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December 13, 2007

Personal Blogs on Coping With Schizophrenia

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December 11, 2007

Schizophrenia: Psychological and Social Causes and Treatments

As we've reported in the past, research is revealing the specific aspects of family and environmental stressors that interact continually over time with a biologically predisposed brain to eventually trigger schizophrenia.

Related to this topic, Researcher William McFarlane, M.D., a Maine Medical Center-based researcher we've mentioned before, was recently awarded the APA/American Psychiatric Foundation 2007 Alexander Gralnick Award for Research in Schizophrenia. After receiving the award, Dr. McFarlane presented a lecture, titled "Biosocial Treatment of Schizophrenia". In his lecture Dr. McFarlane made some interesting points on the subject of the development and outcomes in schizophrenia. Some of his points are very relevant to past findings on the causes, preventative actions, and treatments for schizophrenia we've covered before. Here's a summary:

Dr. McFarlane discussed the fact that it is now known that schizophrenia is a disorder that develops overtime as a result of genetic / biological and environmental factors. So for example, if a child already has increased genetic risk due to a family history of schizophrenia and/or other mental illnesses, certain environmental stressors (such as a home environment that is frequently highly emotional, or judgemental), combine with these genetic susceptibilities and result in the development of mental disorders.

One important point that Dr. McFarlane stressed was that:

"a decade's worth of research on microcomponents of environmental stress affirms the genetic nature of schizophrenia and does nothing to revive long-discredited theories blaming families or "schizophrenogenic" mothers.
Time and again research has shown that family and environmental stressors — encompassing very subtle interactions common to many families — work only in tandem with biological determinants to produce psychosis [and schizophrenia]."

Dr. McFarlane discussed that even until recently, environmental triggers were thought of as discrete events (for example, extreme stress due to a single event such as a loss of a mother, or extreme abuse), however current research demonstrates that some environmental triggers are continuous. (An example of a "continuous" environmental trigger might be again, a family environment where there is frequent highly emotion levels, high anxiety and conflict (or judgment and pressure) and therefore significant levels of stress in the home).

Dr. McFarlane further explained that continuous triggers can combine with inherent susceptibilities to mental disorders and result in the development and then worsening of prognosis after development of mental disorders. A model Dr. McFarlane used, that he believes does a good job of explaining this relationship, is that of a helix; that is, the cause and effect are closely entwined.

Of all the biologically determined psychosocial sensitivities believed to contribute to the development of schizophrenia and psychosis, the most subtle are negative emotional experiences.

It is especially the family with high "expressed emotion" for which there is the most research studies and data. High expressed emotion refers to the rejection, criticism, and anxious over-involvement that can occur between children and parents and other family members. It isn't that anyone is to "blame" for this - its simply that sometimes there is a negative dynamic between parent and child that causes a great deal of stress. Its important for parents to try to avoid these situations or minimize them.

As Dr. McFarlane says, some people predisposed to schizophrenia or just developing "symptoms seem to elicit certain kinds of rejecting or anxious responses, which in themselves elicit more symptoms," ... "Who do you blame? It's really a no-fault situation—the family is doing something, but they are only responding to the disorder. The negativity is reciprocal."

The key message here is that the psychological and social environment affects the biology of a person and vice-versa, so that both are in constant, continual interaction. This idea brings up the issue of less controllable versus more controllable factors of a mental disorder.

For example, the genetic vulnerability to a mental disorder isn't controllable, but certain environmental factors are: One of the most widely examined continual environmental triggers of mental illness and as mentioned above is the frequent experience of a highly emotional environment. In an attempt to combat this problem, researchers have studied preventative methods and found that adopting the growth, mindset approach is one way to effectively control stress factors in the environment. (Stress is known to increase the likelihood of the development of mental disorders.)

Dr. McFarlane also emphasized the importance of psychoeducation, stating that psychoeducational "...groups are designed to empower family members with information about the disease and the kind of social interactions that can exacerbate symptoms in the affected family member...In highly structured sessions, multifamily groups are taught specific strategies for lowering anxiety, conflict, and expressed emotion."

Read the full Article: Psychosocial Interventions Beneficial in Schizophrenia. (Psychiatric News)

Is Schizophrenia Psychological Or Biological?

Schizophrenia: The Value of Realizing Risk Factors Before Becoming a Parent

Social Stress Factors in the Development of Schizophrenia: A Review of Recent Findings

Child and Teen Brains Very Sensitive to Stress, Likely a Key Factor in Mental Illness

A Healthy Family Social Environment May Reduce Schizophrenia Risk by 86% for High Genetic Risk Groups

How Stress in Early in Life Changes Stress Response for Many Years Afterward

Posted by szwriter at 09:59 PM | Comments (9)

1970's Tale of Schizophrenia (Kristin's Blog)

This is a short film about a guy named Gary who became schizophrenic among the decadence and bright lights of the disco era. In this video he gives a good description of the strange associations that people with schizophrenia often make--things like thinking numbers have mystical meanings and thinking that there are bizarre, super-spiritual connections to things that most people would consider benign. It is not clear whether or not his schizophrenia was brought on by drug use and it is also not clear what happened after his onset of symptoms.

To see more stories by and about other people with schizophrenia click the following link:
Schizophrenia Stories

Posted by Kristin at 05:26 PM | Comments (2)

Stress and Schizophrenia: How Do You Deal?

Hi Everyone! It is me, Kristin, again!

Since some of us are people living with schizophrenia, I wanted to talk about different ways of dealing with stress in day to day life. In these first two videos I talk about the stress of "normal" living as opposed to how we live when we are fully psychotic. In the first video I discuss basic living issues that we need to keep in mind: eating, taking meds, sleeping, bathing, not doing drugs or alcohol, the kind of stuff every doctor will remind you about.

In the second video, I talk about some things that I like to do to keep my stress-free bank account high, so when something takes a hit on my happy bank account, the effects will not be to terrible or long-lasting.

Also, please feel free to share in the comments what kinds of things you like to do to help you deal with stress in your day to day life! I feel it is important for those of us living with schizophrenia to be tuned into how stress shapes our lives, because if we undergo too much stress we can often find ourselves in a bad position with more symptoms.

Please check out these links with more info. on coping with schizophrenia:

Mental and Physical Exercise Helps in Schizophrenia

Playing Soccer To Alleviate Symptoms

Intimacy: An Important Aspect of Recovery

Posted by Kristin at 11:24 AM | Comments (6)

December 10, 2007

Schizophrenia: The Value of Realizing Risk Factors Before Becoming a Parent

Yesterday, The New York Times, published an interesting article relevant to our website. The article, begins with the story of a boy diagnosed with high-functioning autism and discusses the increase in psychiatric and developmental diagnoses many children are receiving and the connection of these disorders to the functioning of the parents of the diagnosed children. The article discusses the idea that when a child is diagnosed with a disorder (ranging from autism to schizophrenia), parents of the child may examine their own behavior, history and functioning and realize risk factors that increased the likelihood of their child's disorder.

In the case of the high-functioning autistic boy, the father of the boy stated that after his son was diagnosed, he himself--the father--became aware of "abnormalities" in his own behavior that his son possibly inherited. The article, however, points out both the usefulness and danger associated with this kind of thinking. This type of thinking or realization may be useful in that the child is no longer alone in experiencing the disorder, once the parent(s) realize that they also exhibit the same behavior. That is, if a parent has also gone through or goes through the same experiences the child goes through, the child, in a sense, has a "co-experiencer". On the other hand, this way of thinking is harmful in that it stresses the genetic inevitability of a disorder. Though we know that a disorder like schizophrenia has a genetic component, recent research has shown that schizophrenia is not genetically inevitable and that the environment and/or psychological components are also at play in the development of the disorder. So the realization of "abnormal" behaviors on the part of the parents would perhaps be more useful before they become parents. That is, being aware of risk factors of a disorder can help parents to-be take preventative measures such as behavior modification prior to the birth and/or development of a disorder in their child.

Full Story: Your Child’s Disorder May Be Yours, Too. (The New York Times)

Posted by szwriter at 04:45 PM | Comments (8)

People With Schizophrenia Less Likely To Develop Cancer?

Teen Perspectives on Schizophrenia

Recently, we've come across a website called Teen Ink. It's a website that, as implied by its name, focuses on writing and art created by teens. On it, we've found perspectives of teenagers who either suffer from mental illness themselves or have loved ones who do. This is an age group we don't usually hear from on the subject of mental illness and we find these perspectives informative and difficult, yet still positive. Below are a couple of summaries of two personal perspectives on mental illness we've found on Teen Ink, along with links to the full stories:

My Schizophrenic Sister
This first story we've found is the perspective of a female teen whose sister suffers from schizophrenia. The author of the story says that her 13-year-old younger sister has been diagnosed with schizophrenia and has problems with food. She says her sister wants to eat, but believes that she will became ill if she eats or drinks anything. So in addition to suffering from schizophrenia, her sister also suffers from anorexia. The author also comments on the stigma her sister experiences as a result of suffering from schizophrenia. She says her sister "...is quite intelligent, which people do not always see because they focus on the abnormalities of her personality," and stresses that schizophrenia is an illness "that should not be shunned or made fun of but understood and, eventually, cured." The author says she loves her sister, and will continue to support and care for her.
Full Story

Loving Life
This story appeared in their May 2007 issue. It's a daughter's perspective on her mother's mental illness. Though the author never states which illness(es) her mother suffers from, the symptoms sound like schizophrenia. This account is particularly interesting because it describes the author's (daughter's) experience on visits to her mother in the hospital. She says her mother stops taking her medications because she feels she doesn't need them, and then ends up in the hospital. The author says, "...(s)he’s (her mother is) always glad to see us when we visit, and I rejoice to see her, but sometimes it makes me feel hollow inside. The halls are empty, the rooms so quiet you can hear your breathing. Visitors sit quietly, waiting anxiously to see their loved ones. The doctors smile sympathetically, but they don’t know how it feels to have that hollow feeling, like nothing will ever be right again." Still, the author says she tries to focus on the positive, the good things in life and emphasizes the importance of smiling.
Full Story

Related Stories on Teen Ink:
Prozac Nation
Psychotropic Drugs

Posted by szwriter at 11:21 AM | Comments (2)

December 07, 2007

"Special K" and Possible New Therapies For Treating Schizophrenia

It's known that the street drug "Special K", proper name ketamine, though initially created for anesthetic purposes, because of its hallucinogenic qualities is used as a recreational drug. Unfortunately, and as we've covered in the past, ketamine is known to induce psychosis including schizophrenia-like symptoms in its users. Interestingly enough, scientists have been able to use the psychosis-inducing aspects of ketamine to better understand the way schizophrenia effects certain functions of the brain. Scientists are saying that this increased understanding may lend itself to the development of new treatments for the illness.

In order to study the effects of psychosis on the brain, scientists at UCSD performed a study, (published in this month's issue of the journal Science), where they injected ketamine into mice to create schizophrenia type symptoms. They noticed the increase of a chemical known as "superoxide" in the brains of the injected mice. Superoxide is a toxic, highly reactive chemical created in the brain by an inflammatory enzyme. Apparently, an increase in superoxide results in the loss of "a specific subset of cells in a region of the brain called the prefrontal cortex."

This finding lead the scientists to a drug known as a Nox inhibitor. The researchers believe that if they use the Nox inhibitor, a drug which has the ability of not only targeting the inflammatory enzyme which creates superoxide, but also of destorying superoxide itself, they could prevent the loss of cells in the prefrontal cortex. This idea then lead scientists to believe that drugs or antioxidants related to the Nox inhibitor may be able to "mop up the superoxide," and potentially "provide future treatments for drug-induced psychosis or schizophrenia."

Perhaps the most intriguing finding in this study, is that the inflammatory enzyme which produces superoxide, called NADPH oxidase, usually has a protective function in the brain. NADPH oxidase "is normally found in white blood cells circulating outside the brain, where it helps kill bacterial and fungal infections by producing superoxide." Thus researchers were surprised to find that NADPH oxidase "is also critical for modulating signaling in the brain." The researchers believe that future, more effective therapies for schizophrenia can be conceived through the use of compounds that inhibit NADPH oxidase without eliminating its protective function.

Ketamine-Induced Loss of Phenotype of Fast-Spiking Interneurons Is Mediated by NADPH-Oxidase. Behrens, M., et al (Science)

Posted by szwriter at 11:28 AM | Comments (2)

December 06, 2007

Mental Health Starts During Pregnancy: Lower Birth Weight Babies Have More Mental Problems

A new research study has confirmed the relationship between low birth weight and the later development of mental health problems. The study, which is published in this month's issue of the journal, Biological Psychiatry, looked at data collected during a large and long-running study.

Over 4,600 participants of the original study, which was conducted in survey form, were "tracked...in Great Britain...for symptoms of anxiety and depression over a 40-year period" beginning with their births in 1946.

Researchers of the recent study analyzed this data and found that participants with low birth weights were more likely to later exhibit symptoms of both depression and anxiety:

We found that even people who had just mild or moderate symptoms of depression or anxiety over their life course were smaller babies than those who had better mental health," said lead author Ian Colman of the University of Alberta's School of Public Health. "It suggests a dose-response relationship. As birth weight progressively decreases, it's more likely that an individual will suffer from mood disorders later in life.

Researchers of the study believe the results further support the idea that conditions in the womb have a direct impact on the long-term health of the baby. However, mental health doesn't seem to be the only thing negatively affected by conditions in the womb; the researchers also discovered that babies with lower birth weights showed developmental delays in the areas of standing, walking, etc. (problems that have been identified at a higher rate in studies of children that later develop schizophrenia).

Its important to note that the researchers aren't saying that a small baby is inevitably going to experience developmental or mental health related problems - just that they have a higher risk of these problems (and therefore it may be more important to look at risk reduction strategies that we've outlined here). Further, the data had no information on gestational period, so the researchers didn't analyze any data connecting premature babies to later mental health or developmental problems (premature babies are generally of low birth weight, and also have a higher incidence of health problems).

The researchers, however, bring up a topic that we've covered in the past: stress and its effect on a child. They say that it isn't the size of the baby necessarily, but rather the cause of the small size, that's of importance here. For example, they say that stress experienced by the future mother during pregnancy is a possible cause of low birth weight in the baby, and resulting future mental health and developmental problems for the baby:

When a mother is really stressed, blood flow to the uterus is restricted and the fetus gets fewer nutrients, which tends to lead to lower birth weight. At the same time, because the mother is stressed, stress hormones are passing through the placenta to the fetus and may affect the fetus's neurodevelopment and stress response...Under these conditions, the part of the child's brain that deals with stress could be programmed incorrectly in utero--the brain doesn't develop as it would under ideal circumstances. If this theory is correct, you would find that when stressful events occur, the people who were smaller babies would be more likely to become depressed or anxious...

The researchers conclude by saying that pregnant women should be better taken care of and that stress during pregnancy has potentially serious negative consequences on the future health of the fetus.

Also relevant to this story are other findings on actions that help pregnant women have healthy babies. Some important dietary components relevant to pregnancy are:

Folic acid - Low amounts of folic acid in the diets of pregnant women have been linked to lower birth-weight babies. A contributing factor to these low levels is smoke, i.e., pregnant women who smoke are likely to have low levels of folic acid and as a result, smaller babies. Therefore its important for pregnant women to get adequate amounts of Folic Acid, also called "folate". Medical professionals recommend at least 800mg of Folic Acid per day during pregnancy - The simplest way to increase folic acid levels is by taking supplements, but it is also advisable to eat folate-rich foods such as green vegetables (broccoli, spinach), citrus fruits (oranges, limes, grapefruit) or wholemeal products such as brown bread or high-fibre cereals. In some countries, including the US, food is fortified with folic acid to ensure that women have enough.

Vitamin D - Vitamin D has long been known to prevent bone malformations in babies. However, researchers have also found that low amounts of vitamin D in diet of pregnant women can also result in smaller babies and babies may be at higher risk of schizophrenia and other mental disorders. Therefore, its very important that pregnant women get sufficient Vitamin D in their diet. New research has found that more than 80 percent of black women and nearly half of white woman tested when their children were born "had levels of vitamin D that were too low, even though more than 90 percent of them used prenatal vitamins during pregnancy". Canadian experts are now recommending that pregnant women take 2,000 iu of Vitamin D per day. Many doctors are suggesting that mothers continue to consume at least 800mg of Vitamin D a day while breast feeding, to make sure that the child gets enough Vitamin D. Infants, whether they are breast-fed or not, should receive 200 IU of supplementary vitamin D daily from 2 months of age until they are drinking a minimum 17 ounces of vitamin D--fortified milk daily to prevent rickets, a recent policy statement by the American Academy of Pediatrics recommends

Vitamin C & E - Women with larger amounts of both vitamin C and E in their diet while pregnant, have larger babies

Full Story: Study finds smaller babies prone to mood disorder later in life (University of Alberta)

Posted by szadmin at 05:10 PM | Comments (2)

Join Me, Kristin Bell, In Schizophrenia Research Participation!

I wanted to let you all know that I recently found out about a research project funded by the National Institute of Mental Health through the site here at schizophrenia.com and I am hoping that any of you out there who might qualify for the research study will join me in being a research participant. I am going to be documenting as much of my journey through the research process as I can, so stay tuned for further videos!

In the following video I talk about the benefits of volunteering for research and a little bit about what the research will be like. My whole family is going to be involved, so I'm going to try to get them in the video, but they are very camera shy, so it will be a major accomplishment if you get to view them!

I originally made this video for my YouTube channel. Anyway, I hope you will consider joining me in this fight to find out more about schizophrenia so someday no one will have to suffer! Our participation is very important!

Mentioned in the Video:
My Blog Entry on Research Participation

Also, please check out the following related links for more opportunities to participate in research and further scientific understanding about schizophrenia:
Opportunities to Participate in Research - A List

Researchers Helping Advance Knowledge and Understanding of Schizophrenia

Posted by Kristin at 01:27 PM | Comments (10)

December 05, 2007

New Treatment Guidelines for Mental Health Problems in Pre-School Children

Read more... Early Schizophrenia Treatment

A statement by a child psychiatry research group today announced that even though little research supports it, recently, there has been a rise in the numbers of children being prescribed stimulants and psychiatric drugs including, antidepressants. In hopes of providing the best treatment for young children, mental health professionals at the Bradley Hasbro Children's Research Center (a teaching hospital affiliated with Brown Medical School) in Rhode Island are combining their efforts with other mental health professionals from 11 other mental health institutions to create recommendations for clinicians planning on prescribing medications to children aged 3 to 6 years.

The treatment guidelines appear in this month’s issue of the Journal of the American Academy of Child and Adolescent Psychiatry. The group of mental professionals developing the guidelines, known as the Preschool Psychopharmacology Working Group, hope to, as one of the authors states, "begin to close the gap between practice and evidence by clearly defining the current state of psychopharmacological treatment of preschoolers, encouraging judicious practice, and using existing evidence and clinical consensus to provide treatment guidelines for these young children."

The group created the guidelines by reviewing past literature relevant to the prescription of psychiatric medications to preschoolers on topics such as the development of preschoolers. They then created instructions on treatment of nine commonly treated mental disorders among preschool children. The instructions, or algorithms provide the prescribing clinician with recommendations on which kinds of assessments and treatments to provide step-by-step. They suggest that clinicians first begin by performing a diagnostic assessment that considers "the child's emotional and behavioral symptoms, relationship patterns, medical history and developmental history and status."

If a psychiatric diagnosis is confirmed, the authors recommend clinicians start with family-focused psychotherapy -- such as parent management training or dyadic (parent-child) psychotherapy -- before considering medication. However, if the child is not responding and medication is deemed necessary, they suggest it be used in conjunction with psychotherapy.

Some of the disorders covered in these guidelines include: bipolar disorder, pervasive developmental disorders—an example of this is autism, major depressive disorder, attention deficit and hyperactivity disorder (ADHD), disruptive behavior disorders and anxiety disorders.

The guidelines stress the value of family-focused assessments in young children and encourage the use of psychotherapy prior to prescription of any medications, among other things. The authors state that the guidelines should reduce the numbers of preschoolers being prescribed psychiatric drugs.

The algorithms provided in the guidelines focus on five factors. These include:

Assessment and diagnosis at every decision point in order to reassess the diagnosis and formulation -- both of which are critical, given the rapid development of preschoolers

Psychotherapeutic interventions

Each step is marked by the "level of evidence" supporting the recommendation, allowing clinicians to consider the body of evidence and apply it to the individual patient

Recommendations for a discontinuation trial after successful medication treatment to reassess the child's symptoms and appropriate treatment

Consultation with an expert in child psychiatry if the physician arrives at the end of the algorithm with ongoing impairment and distress

The authors also state what they believe is immediately needed in the preschool population, more research efforts that examine the effects of therapy and medication based treatments for young children.

See Abstract of Guidelines: Psychopharmacological Treatment for Very Young Children: Contexts and Guidelines. (Journal of the American Academy of Child and Adolescent Psychiatry)

Posted by szadmin at 02:18 PM | Comments (0)