A breakdown in the correct circuitry between the prefrontal cortex and the cerebellum is likely to blame for the negative symptoms of schizophrenia. According to a new study from the Beth Israel Deaconess Medical Center, doctors can now treat negative symptoms directly, this is something traditional antipsychotic treatment (which treats only positive symptoms) has never been able to do. This is a huge breakthrough for people with schizophrenia. People tend to see schizophrenia through one lense, assuming that the only symptoms are hallucinations, delusions, and paranoia. This certainly isn’t true for anyone. Some people with schizophrenia will have only hallucinations while others might have only delusions (with no hallucinatory symptomology). But even this is flawed because this view of schizophrenia leaves out all negative symptoms like social isolation, inability to feel happiness, flat affect, and total lack of motivation and many, many more. Many people attribute these symptoms as side effects of strong medications, this would be incorrect. While antipsychotics can, and often do, have side effects, negative symptoms stand on their own.
Negative symptoms are debilitating, for some people just as much or more so than positive symptoms. We tend to over-associate positive symptoms with the disease, and as a repercussion, many of the trial treatments, and much of the research tend to sound only in the direction of treat the one type of symptomology. This mindset leaves an entire, exhausting, aspect of schizophrenia untreated.
So, what is most important about this study, is that researchers and doctors are finally pushing to uncover and treat the source of negative symptoms. If this type of treatment was approved it would bring relief to many, even if it doesn’t work for everyone.
Negative Symptoms: Apathy, absent, blunted or emotional responses, reductions in speech, social withdrawal, trouble paying attention, inability to feel pleasure, sexual problems (near to total lack of libido), lethargy, lack of facial expression, talking very little.
Positive Symptoms: Hallucinations (visual, auditory, tactile, olfactory), delusions, thought disorders(illogical thinking), movement disorders(repetitive movements, or a complete lack of movement or speech).
Every person’s experience with schizophrenia is different and varies greatly in severity. While some people may have many of these symptoms, others may have less. Additionally, all of these symptoms run on their own spectrum (from very severe to less severe versions of the same symptom).
Beth Israel Deaconess Medical Center. (2019, January 30). Researchers ID, treat faulty brain circuitry underlying symptoms of schizophrenia: Non-invasive brain stimulation alleviates the chronic, treatment-resistant symptoms of schizophrenia. ScienceDaily. Retrieved June 9, 2019 from http://www.sciencedaily.com/releases/2019/01/190130075801.htm
A recently published study suggests a strikingly high mortality rate for people schizophrenia, epilepsy, or the combination of both illnesses. Many of whom died between 25 and 50. In SARDAA’s campaign for the reclassification of schizophrenia from mental illness to a neurological one, they also present supporting information that, “There are published studies suggesting that patients with schizophrenia die on average 28.5 years sooner than other Americans…Unfortunately, lack of treatment leads to severe negative health outcomes. If correct, this means that individuals with schizophrenia have a life expectancy similar to that of Sub-Saharan Africa. Additionally, co-occurring medical conditions, such as heart disease, liver disease, and diabetes, contribute to the higher premature mortality rate among individuals with schizophrenia. Possible reasons for this excess early mortality are increased rates of these medical conditions and under-detection and under-treatment of them” (SARDAA’s reclassification letter to the CDC).
This study specifically says that “The mortality rate for these subjects at age fifty was 3.1 percent for people who did not suffer from epilepsy and schizophrenia; 10.7 percent for people with epilepsy; 17.4 percent for people with schizophrenia; and 27.2 percent for people with both epilepsy and schizophrenia.”
With more than one published study pointing to an epidemic amount of younger people dying from treatable conditions, it’s impossible to dismiss. Schizophrenia has too long been stigmatized and seen as an impossible to treat condition, not unlike epilepsy. This stigmatization should be viewed for what it is, discrimination. Discrimination which is leading many people to early deaths with little consideration from medical professionals. People with schizophrenia have done nothing to deserve to die so much earlier than the general population, and yet, we are. We aren’t dying from schizophrenia (not directly, although death by suicide will claim about 15% of people with schizophrenia). We are dying from diseases which are treatable, curable, and reversible. Although many of these diseases are bought on by poor lifestyle choices, they are still treatable. Physicians choose not to treat people with schizophrenia simply because they have schizophrenia. Physicians choose not to educate and work with patients on healthier lifestyles simply because they have schizophrenia. People with schizophrenia are often over-medicated simply for having schizophrenia, physicians are choosing not to work with patients on correct medication dosing SIMPLY FOR HAVING SCHIZOPHRENIA.
This isn’t stigma, this is discrimination.
This isn’t a misunderstanding, this is the conscious choice not to educate and understand schizophrenia.
WE CAN DO BETTER.
WE HAVE TO DO BETTER.
- Katrine M. Andersen, Liselotte V. Petersen, Mogens Vestergaard, Carsten B. Pedersen, Jakob Christensen. Premature mortality in persons with epilepsy and schizophrenia: A population‐based nationwide cohort study. Epilepsia, 2019; DOI: 10.1111/epi.15158
- SUPPORT THE RECLASSIFICATION OF SCHIZOPHRENIA
- Schizophrenia and death by suicide.
Join me and sign letters to both the Centers for Disease Control and Prevention (CDC) and the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) to promote the reclassification of Schizophrenia from a mental illness to a neurological/brain disease. Reclassification of Schizophrenia would greatly improve the care of those with the illness, as well as make treatment options more accessible. Reclassification would also end incarceration of those with the illness and reduce homelessness in people with Schizophrenia.
statistics courtesy of SARDAA
In 1927 a man named Julius Wagner-Jauregg did something fascinating, he began treating patients with severe psychiatric illness by inoculating them with malaria virus. He went on to win the Nobel Prize in 1927. And while Jauregg mainly treated patients with illnesses like syphilis and dementia, he was the first to identify how immune response and fever affected psychiatric illnesses like psychosis and catatonia. The patients who survived long enough for the treatment to work eventually recovered or had significantly improved quality of life.
It would be a leap to say that he cured them. He didn’t. What he did do, however, is set the stage for later research into the immune response is a factor in the development of Schizophrenia. Further, it may no longer be an unwarranted leap to suggest that bone marrow transplantation and low dose antibiotic treatment may help or even eliminate Schizophrenia and its symptoms.
If you’ve ever known anyone with Schizophrenia or, like me, have it yourself, you understand how difficult the condition can be and what it can take away from you. Most frequently developed in a person’s early twenties, the condition is one of the most disabling diseases documented and for some may even be degenerative. Ranging from effective to severe and manifesting in several subtypes including catatonic, paranoid, disorganized, early onset (childhood), and Schizoaffective Disorder, it affects everyone equally with no racial or sexual preference. Schizophrenia can have genetic components, with the chances of development increasing in the children of parent(s) who have it but can also affect a person with no family history of psychiatric illness.
Until recently, the typical treatment for Schizophrenia consisted of antipsychotic medication, sedatives, mood stabilizers, and antidepressants. These medications, while integral to the process of recovery, often come not without severe and/or damaging side effects. Antipsychotics can have lasting damage to the body if taken over a long period of time. Antipsychotics can also cause significant weight gain which can lead to cardiovascular disease risk and diabetes. However, scientists now have a new treatment to consider: bone marrow transplants.
Incredibly, in 2017, a man who had been diagnosed with Paranoid Schizophrenia at twenty-three, developed cancer at twenty-four, and in an effort to treat his cancer, a bone marrow transplant ended up curing both his cancer AND his schizophrenia. Similarly, a man without schizophrenia developed the illness after receiving a bone marrow transplant from his schizophrenic brother. If a bone marrow transplant can cure or induce psychosis, naturally, the immune system must play a role in the development and symptomology of schizophrenia and other psychotic disorders, as bone marrow transplants essentially reboot a person’s immune system.
Historically there is a great deal of evidence that points to the immune system playing a huge role in schizophrenia. In their case report, which reviews the evidence that supports a bone marrow transplant causing a remission of schizophrenia, Miyaoka wrote, “Although schizophrenia is regarded as a syndrome with different biological backgrounds, involvement of immune system disturbances could be one of the common mechanisms. The association between maternal infection and neurodevelopmental disorders is long-standing but not without controversy. After the 1964 rubella pandemic, the incidence of schizophrenia rose from less than 1% in the unexposed population to about 20% in the exposed population. Subsequent studies charting historic outbreaks of flu, measles, mumps, chickenpox, and polio have revealed an association with schizophrenia.” The New York Times has even reported about a recent study in which a woman with schizoaffective disorder was relieved from her psychotic and depressive symptoms after a dangerously high fever.
But this doesn’t come without risk, as bone marrow transplants are extremely risky and require weeks of chemotherapy and isolation. This idea of treating schizophrenia with something other than heavy medication and long-term hospitalization feels like a step in the right direction. Furthermore, the possibility that we might come to fully understand the mechanism behind the development of schizophrenia would, automatically, help us to understand how to prevent people from developing it all. Of course, scientists can’t confirm if the immune response is the cause of all types of schizophrenia. Some schizophrenias maybe be driven solely on the dysfunction of serotonin and norepinephrine, while other types may be autoimmune diseases masquerading as schizophrenia or psychosis. In the previous case study highlighted, Miyaoka wrote, and it is important to remember that, “…[a] single case report, we apparently cannot confirm an immune pathogenesis of schizophrenia. However, several reports support the theory that immunological system is one key factor of pathogenesis of schizophrenia.” As time goes on people with or affected by schizophrenia can only hope that these possibilities become more solidified.
Psychosis can be beautiful, but there isn’t a single day I wouldn’t prefer to live without it. Would I try something as risky as a bone marrow transplant to cure me? I’m relatively high functioning. But I’m only high functioning on my medications. Off my meds and I’m sure many people wouldn’t even recognize me. I would very much prefer not to have to take all of these medicines for the rest of my life. And even on my medications, I’m still hearing voices constantly. I’ve been hearing voices for so long now I don’t even really remember what it was it was like to not hear them. I would risk a procedure like this if it meant security and protection from schizophrenia. If I wouldn’t ever have to worry about my medications stopping working. If the world could be quiet again. Then I’d do it.
I can’t imagine living in a world not haunted by mental illness, not stalked by twinges of paranoia, not exhausted by an utter lack of motivation to do anything more than breathe, not living a noisy life even when it’s actually quiet, not living under the thumb of psychosis, or held down by the big, wet blanket of depression, not waiting to be tossed into a manic episode. To avoid never having another hallucination or delusion again I’d do anything.
These are things someone with schizophrenia lives with. We live with the fear that our symptoms bring and fear of stigmatization. Schizophrenia and it’s related disorders impact every part of the person who has it. And any glimmer of hope, any sign of a cure, is reason enough to pursue the possibility to its end.
Chen, S., Tvrdik, P., Peden, E., Cho, S., Wu, S., Spangrude, G., & Capecchi, M. R. (2010, May 28). Hematopoietic origin of pathological grooming in Hoxb8 mutant mice. Retrieved April 6, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/20510925
Miyaoka, T., Wake, R., Hashioka, S., Hayashida, M., Oh-Nishi, A., Azis, I. A., . . . Horiguchi, J. (2017, September 21). Remission of Psychosis in Treatment-Resistant Schizophrenia following Bone Marrow Transplantation: A Case Report. Retrieved April 6, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613125/#B26
Sommer, I. E., Bekkum, D. W., Klein, H., Yolken, R., Witte, L. D., & Talamo, G. (2014, October 06). Severe chronic psychosis after allogeneic SCT from a schizophrenic sibling. Retrieved April 6, 2019, from https://www.nature.com/articles/bmt2014221?draft=journal
Velasquez-manoff, M. (2018, September 29). He Got Schizophrenia. He Got Cancer. And Then He Got Cured. Retrieved April 6, 2019, from https://www.nytimes.com/2018/09/29/opinion/sunday/schizophrenia-psychiatric-disorders-immune-system.html