Acceptance of diagnosis, medication & lifelong condition

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i had difficulties in childhood, first sectioned at the age of 17, & problems ever since (am now 42).

i have made a lot of progress, but also still have a lot of problems. Overall circumstances are hard. i’ve been single 16 years, living alone & out of work for 14 years. i can’t see that i’ll ever work again (i did 8 years of full time work & 7 years of further education in the past).

i maintain a low dose of one neuroleptic medication, & it does help, i can’t see that i’ll ever successfully get off it.

i have really struggled to accept the biomedical psychiatric view of my condition, but i do accept the diagnosis.

i’ve tried my best with everything & continue to do my best, i have felt that i have been blamed & shamed a lot with everything.

i get difficulties with sleep/bad & strange dreams, bad feelings & difficult emotional states, anxiety/social anxiety (a lot of worry & fear), depression & what i identify as some form of PTSD.

i find motivation so hard, especially with trying to do more exercise & managing the basics of my life. i feel drained a lot of the time. i’m coming up to 14 years sober, but i smoke a lot of tobacco & feel hopelessly addicted to it, & live a very sedentary lifestyle.

i have always felt & feel i need more in the way of understanding & support - proper psychological help & social support - But i can’t access it, nor create/find that in my life, & not through lack of trying.

There is a lot to be very grateful for - there is also a lot of struggle & suffering at times.

i don’t want any suggestions - just wanted to share some of where i’m at.

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It’s a good thing that the biomedical explanation of mental health conditions is not a direct contradiction of other explanations. I think everybody does come up with some of their own material, but the biomedical combination of model-diagnosis-medication-aftercare does help keep you grounded in the real world, and it’s important to give it a place in your life alongside whatever other beliefs you hold.

Whether it should be the only explanation, that is a much harder question. I think in one way it would be a positive, because things get really physical and simple, and you can drop many thoughts that cause anxiety and difficult feelings and emotions. But on the other hand it means letting go of the heart of meaning in ones experiences, the stuff that has been a core part of your experiences that has shaped important parts of your life.

There have been some interesting books written in the Netherlands about the Philosophy of Madness and the place of the psychotic in the thinking spectrum, and how one should process the contents of ones psychosis. Not sure if they’ve been translated though.

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I think this is important as well, it concerns a distinction that is sometimes made between understanding and explanation, where the first would be an elaboration of the meaning of the phenomenon and the second an account of how it comes about. The former is often found in the definitions and descriptions of phenomena whereas the latter is phrased in terms of causes that are responsible for it. There is continuous work being done on the meaning of the phenomena of schizophrenia. An example is the change in the definition of delusions in the latest DSM. In the DSM IV, delusions were primarily defined as:

“A false belief based on incorrect inference about external reality (…)”

Following conceptual considerations the DSM V, however, dropped 3 of the 4 key notions (maintaining only the key notion of belief) in its definition:

“Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence.”

Personally, I doubt whether the term belief is even apt in all cases, for distinctions between beliefs, imaginations, memories and perceptions might be blurred in some cases, such that the use of folk-psychological terms may be exhausted in interpreting such patients.

A consequence of the change in definitions in the DSM is that we might not have to view delusional patients as irrational and therefore unintelligible. There has been a tendency in the treatment of patients to render them unintelligible dating back to at least Jaspers. To me that seems like giving up.

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Does that mean you constituted as a lunatic who could not discern he was merely a fruit cake these past few decades? You can count me out on your “epiphany.”

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Exactly right on the giving up, flybottle. The giving up on untangling the meaning of a psychotics experiences has large ramifications for how it is processed. A friend of mine once said to me, “you know, in all my years with mental health services, never once has a psychiatrist asked about the contents of my psychosis”. There was a cry for help there. But the fact is it’s not unintelligible, it has to be placed correctly in the patients internal world of symbology, and the extension thereof which is in the subconscious, which is a big job and in some cases essential to finding healing.

You can leave it unresolved, but I think that is like leaving an open wound untreated - it is taking a chance that it won’t get infected and fester.

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It is very hard to place it all into words. Whatever way you wish to frame it, imo mental/emotional suffering/illness/disturbance exists & is very real - & people suffer to various degrees, in various ways, & their overall functioning/prognosis is also equally varied. You can argue/debate the reasons why, but the facts remain that no one really fully knows - there is no definite known aetiology.

My experiences are real, but that doesn’t make these experiences truth in some objective nor rational sense. Much of it was delusional. That isn’t to say there isn’t some deeper psychological/social/spiritual sense & meaning within the experiences & my life - But no one seems able to really fathom what i’m on about when i go into it all. From a consensus view it is largely meaningless nonsense & insanity. i can’t work out the answers & make full sense of it all, & i’ve spent thousands of hours in contemplation & study on it all, & these areas.

i do think there is a physiology/biology to these conditions, & i also think there is a psychological, spiritual & social aspect. i ‘divide’ reality as follows -

Spirit.
Soul/Psyche/mind.
Physical - Body & Brain.
Social/Environmental.

i lean to the primary aetiology being psychogenic - pertaining to the psyche.

After 25 years of schizophrenia & medical treatments, & trying everything to more fully resolve things - despite a huge amount of progress, i also feel i have to more fully accept that i have a disorder/disturbance of the psyche/mind, a severe mental illness - or whatever way you want to frame it.

For all the criticisms of medications & claims of alternatives - the non-medical approaches i have accessed haven’t fully resolved things & the medication has been probably one of the biggest reasons for a continued relative stability over the past decade.

What working conclusions am i meant to arrive at? i can discuss an ideal World & treatment, that uses very in depth & comprehensive integral (biological/psychological/social/spiritual) approaches - But that isn’t the reality of the World/society that we live in - the system/society is the way it all is & has to be very largely accepted as such. i have to live in this World as i am, with the difficulties i have, & with the way everything is.

i don’t like people giving suggestions any more, it annoys the hell out of me - But what exactly do you suggest i do? Given my history & the realities of the circumstances that i am in (as far as you know of it all).

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Is the cause truly important, compared to the exposition of what it really was that you experienced?

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i say that, but there are intimations within some literature - especially of the more religious kind. Was Jesus a schizophrenic? Of course we’re back with the classic ‘symptomatology’ of schizophrenia.

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Exactly. Of course, our doctors need to know all about the causes in order to treat us. Then there is the question of making sense of it all, fitting it into a narrative about yourself.

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One of my posts seems to have disappeared - Not sure why?

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It looks like someone else’s edit has been applied to your post, I saw the original text, it was quite a bit longer and you quoted me, not “Apo”… Very strange.

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i may have made a mistake & edited the original post instead of posting a reply.

Basically i was saying the original experience was a very profound state of being that was in many ways beyond the mind & that people don’t understand, nor fathom it.

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Can I tempt you into trying to describe this state of being? There are quite a few meditative states in Zen Buddhism, maybe there is a match and you can find something which gives a handle on how to interpret it?

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Instantaneously - i heard a disappearing scream fall away inside of me & was convinced that i’d lost my soul to the devil & was going to hell for eternity - at the exact moment that happened everything profoundly & fundamentally changed.

It was like a reverse enlightenment. i was turned inside out - there was no separation/distinction between me & the entire Universe/existence. Nothing had any solidity, nor boundary - nothing was contained by anything. Everything was vibrating wildly & moving around in very energetic ways. It was a little like being on very powerful hallucinogenics but even those in comparison to the experience seem like nothing.

i was in a state of absolute terror - Not fear, fear doesn’t come close.

i ‘saw’ a very complete & in depth vision of existence & reality - very much similar to David Icke’s World view, but far more in depth & ‘religious’, where i knew throughout my entire being what the truth of everything was.

There is no answer/resolution that i can find to that experience? Other than to just put all down to an experience.

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It does sound more metaphysical than an ordinary hallucination. To hazard a guess, you might have externalised your internal space, the ‘universe’ you contain. Which might explain its highly energetic nature. Fear and terror is a natural reaction, but it draws to you things which have that vibration, so you end up attracting and confronting the worst of yourself. The first time this happens can be very overwhelming.

The actual vision-in-a-vision, the David Ickian world, would be the consequence of your confrontation. It’s personal to you and won’t have the same resonance with others, and the whole point of it is it leaves it’s mark, it’s a reflection of your personal darkness which is part metaphor and can be resolved piece by piece. It sounds like classic dark night of the soul stuff, part of the path of enlightenment.

Anyway that would be my interpretation. I’ll have a look and see if similar experiences to the first part exist.

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Thanks. i do see a spiritual aspect to it all. But have also concluded, especially as metaphor that it’s been an illness - there is i think a psychopathology - my history does very much fit certain symptomatology ranges of schizophrenia - i have 'ticked all the boxes '. i do currently accept the diagnosis & medication.

To me it just raises the questions - what is schizophrenia? & what are the best approaches to healing it all?

Both highly contentious, controversial & really unanswered questions.

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I can’t really speak to schizophrenia, I’m missing a bunch of the symptoms, but dealing with psychosis for me had several elements.

The medication was the immediate help in suppressing the symptoms. But in the long run I felt the need to find a deeper meaning in the most important parts of what I had experienced. It took several years. But together those two allowed me to make my peace with it. I feel healed, complete, able to move on, even matured and positively changed by successfully coming through the difficult experience.

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We’re all individual. i do feel i have made a lot of progress. After 25 years since the above experience, & everything that has gone on since - i think it is a case of acceptance & letting go of this need to find an answer/resolution - there isn’t one - it’s madness & mystery. There is certainly not an answer at the level of mind.

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Trying to find pseudo philosophical meaning to it all, might it not be seen as part of the overt illness process and the loose associations/over-inclusiveness typical of psychotic thinking?
Having said that if you are not distressed and functioning ok - weird thinking shouldn’t be a definite platform for psychiatric intervention.

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