at least associated with drug treatment, dosage, and duration -- and have been shown to increase over time as drugs are given." He cites one "horrific study" of children between the ages of 10 and 15 in which the researchers measured the volumes of the kids' cortexes. "The cortex is what you think with, the part on the outside," Mosher explains. Over time, "They watched the cortical volume of these young people decline, while the cortical volume of the nonschizophrenic controls was expanding because they were adolescents and still growing." The researcher concluded that their schizophrenia had caused the decrease in the subjects. "And yet every single one was taking neuroleptic drugs," Mosher says.

Source: Still Crazy After All These Years

==============================================================================

The WHO Study of Schizophrenia is a long-term follow-up study of 14 culturally diverse, treated incidence cohorts and 4 prevalence cohorts comprising 1,633 persons diagnosed with schizophrenia and other psychotic illnesses. Global outcomes at 15 and 25 years were assessed to be favorable for greater than 50% of all participants. The researchers observed that 56% of the incidence cohort and 60% of the prevalence cohort were judged to be recovered. Those participants with a specific diagnosis of schizophrenia had a recovery rate which was close to 50%. Geographic factors were significant in terms of both symptoms and social disability. Certain research locations were associated with greater chance of recovery even in those participants with unfavorable early-onset illness courses. The course and outcome for persons diagnosed with schizophrenia were far better in the “developing countries” than for such persons in the “developed” world of Western Europe and America.

The first of the WHO studies, the International Pilot Study of Schizophrenia (IPSS), assessed 1,202 persons diagnosed with schizophrenia in nine countries. The results showed that persons with schizophrenia in the “developing” world (e.g., Columbia, India, Nigeria) had better outcomes than persons in the “developed” countries (e.g., Moscow, London, Washington, Prague, Aarhus, Denmark).

Source: Long Term Folluw-Up Studies of Schizophrenia

==============================================================================

The "Soteria paradigm" attempts to support people diagnosed with schizophrenia spectrum disorders using a minimal medication approach Interest in this approach is growing in the United Kingdom, several European countries, North America and Australasia.

The Soteria paradigm remains an intriguing example of medical parsimony in the treatment of schizophrenia, via its use of significant numbers of nonmedically indoctrinated staff and minimal use of medication. The studies included in this review suggest that the Soteria paradigm yields equal (and in certain specific areas, better) results in the treatment of schizophrenia when compared with conventional, medication-based approaches.

Source: A Systematic Review of the Soteria Paradigm

==============================================================================

Jaakko Seikkula, Ph.D. is a professor at the Institute of Social Medicine at the University of Tromso in Norway and senior assistant at the Department of Psychology in the University of Jyvskyl in Finland. Between 1981-1998, he worked as a clinical psychologist at the Keropudas hospital in Finland where he and colleagues developed a highly successful approach for working with psychosis known as Open Dialogue Treatment (OPT). The approach de-emphasizes the use of drugs and focuses instead on developing a social network of family and helpers and involving the patient in all treatment decisions. Ongoing research shows that over 80% of those treated with the approach return to work and over 75% show no residual signs of psychosis. Official government statistics comparing 22 health districts in Finland found that Dr. Seikulla's district was the only one not to have any new chronic hospital patients in a two year period and led the National Research and Development Center for Welfare and Health to award a prize for "over ten years ongoing development of psychiatric care".

Source: Open Dialogue Treatment

==============================================================================

"...85% of our clients (all diagnosed as severely schizophrenic) at the Diabasis center not only improved, with no medications, but most went on growing after leaving us."

Source: Trials of the Visionary Mind

==============================================================================

I didn't meet Benjamin. I met his mother. She was a truly beautiful person who was deeply grieving the loss of her son. Benjamin had died due to a rare complication of anti-psychotic medication known as Neuroleptic Malignant Syndrome. The cause of death on his autopsy report was listed as, "Natural". Benjamin's mother didn't quite know how to wrap her mind around such a word. How could the death of her beautiful son be natural? How could he die as a result of the treatment that was supposed to help him? How could those within the medical community dismiss his death so callously as being "natural"?

Benjamin was 25. His mother is currently recovering.

Source: Dedication


</div></font></blockquote><font class="post">

I hope you will not take it personally Lenny, if I continue to offer support, encouragement and information to individuals who have a stated preference of wishing to avoid the use of neuroleptic medication. People often have a number of perfectly valid reasons for why they might wish to withdraw from or not use medication at all. Other people have a stated preference for treatment with psychiatric medication. Although laws vary by geographical location, an individual is usually within their legal and moral rights to choose the treatment option they feel will be most beneficial and least harmful to them. Since there are some psychiatrists and psychologists who are producing very good recovery rates with minimial or no use of neuroleptics, if an individual is interested in pursuing that route I see no harm in passing on some links that will assist them in further educating themselves on treatment options.

As for me, I am not a professional and have never presented myself as such. What I am is an individual who has undergone the experience known as psychosis and/or schizophrenia in this culture and made a full recovery without hospitals, doctors, or medication. There is no law I'm aware of that prevents me from sharing with a fellow sufferer what I have found helpful in terms of my own recovery. Please note that at no point have I suggested that mayanbard should not seek out professional advice, I have merely encouraged him to seek out medical advice from professionals who have a background in the area he has expressed an interest in -- recovery without medication.

~ Namaste.

I have humbly agreed with your purpose SE..I know my limitations and by design,,,I suppose,,they are less than yours..

You do good work as I see by your links and your reference material certainly supports your mission. But, as I said we could exchange such detail for gigabytes..

My argument has never been about the appropriateness of medication,,it is the direction of suggestion. I, personally defer such critical decisions to those who know far more about the patient.

Be well,

Lenny

My personal experience with professionals and authorities has led me to be quite skeptical about how well they pay attention to the patient as opposed to paying attention to people they consider to be authorities, when the two conflict. The history of medicine contains a number of instances in which the accepted norms were completely wrong. I personally think the state of understanding in mental health issues is about as advanced as that in most physical health matters of a hundred or more years ago. In such a state practitioners accept almost anything that has general approval, and patients suffer or have to make up their own minds as to what is a valuable treatment, not being able to rely upon "generally accepted" wisdom.

As spiritual_emergency said, even if you stick to "professionals" you can find a wide variety of ideas about what "mental illness" really is, its origins, and what constitutes valuable treatment. In such a state the burden is on the patient to decide. This can be a major challenge, can be very frightening -- and can lead to major personal growth when one is forced to think things out for oneself -- with help one can gain from other people who have been through similar things, and writings of people who make sense to you.

As frightening as it may be, I think we have seen in our national life as well that "authorities" are not always to be depended upon.

Here's an excerpt from the online book "Psychological Self-Help" by Clayton E. Tucker-Ladd, Ph.D., which I have recently discovered and which is discussed in the Sharing Self Help Ideas forum on Psych Central. I post this because I am in agreement with a lot in this book!

"You are, thus far, pretty much on your own to take care of your life. No system or basic institution, such as family, church, school, friends, or health/psychological caretakers, has taken on the task of helping you learn to cope with the minor or serious troubles that will come your way (denial is easier and, thus, self-help isn't a big money maker). A lot of your welfare depends on luck--being born middle class... or being raised in a psychologically healthy family... or being given healthy genes... or being endowed with the ability to learn coping skills on your own. To become effective at coping, you need to practice thinking of self-help as being applicable to all parts of your life, i.e. helpful all the time with serious problems, minor concerns, and self-improvements of all kinds."