I think you cant. I am confused why they still gave me the diagnosis and didn’t remove it
Mental illness doesn’t always show up on an mri.
Especially on such a young brain as yours
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An MRI basically just shows the parts of your brain, sees if you have any tumors. Not everyone’s brain with mental illness looks different, in fact there is only weak evidence that our brains look different at all. (The studies that showed differences were all on people who took meds so it was unsure what changes were caused by meds and what was caused by illness. Many many research studies have shown no physical differences at all).
In other words, psychosis is not diagnosable from an MRI. You can’t diagnose it with an MRI.
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This is incorrect. IIRC, there are several large-scale studies and meta-analyses on this. This is from one review:
It is evident that once psychosis is present in patients with schizophrenia, the underlying biological process of the illness has already been ongoing for many years. This conclusion can be based on the multitude of neuroimaging studies that we recently reviewed in a meta-analysis of over 18 000 subjects, including 771 medication-naive, recent onset patients.[2] These data show a slight, but significant, decrease in intracranial volume in patients with schizophrenia (effect size−0.2), in chronic and recent onset, medication-naive patients. Intracranial volume is driven by brain growth, as it is the enlarging brain that determines the expansion of the skull.[3],[4] The growing brain reaches its maximum size at approximately 13 years of age.[5] Therefore, brain development must be stunted in patients with schizophrenia before that time. From the same meta-analysis, it can be gleaned that there must be additional brain loss, or continued abnormal development, after the age of 13: total brain volume in never-treated patients is decreased to a larger degree (effect size−0.4) than is intracranial volume and this is due to decreases in both white and grey matter.[2] Importantly, while grey matter loss is larger in chronic than in medication-naive patients, white matter volume is decreased to a similar extent in both groups. Indeed, longitudinal studies indicate that loss of white matter volume, while present at psychosis onset, does not progress further after psychosis has emerged.[6] This is consistent with the finding in twin studies that decreased white matter volume in schizophrenia may be related more to the genetic risk to develop the illness than to the effects of illness itself.[7] In contrast, grey matter volume loss (mainly expressed as reductions in cortical thickness) progresses further after the onset of psychosis, and is related to outcome,[8] cannabis smoking,[9] medication use[10],[11] and psychotic relapses.[12] Thus, although some of the brain abnormalities in schizophrenia worsen after the onset of psychosis, abnormal development of the brain must have been ongoing for many years before the first psychosis—expressed, as it is, in decreased intracranial volume and even larger decreases in white and grey matter.
https://www.nature.com/articles/mp201466
@Crystal-Cotton it is rare that neuroanatomical changes in schizophrenia are visibly present on any single MRI. The kind of MRIs used in studies like this one are composite MRIs of the brains of large numbers of patients.
what about single-episode psychosis? does it show up on MRIs too?
Most of the changes seen in patients with schizophrenia are present before the first psychotic episode. But there is no reason to assume that single-episode psychosis would be any easier to spot in a single MRI than schizophrenia. Your MRI is completely irrelevant when it comes to your current psychosis/SZ diagnosis.
why is it irrelevant? and I dont have a sz dx
It does not factor into the diagnosis at all except that it is used to screen for and exclude other brain abnormalities like tumors or epilepsy. So you should just ignore your MRI results and be glad they are normal. It doesn’t mean your diagnosis is wrong (if anything it makes it slightly more likely to be right).
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My sister has Sz also and she spent many years suffering and crying into her coffee even though she was well medicated. Her MRI was perfect, with plenty of brain tissue and very small ventricles. It wasn’t until a med was released onto the market that suited her did she recover and now she’s happy and well. To anyone who’s struggling, hang in there, the wait might be worth it.
but if there are structural differences of the brain what does it mean then… i dont understand i just want to get off medication
The structural changes in SZ and psychosis are small, and normal variation in brain size and structure makes it almost impossible to detect in any one patient. Most patients with SZ and psychosis show unremarkable MRIs.
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It might be possible to get off meds if it was just a single episode, but coming off meds must be done under strict 24/7 supervision. You WILL strongly resist going back on meds if you relapse, and the desire to commit suicide may become overwhelming. Going off meds is really serious business and the risk of suicide, brain damage, permanent physical injury, judicial prosecution or imprisonment is very significant. The illness WILL take control and you WILL lose all ability to control yourself.
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Research is always changing and being added upon! Thanks for updating me.
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