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The concept of schizophrenia is dying (theweek.com)
118 points by LiweiZ on Oct 31, 2017 | hide | past | favorite | 122 comments


There's something important the article seems to be getting wrong: psychosis is a symptom, not a disease.

There are such things as psychotic depression and post-partum depression; psychosis is a symptom of severe bipolar mania, etc.

By the way, the concept of schizophrenia first comes up in Emil Kraepelin's realization that bipolar disorder (manic-depression) and schizophrenia ("precocious dementia") are distinct pathologies -- even though they may have similar presentations at times. With this, Kraepelin also inaugurates the idea of differential diagnosis.

Similar in spirit (but less compatible with our contemporary understanding) is Freud's distinction between neurosis and "psychosis", the former being amenable to analysis. I.e. schizophrenia has always been a diagnosis of exclusion.

If people are actually being able to open up schizophrenia into further detail -- well, that's good. But there will always be a diagnosis of exclusion, we'll just euphemize it as "psychotic disorder NOS" or some such.


Freud is dead. Dead and gone. We moved on. Really, i know he founded the field and made for a nice soap opera gossip generator when discussing other peoples problems sources (generating alot of unnecessary drama, to people who already had drama, like having the genes for schizophrenia in the family)- so please could we stop mentioning him, when discussing modern neurology.

Its like a tribe on a pacific island had discovered boolean algebra first, and every time somebody tried to discuss comp science ever after - out of nowhere someone yells "This calls for a ritual, sacrifice the chicken, you cant discuss booleans, without being ridden by baron samedi."


We actually shouldn't. The psychoanalysis is contempted and forgotten however psychoanalysis is something like a computer language, the language of human inner world.

Some kind of lisp with probably terrible interpreter.

The modern neuroscience is of course something like an assembler. So lisp or assembler? If you want to write modern OS, then you know the answer.

The Freud, Jung, Lacan theory is related to psychotherapeutic work is like automata theory relationships to writing modern enterprise applications.

I don't believe there is something 'true' or 'objective' in psychoanalysis - deep inside is some ocean, some chaos of different introjections, emotions and feelings. But the psychoanalysis helps to create structure there, to look and make sense out of the ocean.

There is no substitude for psychoanalysis except really good prose probably or poetry.

And of course Freud was a genius.


I would not call him genius. Alfred Adler perhaps was.

Freud was a misogyn and a drug addict, and he proposed a lot of theories that leave modern people scratching their heads. Eg he attributed almost all mental problems to sexuality, coined the ridiculous Oedipus complex, and once called girls „strange little beings without a penis“. Sure, the field was at the very beginning, but why did he always have to bring penises into play?

He happened to found the first thought school for explaining mental illnesses, but most of his ideas have since been accepted to be wrong or way too crude.


>Freud was a misogyn and a drug addict, and he proposed a lot of theories that leave modern people scratching their heads.

All three are totally orthogonal to someone being a genius -- and at least the second is a very puritan concern to level at someone regarding their contributions to science/culture/etc.

>Eg he attributed almost all mental problems to sexuality

And a heck of a lot (of the soft kind, not physiological issues) can be attributed there -- especially since the only real mechanism behind humanity's (and any animals) continued existence, and the closest thing to an "end purpose" for any individual, is reproduction.

>coined the ridiculous Oedipus complex

Nothing ridiculous about it -- and it was not for some irrelevant chance that those kind of relationships and dynamics were studied and concerned civilizations for millennia (including, but not limited nor starting from, the ancient Greek play on Oedipus).


Your arguments are rather philosophical than based on hard facts (IMO that’s a big problem with a lot of psych research, giving the field a bad rep). Those ideas have been discarded via proper scientific studies, and research has long moved on. Psychoanalytics who hold onto Freud need their patients to come to them for years or even decades - I think this also tells a lot about the efficacy of applying Freudian theories clinically. Behavioral therapy works way better and faster, and it does so by integrating our knowledge about how the brain works.


>Your arguments are rather philosophical than based on hard facts (IMO that’s a big problem with a lot of psych research, giving the field a bad rep).

On the other hand, I find arguments based on hard facts naive and ignoring that the interpretation of facts (and the framework for understanding them) is what makes them usable for anything, not their inherent quality.


>> >coined the ridiculous Oedipus complex

>> Nothing ridiculous about it

Except that Freud suffered from it himself - he had a thing for his own mother - and then projected his shame onto patients to such an extent that he thought it was the foundation of everyones problems.

The challenge with analysis is that it needs to be done by the patient. Only they can see/hear whats going on in their head.


> The challenge with analysis is that it needs to be done by the patient. Only they can see/hear whats going on in their head.

Based on my limited personal experience as a patient, this is quite insightful.

No medication could solve my issues with depression. What did turn my life around was when I was finally able to get a hold on the cycles that my mind goes through on a regular basis and terminate the feedback loop that leads to despondency for me. Counseling was only useful for me in that it allowed me to consult with someone with much more experience in the field to make sure my own observations of self matched the outward reality.

In my early twenties I believe I experienced a taste of what schizophrenia is, although I was never diagnosed with it. My mind would make connections between ideas that seemed extremely important at the time, but between which no connections actually existed. I developed a habit of taking notes when I get excited about an idea and then going back in a day or two to review them to see if it still makes sense. In the vast majority of cases they don't.


When and how did the behavior described in your last paragraph end?


If a man who was wrong about almost everything can be considered a genius then the word "genius" has lost all meaning.


There are dimensions to genius.

Seeing a common subject, a set of boundaries, a possible (even if incorrect) set of guiding principles, can be genius. If it inspires further exploration or refinement or even rejection of ideas, it's a productive step.

Einstein railed against QM, Newton believed in alchemy, Kelvin though the Earth was 30 million years old, the list of people opposed to continental drift / plate techtonics is vast (see Naomi Oreskes several papers and books on the history of the development of that subject), Samuel Morse had what would now be dispicable views on race and religion, Ford was an anti-semite, Crick and/or Watson have their own failings, etc., etc., etc.

Much of genius is being able to jump out of and beyond the present dominant paradigm and mental models. It's not about being right but of being less wrong. Than that which came before, not after.


The scientists you listed at least attempted to follow the scientific method as best they could in most of their professional work (although they certainly made their share of methodological errors and allowed personal biases to affect their work). Whereas most of Freud's writing was the moral equivalent of astrology: based mostly on random anecdotes and not falsifiable. Hardly equivalent.


That is not the original criticism you raised, nor is it the one I addressed.


I don't know how he was 'wrong about almost everything'? I just searched the article with the same name.

Penis envy? Well, I saw myself and read myself about women who desired to castrate their brothers for example because they attributed their envy and jealousy of parental attention to them.

Oedipus issues? Seriously? I believe every other mother or father out there in emotionally incestous relationships with their kids.

Id, ego, superego? It's a model of consciousness, pretty primitive, but still useful. You basically split everything into 3 buckets - e.g. compulsive lust, fetishism goes to id, rational thinking to ego, overresponsibility to superego.

Oral, anal, phallic, etc. stages of development? There were much more better theories by Theodore Lidz and Erickson.


I really hope you're being sarcastic, and that you're not deranged enough to believe that nonsense.


Would you consider Democritus a genius? Or Zeno?


Everytime I reflect on Zeno, I get halfway closer.


Sorry, but all those people he helped to blame themselves for being uncurable, those are something to glance over, right?

Oh, you are a paranoid schizophrenic. Well, im not going to admit defeat and helplessness- i got a reputation to run here- no Sir, you are eternally afraid for having a shorter wiener then your father. This is genius, yes, but of the marketing kind.


If you want to call something irrational, at least make sure it's an action, rather than a belief. It doesn't matter what zero-cost belief someone holds until they put their money where their mouth is.

The whole point of this thread is that modern neuroscience is showing us that the classification of schizophrenia in modern terms was not rational either.

It makes sense to work at higher level information, at the level of feelings and dialogue, than at a lower level, e.g. epigenetic circumstances or neuronal metabolic disorders, if one mistakenly overestimates their grasp on the phenomenon.

Furthermore, there is no such thing as "the genes for schizophrenia" - nor would I be so quick to dismiss the skepticism he brought to the preexisting field of analyzing people's problems, just because he became a mythical figure in pop culture to the point that more people have a mistaken view of what he wrote than have read him.

Why did it matter what he wrote? Because there were many things he wrote that made people recognize things in others. Of the things they recognized, what worked either lasted and was retained, or fell out of mode due to people becoming fed up with him as long ago as the 1920s, or served as a benchmark/competition for others to test ideas against to find any that worked better. It really doesn't have much to do with stymying conversation because of cargo cult thinking..


Hardly. Freud's proposition that everyone is neurotic is important, relevant, and true. Also, neurology is not the same as psychology or psychoanalysis or psychiatry.


I grew up with a close uncle who suffered for decades from this disease. The tales of his brilliant youth, on track as a naval nuclear engineer, are only more tragic to the shattered shell of a man I knew. Most of his treatment involved a cocktail mix of a dozen or so "medicines" who's primary purpose appeared to be to keep him sedated for long stretches of the day.

He was absolutely unable to hold a job, or even a coherent conversation, and was in and out of half-way houses and treatment programs. At times he would get violent to himself or others as various psychotic fantasies moved him to be. He famously assaulted my sister one day before my father sent him away to stay with my mother's family (of which he was a sibling)...when he remembered the event at all he insisted he was trying to save her from one of a variety of fantastic and impossible sequences of events.

Often in tears trying to explain what he had been trying to do, the family eventually concluded that in his mind he was trying to do a good thing and help against some imaginary evil, but his reality was so distorted it had turned into harm and that we simply couldn't risk his presence any further.

Drugs of various levels of legality were a constant feature of his life. It was well known that he ended up dropping out of the Navy as a pot head that morphed into a serious cocaine and lsd user. Much of his treatment in his later years was trying to get him to stop self-medicating and to let the professionals provide the legal stuff.

He made it to his 60s before a tumble in the bathroom knocked him unconscious and sent him into a hospital bed where he never woke up. Another Uncle, the guardian of his estate, made the decision to take him off of life support and hope his next chance turned out better than this one. His autopsy wasn't revealing, his system was basically a mobile pharmacy and narcotics evidence locker combined, but it still devastated the siblings who had tried to help him find his way back to the brilliant 20 year old they last remember.


I know somebody who was brilliant (I mean brilliant as hell) as well until the age of about 20. He started suffering from bipolar disorder later on (at about 23). Between that age he was registered at university but was not attending it. Instead he was partying all the time. I noticed him acting odd first when he came back from a trip to the other side of the world - my impression was that the jet-lag in combination with alcohol consumption and the realization that other people made a lot of progress during the years he was partying helped initiating the illness. I think summarized the factors were lack of sleep, alcohol, stress and high vulnerability due to inheritance.

Therefore I think the best way to prevent this illness is:

- Avoid stress, especially in your 20's

- Try to have an ordered life

- Get enough sleep

- Avoid too much alcohol consumption

- Do sports (rarely a mistake I assume)

- Take jet-lags seriously

I am not sure if drugs (from the trip to the other side of the world) were involved. It is possible but I doubt it.


I forgot to mention: He was smoking a lot as well.


Most schizophrenics smoke a lot of cigarettes. Though not well understood, the nicotine may act as a general stimulant and help with the disease. It's an active area of research right now.

It's a very strange site, but it may be a good jumping of point for those doing research in to the link: http://www.schizophrenia.com/nicotine.benefits.htm


Schizophrenia is one of those disorders that medicine has, that is likely not one discrete condition, its likely a multitude of different psychological illnesses all flying under one banner, even if the underlying psychology and physiology are quite different for different people. As we get better with medicine, we find more illnesses - for example, its part of why I think cancer is found so much more often now, while there is undoubtedly more cancer (we're living longer, as it turns out, old age is a fellow traveler of cancer), we're also much better at finding it.


Like Asthma.


I’d suggest that not taking a drug (weed/lsd/mushrooms) that alter ones perceptions of our very existence is a good way of staying mentally sound.

If you take ten 16 yr olds, allow them to experiment, 1-2 will drop off the world, 2-3 will have major, life changing changes to the way they view life (border line changes in said spectrum) and the rest handle it fine although with a significant change in lifestyle.

As someone who has had a close call with the boundaries of perception I believe weed is of significant concern. It has a ‘benign’ perception but for those it effects it can take their heads off to places which are not healthy for fitting into normal, standard life. Aka the general ‘schizophrenic’ term


While the experience itself may resemble psychosis at times, lsd/mushrooms, when taken in a proper setting, will not turn you mentally unsound.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/ "21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems."

Now everyone agrees 16 yr olds shouldn't be abusing any psychoactive drugs while their brain is still developing, but don't ruin it for us adults, it is an important part of the human experience (though it isn't for everyone, since for psychedelics, expanding the way you view life is generally the end goal.)


Granted, I haven't really taken any large doses, but for me psychoactives don't expand my perception in any way. They're just a really really fun thing to do a few times a year, when I have nothing else to do for 8 hours. I never experienced the spiritual element, or oneness with the universe, etc. Maybe I need to take more than 100ug.

I definitely feel it's a pity that it's illegal and so demonized, though. It's the most fun I've had with $4, and I unreservedly recommend it.


LSD is hit or miss for that really deep trancendent experience. There is a lot of low quality acid that just feels speedy with some visual enhancement.

Try Ayahuasca. In my experience it is much more consistently mystical.


Or insist on actual LSD and not some cheap psychoactive passing as such?


Pretty sure it was LSD (and mushrooms once), I've bought from different people.


Saying that because I've seen people selling crap as LSD before -- especially in one-off encounters.


Ah, I buy from well-reviewed online vendors only.


It's possible that people gravitate towards different drugs in a way that makes the users of any given drug a non-representative sample.

If I use myself as example. I don't use any psychedelics because I'm completely satisfied with my level of creativity. As a result it's possible that we completely lack data on how psychedelics mingle with naturally high creativity.

I also don't use weed, because it just simply makes me uncomfortable. That could be my brain protecting me from weed, as I may have strong tendency to go completely insane with prolonged use.

Those are just anecdotal speculations to illustrate a point. I'm not really claiming that they are any sort of facts.


>If I use myself as example. I don't use any psychedelics because I'm completely satisfied with my level of creativity. As a result it's possible that we completely lack data on how psychedelics mingle with naturally high creativity.

Given that tons of (already very creative) musicians, painters, writers, etc have tried and used them, I really doubt this...


You don't need to be creative to sing or play. You need to be creative to compose.

Do we actually know that many creative musicians, writers etc. were creative before using? I'd imagine it's really tricky to track down the starting dates of drug use. Or when someone started composing for that matter.

But yeah, that was just to illustrate the point anyhow. And the point is that people self select heavily on which drugs they use. So the user group of any drug is not representative sample.


Could you try them and let us know, instead of speculating what may or may not exist?


...and produce single anecdote. Boy I'm misunderstood here big time.


Take this however you want, but I know that a significant source of anxiety for me when I tried weed was the severeness of the consequences if I had been caught. I'm not sure about "the boundaries of perception", from what I remember weed didn't alter my reality much more than getting really drunk does.

I don't think it's helpful to put cannabis in the same baket as literally hallucinogenic substances like LSD or "magic mushrooms".

(By the way, I don't smoke weed anymore and possibly never will again.)


>a significant source of anxiety for me when I tried weed was the severeness of the consequences if I had been caught.

In most of the civilized western world (EU etc), usually not even a slap on the wrist.


I'm from a country in the EU and I can tell you that in 99% of EU states (The Netherlands excluded), having cannabis on your person will not entail "a slap on the wrist". Sweden, like another commenter mentioned, is very strict. Also, your exclusion of Poland is borderline ignorant.

On that topic, few things is more irritating than reading a high-nosed comment telling you that "actually, in the EU/civilized world..." as if you were american when you're not and you do actually live in that fantasy land you're being lectured about. It happens a lot these days.


That's definitely not the case in Poland, which is part of the EU.


Yeah, hence "western" -- for me the "real" EU would always be the early 12 states :-)


That's a rather bizarre definition, by which Greece is a ”Western" country (ex-Byzantine!), while eg. Switzerland is not.


And also in those "real" EU states, you can get serious problems, if you are in the health sector for example.

But if you are a student wanning to become a software-developer, then yes, allmost nobody cares.


Could you elaborate on the problems?


Not in detail, but afaik they can revoke your permit to work in health sector, if you get charges from drugs, as you are then not seen fit.

Also in bavaria, there have been charges against people for driving under drugs, even though they only posessed them and did not consume at that time ...


In Sweden, which I definitely consider to be part of the "civilized western part of the world", getting caught with weed has dire consequences.


I agree. Weed (etc.) can not be healthy "for fitting into normal, standard life".

But there is a different view to it, than just claiming "drugs are bad".

Because there are quite some people claiming, that a "normal, standard life" with a 9 to 5 job and bounded by many weird social customs in a hectic enviroment which very often rewards lying and assholeness - is in itself not healthy. And some drugs can enable people to step outside and see things from a different angle, that "normal" is maybe not allways good. And that a different "normal" might be possible.

The main problem arises if those people now decide to escape into the psychodelic world, instead of using their insights to actually do things differently. Most of them will mentally break down, sooner or later.

And btw. "If you take ten 16 yr olds, allow them to experiment" ... most 16 yr olds will experiment, whether you allow them, or not. Which I think is good in general, for progress for the new generation, but I think the chances are much higher for things go dark, if you push them too much into illegality. Then it is much harder to help them find moderation and balancing.

So I would argue, drugs can be and are beneficial for society to develop. But they are powerful and therefore dangerous.


I don't disagree BUT there is a cost with consumption In My Opinion.

p.s. I was part of the ten 16 yr olds. I am very aware of how far it can go.


For sure there is a cost. But there is a cost with everything.

And I know that it can go very far. And also very far down. Actually I have to deal with exactly that right now. Someone who started of dreaming of a better world, but now reduced to a lying, selfish asshole, who now only cares, on how to sneak money out of people around him, so he can continue doing nothing and smoke his last brain cells out, while blaming everyone else. No wonder this person developed a heavy psychosis. So I know of the dangers.

But still, this person is an excemption, because otherwise allmost everyone I know of my generation, smoked weed (or more) at some point, got new experience of it or just had fun - and now lives a ordinary life.


"very often rewards lying and assholeness". How true.


How do you mean? Most folks I know who regularly use marijuana aren't close to anything I'd call schizoaffective.

Those who I know whom have gone off the deep end so to say, seem to have had other troubles in life which compounded to become too much to handle for them.


It's probably a bit of column A and a bit of column B.


Are you replying to me? So, you are suggesting my story is lies? I guess you should study stats to know that there are more than 60 people in this world.


Clearly weed has not helped me comment on HN . Wrong reply


The plural of anecdote is not data.


Same can be said about the original comment. Nothing in there of value except some dubious extrapolations.


Yes. countering it with another anecdote doesn't really help though.


Could you be more descriptive about the "close call" you had "with the boundaries of perception"? I've been using cannabis daily for over a decade to be a normal person, having found that it removes my anxiety, and allows me to operate as a normal individual in society. When I am not using, I become a terrible anxious mess who can't even talk to clerks in stores.

Also your last sentence seems incomplete - did you intend to complete your thought, or at least use punctuation?


The problem with cannabis is its extreme variance of effects. Some people like yourself seem to have very positive effects. Myself, I've consumed a whole wack of different drugs including the usual psychedelics plus various dissociatives over the years and cannabis is easily the most unpleasant in its effects on me.

Paranoia, very unpleasant thoughts and paranoia, sad feeling, accentuated body pain (I have chronic back/hip pain), headaches, anxiety. It's basically the opposite of what THC advocates seem to describe. And I've consumed quite a bit of it.

Hopefully along with legalization we can see a lot less proselytizing and some more realistic and scientific analysis.


> Myself, I've consumed a whole wack of different drugs including the usual psychedelics plus various dissociatives over the years and cannabis is easily the most unpleasant in its effects on me.

I'm the same.

Cannabis is easily the most unpleasant drug for me these days (don't do them so much anymore though). It just gives me paranoia and anxiety and makes me totally unable to hold a conversation or even relax.

Compare that with LSD, MDMA, DMT where I generally have positive experiences. The only bad ones I've had are when I've foolishly taken them when not in the best of moods.


Most of those feelings are pretty common if you smoke too much pot.

I have a very low tolerance for it and while I had a few good times with it, I had what you describe happen more often than not.

But the feeling you have while on drugs generally goes away when you’re not on them. I wouldn’t assume that because taking a drug gives you a feeling that approximates a psychological problem that it would necessarily be a cause of that psychological problem beyond the time you were intoxicated.


I don't make that assumption at all. But I've also seen many people, including family, go down a road with the drug that did in fact lead to pretty severe emotional and life function difficulties that went away after the cessation of the drug.

All of this applies to alcohol as well, surely... but that is hardly a high bar.

I was a lot more tolerant of cannabis advocacy before I had kids and before legalization came on the agenda here in Canada. Now that it will be legal I hope the emphasis shifts away from advocacy and to education for responsible use.


> did in fact lead to pretty severe emotional and life function difficulties that went away after the cessation of the drug.

I did in fact say that the psychological problems go away when you stop using the drug. Obviously if you're on drugs all the time, you're going to have problems.


Yes, when kids come around you view it in a different light. There are consequences of both and I'll advise my kids differently around both.


Which terpenes are in the plant can have a subtle but powerful impact. And THC can leverage terpenes in other foods too. Some are very calming.

And then there's the non-intoxicating CBD parts, that are becoming popular for those who want the relaxation, but not the head high.

Alcohol has a very broad scope as well, ranging from toxic cleaners, to light dessert wines, to tripel beers and "four loco" drinks. It's very easy to have a bad trip, or a fun night turn deadly.


Took drugs. Got scared about my mental health as my thoughts were very powerful. Others around suffered worse which compounded fact. I was very, very lucky to have survived and have turned that experience into knowledge (which has only come in the last year after 20 years).


Psychedelics (LSD and mushrooms) are VERY different in their effects than weed. Have tried both categories.


So have I, and I've had extreme reactions to both. LSD was actually the easiest on me if I consider my worst experiences together. A bad mushroom trip, being the worst of the worst, left my personality in tatters and it took me over a year to truly recover from the experience. Marijuana induces crippling anxiety in me. I was having issues sleeping a few years ago, so I got a medical card. Even one hit was overwhelming. When I was a late teenager, I would smoke a couple times a week and it was generally fine. I'm not sure how or why my body responds the way it does but, personally, it's not at all fun and not at all relaxing or mind expanding in the ways most people suggest. It's just a really shitty time and it's mostly impossible to talk to other users about it because they don't have these responses and don't understand it.


A bad trip will happen if you take a psychedelic when you are not in a particularly good mood.

If something has been recently bothering you, or you are stressed or depressed or angry about something, those feelings are going to come up to the surface and manifest in very unpredictable ways, given the nature of hallucinogenics.

I learned that lesson myself. Never take a psychedelic unless you are in a good place, emotionally.


It's a moot point for me, at this point in my life. Hopefully it's good advice for someone else. With the psychedelics, we're talking about a 2-3 year period of my life that started roughly 20 years ago. And what you're saying is all common knowledge to myself and my then-friend group. I honestly have no idea what my frame of mind was but I don't recall ever starting a trip in a bad state of mind. I just know that I had good trips and I know that I had bad trips. And the bad trips went very, very bad and grew over time in both frequency and intensity. Maybe I was taking too much? It didn't seem like it, at the time, at least in retrospect. Who knows.

But then, I can't reconcile these things with my experiences with medical marijuana in 2012, either. I was a recreational smoker for probably 4 or 5 years of my life before the bad mushroom trip (after which, I wholesale quit drugs the very next day and also didn't have a drop of alcohol for 5-6 years). I never really experienced much anxiety from marijuana in my youth, but when I went back in 2012 it was a totally different ball game. I worked with my dispensary to try to sort out a strain that would help me and came up short.

FWIW, I opted instead to address the utter lack of physical activity in my life and it sorted out the sleep issues and has persisted to today.


[flagged]


Your anecdote and needlessly aggressive comment do make a very compelling argument.

But in all seriousness: can you explain why you feel so strongly about this?

EDIT: the person I responded to edited their comment to make it 'milder'.


I hate seeing utter lies like this in any debate. It's propaganda and I react strongly to it. Claiming 50% of teenagers smoking weed, let alone lsd, will have problems is an utter, out-right lie.

I was never into drugs like friends, if that's what you're insinuating. I tried a few, but beer was my drug of choice, and nicotine for a while.

There are polls where something like 40-50% of UK teenagers (and probably US) had tried weed.

If this guy were even vaguely right we'd see an epidemic of metal health problems right now.


I don't disagree with you concerning OP's claims, so I'm mostly on your side, but I don't see how you're helping by 1) frothing at the mouth at a point of view that, however wrong it may be, is very common, and 2) making an equally unbalanced claim of the opposite based on anecdata.

There's plenty of evidence that pot smoking can at the very least exacerbate problems, which strikes me as blindingly obvious when it comes to any substance that has mood altering effects as strong as weed, and I have just as much anecdata to support that view.

That said, I guess I can understand the frustration. I don't know where you live and what the status of weed is, but as a Dutch person I do realize that I don't (often) have to deal with the 'weed is evil' argument, and consequently it's easier for me to not get too upset about it.


Yeah whatever you don't like is evil fearmongering. And they don't even say trying it will drive you nuts.


Quoting obviously nonsense statistics in this case seems like fear-mongering to me.


There is a reference to a study on the topic elsewhere on the thread, and in the article itself, if I'm not mistaken. Also AFAIK it's not required to be a medical doctor to talk about these issues here, and not everyone has a list of publications on every topic they discuss. If you think a view is wrong then answer it, but name-calling and accusations only undermine any such discussion. It's not like the opposer is citing the literature too.


>can you explain why you feel so strongly about this?

Because he doesn't like BS arguments?

And because "so strongly" is not based on some objective measurement, but what you could gauge from a random comment. Maybe he likes/is used to using strong language (e.g. like Linus is) without necessarily feeling that "strongly" about it.


> Because he doesn't like BS arguments?

I agree that they're BS, but they're common and pernicious, and as such worth a proper response, frustrating as that might be.

> And because "so strongly" is not based on some objective measurement, but what you could gauge from a random comment. Maybe he likes/is used to using strong language (e.g. like Linus is) without necessarily feeling that "strongly" about it.

Fair enough. I got that impression because of some other comments by the same person in this thread, but you're right, I might be reading into things.


Well, you might be right too (I haven't noticed that the parent had multiple comments about it).

Just that I find a question like "why do you feel so strongly about X" can be infuriating, and make the other indeed feel strongly (when they were just casually writing their opinion with some strong words before).

Kind of like "relax" can make someone angry ("I AM relax") when they were perfectly relaxed before.


Perhaps you are paranoid which is in no way related to weed.


Probably because he has a problem with fear mongering.


It’s not fear mongering. The Lancet published an article about continued and discontinued use of cannabis after psychosis.

http://www.thelancet.com/journals/lanpsy/article/PIIS2215-03...

But it states that there is a well established link between cannabis and psychosis.


Yeah but the numbers are far lower than OP suggested.


No, this is disingenuous fear mongering.

The article you linked examines psychosis outcomes after quitting marijuana. It does not show evidence that psychosis is caused by marijuana.

In fact, the article is similarly misleading, as it makes reference to two studies which show, in the article's words, a "link" between psychosis and cannibus use. However, the two articles cited for this assertion [0][1] similarly only discuss a correlative link between psychosis and marijuana.

While the correlative relationship between marijuana and psychosis is well established, there is anything but a consensus for the causal relationship between illness and marijuana.

As they say, correlation != causation.

Edit: furthermore, I encourage you to browse the wikipedia page [2], which supports my assertion with multiple sources: neither consensus nor causal link has been established. You are spreading potentially harmful misinformation.

[0]Arseneault, L, Cannon, M, Witton, J, and Murray, RM. Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry. 2004; 184: 110–117

[1]Stepniak, B, Papiol, S, Hammer, C et al. Accumulated environmental risk determining age at schizophrenia onset: a deep phenotyping-based study. Lancet Psychiatry. 2014; 1: 444–453

[2]https://en.m.wikipedia.org/wiki/Long-term_effects_of_cannabi...


I’m hardly spreading potentially misleading information. There is actually a wide body of evidence that amongst certain people cannabis can cause psychosis. It’s far more harmful in that your sole reference is a fairly partisan Wikipedia article. Give me primary sources, don’t give me a tertiary source like Wikipedia.


I resent your being down voted, by a audience running out of arguments.

If something that attacks your lifestyle or a dependency of it and you can not bring arguments forth, this does not give you the right to silence the debate.


It's pretty par for the course really.


My brother got heavily into weed at a young age (15-16). He developed strong schizophrenia. Was medicated which helped him, but went off the meds, left his wife, and died falling off a train that he was graffiting.


And you attribute this development to the weed because correlation is causation?


Well... both. But you're right.


I'm not going to claim that weed has absolutely no downsides like some recreational use fanatics, but I'm going to suggest that he was predisposed to mental illness with or without the weed.

Though it did probably exacerbate it.


Or it was the schizophrenia that made him heavily addicted to weed?


Weed (THC) can trigger mental episodes in those with a propensity for it. Sorry to hear that.


A significant chunk of schizophrenia-diagnosed patients have already been chipped away; it turned to be autism spectrum disorder instead. I wouldn't be surprised if other such corrected diagnoses followed, gradually dismantling the schizophrenia itself altogether.


On top of that I would be surprised if autism doesn't (again) split up into separate (sub-)disorders as we find out more. Sooner rather than later, I hope.


I would argue that the indications of schizophrenia being associated with weed is ascribing a causative effect to a correlation. Weed doesn’t increase your chances of schizophrenia unless you already had something that would tilt you in that direction in the first place, from my experience. I would say I do agree that schizophrenia probably needs to be broken up; it was merely a collection of symptoms to begin with that couldn’t be explained by other means. Now we have explanations.

I am curious how this may affect schzioaffective, schizoid, and schizotypal disorders. That they’re not mentioned st all in this article is rather disappointing.


Schizophrenia also has a huge correlation with smoking tobacco cigarettes too but that doesn't mean cigarettes cause schizophrenia.


The text does a decent job of not saying smoking weed causes psychosis:

"Compared with non-cannabis users, the daily use of high-potency, skunk-like cannabis is associated with a fivefold increase in the odds of someone developing psychosis."

But the photo caption below a picture of someone smoking weed explicitly states (not supported by a study; how could one possible do a double blind test on cannabis in the current regulatory environment) a causative effect:

"Smoking skunk every day increases your odds of developing a psychotic disorder fivefold"


Given how carefully written that aspect of the actual article text was, I'm assuming that the photo + caption was added later on by someone else who was more interested in clickbait than differentiation between cause and correlation (or didn't understand the difference in the first place). Journalism is dead, rabble rabble.


Or just not aware of the difference. Not everyone helping with layouts is evil and just wants clickbait. They're just not always experts on the field.


Indeed. Also keep in mind, that though someone might realize, on an abstract level, that ”correlation is not causation”, they might not be used to actively looking for that distinction in text. Everyday discussions tend to be more fluid and inexact.


> skunk-like cannabis

Why don't they just go with the "sticky icky"


There exists cannabis psychosis. Naturally, more psychosis will exacerbate a psychotic illness. It usually brings it on earlier and heavier in severity i.e typically schizophrenia presents later but cannabis usage in adolescents seems to trigger it.

The same is true for amphetamine. Interestingly, amphetamine has been hypothesised as a chemical model for schizophrenia. Amphetamine psychosis is extremely similar to the positive symptoms of schizophrenia. In fact, many of the treatments used for psychotic illnesses repress dopamine activity in certain receptors (the newer ones, the typical antipsychotics, are less 'targeted' than newer ones leading to Parkinsonian side effects).


> There exists cannabis psychosis.

As far as I can tell, this is not generally accepted as true. At best, there is a statistical association between cannabis use in children/young adults and the later development of psychoses. As we all know, "correlation is not causation" - it may well be that those who are more likely to develop psychosis are also more likely to use cannabis and other psychoactive substances to excess.


> Weed doesn’t increase your chances of schizophrenia unless you already had something that would tilt you in that direction in the first place, from my experience

I really wish people on both sides of this argument would stop pushing what they think and just look at some evidence.

The interplay between cannabis, tobacco, medication, and psychosis is incredibly complex. We can't yet say there's no causative effects of cannabis, because it's hard to remove confounding factors.

For example: https://www.nationalelfservice.net/mental-health/substance-m...


I suspect there's some vague "psychosis level" that spikes and decays exponentially when you use weed, lsd, etc. And then people with schizophrenia find these drugs near age 20 just as the level is rising naturally. So it looks like LSD triggered it but there's no real interaction besides adding the two curves.


I was diagnosed schizoid because I was a smartass and said I could "hear things that others couldn't".


I sincerely hope that it took more than just this one sentence for a real doctor to diagnose you as schizoid.


Mistakes can be made quite easily—doctors are only human. For example, once I was diagnosed with “mild scoliosis”, in part because I was slouching heavily when the doctor came in to the exam room for my physical—I was shy about having my shirt off and thought slouching made me look cool and aloof. I was wrong, and as it turned out, so was he.


Doctors only know what you tell them.


The UK British Psychological Society recently released an update to their Understanding Psychosis and Schizophrenia report.

People may be interested in it. http://www.bps.org.uk/networks-and-communities/member-micros...

It's had some criticism: it includes a bunch of people who probably aren't psychotic (auditory hallucinations are common, and not always a sign of illness, for example), and it appears to exclude a bunch of people who have severe forms of illness.

Here are two blog posts that give a thorough, evidence based, review:

https://www.nationalelfservice.net/publication-types/report/...

https://www.nationalelfservice.net/mental-health/psychosis/u...


I love this snippet from Dr Gabor Mate [1], where he talks about "the myth of normal". If you haven't seen this, please take a look, it is truly wonderful.

[1] https://www.youtube.com/watch?v=8_j5mmBa4mw


I think a good case can be made that many of these "mental disorders" are actually metabolic problems. There are many causes behind an individual's metabolic problem that leads to schizophrenia/dementia/psychosis/(edit3: depression)/etc...

Sometimes people are malnourished. The B-vitamins are important cofactors for metabolic activity. An old/new treatment for "schizophrenia" is Vitamin B3 [0]. My girlfriend's treatment provider did a genetic test this past summer and found that she's a poor methylator. This means that she doesn't convert folic acid (synthetic Vitamin B-9) into folate very well. They've put her on prescription folate [1], and she's doing much better than when she was just double-tranquilized. I asked the biochemist about this issue, and he said that when on a good diet with folate-rich foods (liver, etc), even 'mutants' get plenty of folate.

[0] https://www.madinamerica.com/2017/06/schizophrenia-deconstru...

[1] https://en.wikipedia.org/wiki/Levomefolic_acid

The street pharmacy's stimulants (cocaine/meth) shred the mitochondria. These are known causes of substance-induce psychotic disorders.

People who drink heavily train their nervous system to become insulin-resistant and run on acetate (one of the breakdown products of ethanol). I think it's well-established that excess alcohol is inflammatory, which is also associated with psychosis.

So... Cute anecdote from today. I called two attorneys because I've hit a wall in my efforts to convince my girlfriend's treatment provider that she's been misdiagnosed and is not actually benefiting from the palliative maintenance medications (anti-psychotic/etc) they're still forcing her to take.

The first attorney listened to me, confirmed that it was within my legal rights to file pro-se petitions with the court, said that rural judges don't want to cause problems for their community's treatment provider, and said he couldn't help me because he'd already done some work for my girlfriend's treatment provider. He gave me the number for the second attorney.

It later occurred to me that the treatment provider certainly consulted him about my suit against them.

(minor edits)

edit2: physical injuries and inescapable/emotional stress are drains on the body's energy-producing capacity too. My other friend's father gradually became "schizophrenic" after he broke his back falling out of a tree.


Doctors are only allowed to give medications that treat a certain disorder. Experimental herbal treatments are not going to resolve a real mental disorder... you can try some vitamins but no medical professional is going to stake their medical license on it. Both of my parents had schizophrenia and it was a real hell.


> Doctors are only allowed to give medications that treat a certain disorder.

Is this true, particularly in the US?

My understanding is that a doctor can prescribe basically whatever they want as long as they believe that "in their professional opinion" the potential benefit outweighs the potential harm.

It's certainly common for doctors to prescribe medication "off-label" to treat conditions for which the medication is not approved by the FDA. I don't see how prescribing a specific vitamin in an attempt to impact a mental disorder is any different from, say, prescribing modafinil for ADHD?


It is true a Dr could in theory do what they want to but there are treatment guidelines and if they vary off that too much then the medical board could get after them. This happens I know a Doctor who wanted to treat lymes disease for patients and the medical board didn't like that it seems she was experimenting with what would work to treat it (this was about 15 years ago when it was pretty new).


Well, methylation disorders have both a genetic and plain old specific blood test. Ado a good doctor can stake their license on it.


Way back in the 90s when I was doing my neurophysiology degree, one lecturer who worked with schizophrenia said that it was such a difficult disease to work with because it wasn't one disease. Traditionally, if they didn't know what was wrong with you, they just threw you in the 'one-size-fits-all' schizophrenia bucket. One example of this was that the most frequent symptom (hearing voices) was present in only 69% of cases, and all other symptoms dropped off fairly quickly from there.

At the time, he thought that schizophrenia would break up into four basic groups, based on positive/negative affect (does an episode have the person doing extra activity or withdrawing) and, I think, whether or not the person has hallucinations.

I haven't really kept in touch with the literature to see how his 4-way prediction went, but I have never seen anything to counter the idea that schizophrenia is more than a single disease. And, of course, classification of disease is a key element of treating it, so if schizophrenia is not being properly classified...




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