Understanding the cause necessary for treatment?

Question for @notmoses… There is a lot of fixation in these parts about exactly how one wound up with SZ. I’m wondering how relevant this knowledge is to treating the condition? We’ve seen that even the diagnosis itself isn’t as important as the symptoms, which is what doctors now put more emphasis on treating.

My own personal view is that it matters less how your leg got broken than going about healing it up and getting walking again. An oversimplification to be sure (and also apples/oranges). I could be way out in left field here. I’m just seeing a lot of energy being expended on why I got sick that could be better applied towards how I am going to get better.

Would be curious to hear your opinion as I realize it’s based on decades of hands-on experience.



I think it all depends on whether you see it as a singular illness brought about by uniform factors or an umbrella term for a set of similar but different illnesses with a variety of causes. If the latter then different pathways to the illness may require slightly or moderately different approaches. If so knowing the cause might well be relevant to effective treatment. Of course all this would depend on how you view personalised approaches to treatment.

I do agree though that treating symptoms is more important ultimately than a diagnosis. That having been said it’s human nature to want to categorise or be categorised.

Media and history is of course filled with controversy over how doctors treat a broken leg.

I think that getting the diagnosis right is important.

A diagnosis is a cluster of symptoms usually.

Treating paranoia ( a symptom) that stems from personality is usually treated differently than paranoia stemming from a biological based mental illness - like schizophrenia or bipolar.

Paranoia stemming from a personality disorder is usually treated with therapy and sometimes medications, Paranoia stemming from a biological based mental illness is usually treated with medication primarily.

The diagnosis does matter, because all its doing is describing basically what is going on with a patient.

But I do agree with the fact that its more important to treat individual symptoms as they appear.

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I don’t think it matters, at least not for psychiatrists. They are done with researches for cause and effect, what they care about is symptoms and how to lead a fairly normal life without boundaries, at least with minimum boundaries. We care to know the reason why we got ill but it’s an empty ring and will lead us nowhere.

To give you a perspective of my illness (paranoia against my parents ) I have noticed that when I am away from them (city or country ) I have absolutely no illness .

To ignore the cause would be a fallacy .

See? This is why I hate psychiatry at the moment. As you’ve already mentioned it is apples to oranges/ dogs and cats. I also believe that treating the symptoms is far too short sighted. So much so that the current practice basilly totally delegates the work of actual recovery to the sick patient. Caregivers are often clueless as well which no doubt contributes to the problem.

And in regards to the simple question you have proposed “does cause matter?”. And my retort would be: what do the words immune system mean to you?


I actually find myself agreeing somewhere along the lines with @gainesms in what I believe to be the majority of situations…

Just my two cents…

The problem I have with diagnosis is that it can be dependent on (a) the pdoc’s subjective weighting of a patient’s individual symptoms re their importance and (b) Sometimes reflect pdocs subjective bias towards the patient (NB personality disorder diagnoses being given to patients pdocs subjectively define as “awkward” ).
While it may be true that therapy is the usual primary treatment for personality based paranoia (with antipsychotics as a secondary treatment tool) it isn’t always the case.
I ,for example, receive no therapy but am on the lowest therapeutic dose of a depot medication. Perhaps it’s because they see things that are/were present beyond the personality based(?), according to diagnosis,paranoia

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Lol yeah man whne I walk into the office with a mowhawk and pajamas and no shower… It doesn’t matter how well I’m actually doing… Lol… Re-dic…

I agree, I think that diagnoses matter more to the patient - Lots of todays psychiatrists and therapists dont put their focus on diagnosis so much - they primarily focus and treat individual symptoms.

For me however getting the right diagnosis is important - My psychiatrist is now telling me that my paranoia is personality based and is a separate issue from my bipolar disorder.

Well this is important because now she knows that the Antipsychotics I take will more than likely put a small dent in treating my paranoia - Personality disorders are best treated with therapy - Meds do not work as well when it comes to many of the personality disorders, except for maybe Borderline (which I dont have).

For me the meds, no matter which dose - do very little to ease my paranoid symptoms - I am always paranoid no matter what.

That sounds rather like some sort of personality disorder and not SZ.


Does the cause matter after you’ve become ill? Preventing your immune system from toasting your pancreas is a hella big deal for anyone predisposed to diabetes. After your Islets of Langerhans have been wiped out, your treatment options are much more limited. How you became ill matters much less than how you keep living (for diabetics, at least).


The causes do not so much concern me. I am more concerned with the meaning of psychosis, if there is any at all. With this I do not suggest higher powers and divine purpose or anything of the like. It is much more modest. I would like to be able to make psychosis intelligible to people who have not experienced it, by making explicit what it means to be delusional. This is not to explicate the causes, though it is not uncommon to be mistaken about that. But a simple comparison shows that I understand perfectly well what it means to have a toothache, without knowing the particular causal history of how it comes about. Understanding, here, does not consist of knowing the causes. Such an understanding seems hard to establish for others, when it comes to schizophrenic experiences, some maybe more than others. Some experiences may not be intelligible at all to others. To find ways to make ourselves understood is more interesting to me personally than to identify the causes. That is because I myself am unable to do anything with knowledge of causes, I am not a medication researcher or something of the like. In my personal life, however, to be able to convey the meaning of psychosis would make a difference, I think. It can be very comforting to feel understood, and this is often a difficulty with schizophrenia.

Here is what comes to mind- the research literature I have examined talks a whole lot about BLAME and others thinking we are AT FAULT and RESPONSIBLE for being born with SHITTY GENES, YO. In reality, (or do I mean in the Star Wars universe?) this crappy blame transfers from the public to us stigmatizing ourselves and therefore internalizing rejection from society, perhaps expecting it before it even happens (Corrigan, like every fucking year). Here’s an example. You go to college. You meet people like you. You want to tell them you have the illness, but you think they will reject you when you say it, so you dont say it, and this makes you feel like an impostor and makes you avoid talking to these potential friends. Oh not like I have been there or anything.

The stuff also talks about us being perceived as dangerous as well as to blame for being mentally ill. Like we woke up and decided to become insane because we read the Deadpool graphic novels and set out to actually become Deadpool, psychotic disorder included as well as athletics and lethal skills. Uh lol

(what’s a Deadpool, anyways? Is it a person?)

Anyways, back to the topic, I had about four hours of vivid dreams and woke up feeling pretty good.

Anyways, back to the actual topic, I do think that understanding the biological, neurodevelopmental model, which is the new ■■■■, and THE ■■■■ today, is important for moving on with recovery and rebuilding a normal life as well as one possibly can. Oh, and the degree to which one can rebuild a normal life varies for each and every person, not to sound corny, but we are like snowflakes when it comes to the details of how we recover and in which ways.

Neurodevelopmental? Sound confusing? See reference:

Thank you, Dr. Tom Insel, M.D. for this dope ■■■■ homie.

I think that’s all, gratuitous Deadpool trailer and citation and all.

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I’ve mostly gotten past this. Mostly. Honestly experience more actual stigma from being oveweight than having SZ, to be honest. Both from myself and others.

Yeah, gotta thank the media for that. If it bleeds, it leads. Sigh.

Still not sure how knowing how I got SZ helps me cope with it. The process for me has been:

  1. Meds to knock down positive symptoms.
  2. Therapy/CBT to minimize negative symptoms and cancel out bad habits formed.
  3. Avoid what I know to be triggers as much as I can (stress, crowds).


p.s. Totally looking forward to Deadpool. Totally.

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