Columns

Persons with a psychotic type disorder have brains that more easily accept thoughts as being facts. A person with a schizophrenic brain does not have the same ability, compared to someone non-afflicted, to know what is real versus what is merely a thought.  

Antipsychotic medication apparently increases the priority of the external environment and reduces the prominence of the internal environment in one's perceptions. Thus, initially it is harder for someone with schizophrenia to create insulation from the external environment. This allows mental health professionals to impress upon us a version of reality that is closer to what "normal" people have. It allows family members and other people with whom we come into contact to do the same.  

The problem with being psychotic is that the mind has split off from commonly accepted "reality" and has created its own version. This might be valid except that a psychotic version of reality is jumbled, constantly changing, and doesn't allow a person to survive in the human environment.  

If you had a different version of the world yet you could still meet your basic needs and stay out of trouble, you might be considered eccentric rather than mentally ill. Yet, usually, too much unconventionality, especially in the absence of tracking and acknowledging common beliefs, leads to the wrong path. 

It is fine to say, "I'm not crazy--it's everybody else that's crazy," but you won't score too many points if, for example, you think you are above putting a coin in a parking meter where you parked your car, or perhaps if you believe a loaf of bread ought to be free and you behave accordingly. It doesn't matter if the rest of the world is wrong and you're right, because there are more of them than there are of you.  

Again, for someone with a schizophrenic brain--either someone not in treatment or someone who has residual symptoms--almost any thought that occurs in the mind can often be accepted as truth. Someone with psychosis lacks the same filtering mechanism compared to a non-afflicted person.  

If someone with schizophrenia has a "buddy" who is not affected by psychosis, such a friend can help anchor the psychotic person. But even in order to accept a friend's "reality checking," rather than discarding it in favor of believing the delusional thoughts, the person needs to be in treatment.  

However, with training, a psychotic person can learn a number of compensatory mechanisms. Unfortunately, such training is not readily available, and it is more economical to just give the patient more medication, and impose more restrictions.  

For someone with mental illness, it is an almost magical moment when a light bulb comes on in one's head--the compensatory awareness that recognizes that one's mind is subject to extreme error. When error is acknowledged, it is the beginning of self-correction.  

It is common for people with schizophrenia to lack the insight that they have this condition. Anosognosia is the term. Anosognosia is believed to be one of the symptoms typically exhibited by someone with schizophrenia. Thus, the very thing that could help the schizophrenic person is denied them by their illness. 

However, I believe insight can be increased through educating an individual when in treatment.  

When I had relapses of my condition, it began with the attempt to reduce the dosages of medications because I wanted more comfort and wanted to be less restricted by the dampening effects of the medication. Unfortunately, at some point in the reduction of medication, I acquired the belief that I didn't need medication and that I could "think" my way clear of the illness. The result was fully-blown psychotic relapses, which I experienced a couple of different times.  

Once back on medication and in treatment, I had to start from square one in my recovery. Each time I had a relapse, I lost a little more ground as to my capabilities. A psychiatrist said that it takes about ten years to recover complete functioning following a psychotic episode. But if you are having relapses every five or six years, what then? Or, what about persons with mental illness who relapse every one or two years? What about them?  

In April of this year, it will be my nineteenth anniversary of my most recent hospitalization for mental illness. I believe it is within reach to not have any further of these episodes. Surviving in the world and maintenance of my responsibilities is a daily struggle, as is the endeavor to be a professional author. But I would not want to trade this struggle for being taken care of more, because with such care comes more restrictions.  

Yes, life is hard. But I am here for a reason, and that reason entails more than sitting around, watching television, smoking and drinking beer. Thus, while my path in life is harder than it needs to be, I haven't relinquished all of my ambitions in life quite yet