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People with Schizophrenia at Highest Risk for Suicide.

A new study out of Ontario from the Institute for Clinical Evaluative Sciences show that people with Schizophrenia account for 12% of those who die by suicide with young people being affected unequally. For those young people who are between the ages of 25-34, one in five will die by suicide compared to the one in ten that the same age group of young people without the diagnosis to face. While a link to mental illness is apparent in roughly 90% of all deaths by suicide, it is considered that in those with Schizophrenia the risk of suicide might be different. We can assess these risks by hunting for patterns across certain populations.

One important difference stands out in these patterns and that often because of the seriousness of Schizophrenia people with the illness have more contact with the healthcare system. This is reflected in evidence that shows that more than half of people with Schizophrenia sought help roughly thirty days before their deaths. This is compared to the one quarter without the diagnosis who did the same. This data suggests that there is a period where intervention could be useful. Most useful of all are early intervention programs that support people during their first psychotic episode. To begin when Schizophrenia begins to be apparent or likely and support those individuals throughout this period and for some even after. Scientists have found that these early intervention programs seem to be the most effective treatment while their effects tend to be longer lasting.

Preventive treatment often transcends acute care where psychosis is concerned. Supporting those individuals through their first episode and aiding them in accessing treatment allows doctors to negotiate healing. It’s easier for professionals to care for those developing Schizophrenia than it is to care for someone in the throes of chronic Schizophrenia in an acute care situation.

 

Centre for Addiction and Mental Health. (2018, June 22). People with schizophrenia account for more than one in 10 suicide cases: Suicide risk assessments early in the course of illness should be emphasized, researchers say. ScienceDaily. Retrieved September 7, 2018 from http://www.sciencedaily.com/releases/2018/06/180622104709.htm

Appendectomy

When I had my appendicitis recently I was left with very little memory of the day in the hospital. Each moment is like a puzzle piece and all the pieces are out of place. Punctuated by seconds of pain and long half-hours of my body cushioned by narcotics. I am reminded of the cohort of old men that gather every Saturday and Sunday at the restaurant where I work. Discussing how they are getting sicker and sicker. How the long light at the end of their tunnel will be THE LIGHT that comes after the darkness of death. I am reminded of my own chronic illnesses.  I am thankful that the pain in my stomach was only my appendix. And not cancer or a baby I didn’t know about or my liver or kidneys. Only my little and useless appendix which had no function and could be removed the same day.

The doctor said, “we need to put a tube down your throat to breathe for you, we have to inflate your stomach and it’s hard on your lungs, you’ll be asleep for all it.” The pang of anxiety grew like a storm in my stomach but couldn’t replace the pain.

And then a nurse came and gave me some fentanyl. I knew some things about this drug (medicine) but only what I heard on the news. I am reminded that I’ve never been addicted to a drug like that and I am grateful. But I am also terrified.

Then I had the surgery. I woke up so cold I am reminded of winter. Dark and frozen and long. I recall the longest nights. The dead of winter. Water freezing when it meets the air. And now, six feet coming overnight, and the silence which comes on the heels of a Nor’Easter. It is the deepest silence you’ll ever hear. The greatest silence. The most powerful silence inflated over the whiteness of snow. Silence like a legend. The nurses covered me with five or six blankets. If it were more I don’t remember. The darkness and unfamiliarity of anesthesia wear on my body for at least the next week. I can’t imagine there is anything close to death. Aside from the night of my suicide attempt where I hallucinated my childhood cat. I’ve been told that perhaps she was an angel but I don’t believe in God.

In the minutes after surgery, I am basked in unrecognizable light fixtures. My brain grasps wildly for the last hour and a half. It’s made uncomfortable in the absence of time. Our thoughts are linear. I am reminded of our first night in our new house and how I got lost looking for the light switch along the wall. Hands sliding along the smooth wallpaper, confused and lost in a space which I was uncertain of. Uncertain of the door and the lights and how far the ceiling was from my fingertips when I threw my hands above my head. It felt like I was lost forever but I think I was half asleep. Dreaming is the only thing out of time that we can reconcile. The lights in the hospital where an unforgiving brightness. And laying in recovery my thoughts drift to a summer forest sewn up in green and bursting at its seams. Birds are loud and the harder you listen to the more birds you hear. I feel so far away from everything. Like I could lay down and die. Like I could decompose until my bones shown, wide and white against the summer sun.

Then there is soda in my mouth and the grogginess begins to subside. Sugar-water deliciously sweet against my tired tongue. Like lemonade on a hot day.

With my appendix removed I was sent home the same day. I was exhausted but the rocky pain in my stomach was gone. Only an ache was leftover from where the incisions were made. What had my infected appendix looked like? Like a clump of tissue? Like a worm? Like a tiny organ with a little definition? I know that the appendix is small. And that about one in five people will develop and appendicitis in their lifetime. Without treatment, I know that these infections are fatal.

Interestingly enough one in five people will develop mental illness in their lifetime. And while not everyone will need treatment, the more serious the illness the greater the need for treatment becomes. The earlier the detection the more successful the treatment.

I was lucky they caught my appendicitis early. It was caught before it exploded. This meant we could bypass open surgery. I received laparoscopic surgery and the so the recovery time was cut in half.

I was not so lucky with my Schizophrenia and Bipolar Disorder (Schizoaffective Disorder). My mental illness was not diagnosed for three years after its onset. I’ve been living with Schizophrenia and Bipolar Disorder for six years. Getting my symptoms under control after so long wasn’t an easy task. Being dismissed by doctors almost proved fatal for me. Years of grief led me on along a road of self-destruction. If I  had received early intervention for my psychosis would it have been different? Would my first psychotic episode have been my only one? Would it have meant an acute episode and instead of full-blown, chronic, Schizophrenia?

It’s impossible to say. Myself, like too many other people, are lost to the system of psychiatric care. Allowed to fall to the wayside. Too many people will slip into drug abuse and homelessness. And on the brink of a fatal and final symptom. Death by suicide. One of the leading causes of mortality.

But we can continue to make changes surrounding the stigmatization of mental illness. We can change the way we talk about, treat, and support people with mental illnesses. We can change the statistics surrounding death by suicide. We can cultivate understanding about ourselves and others to encourage positive conversation surrounding mental illness.

 

Recovery is Posssible, Don’t Give Up

Chronic illness, mental illness, an illness which endures is indescribable. It’s made up of pain which cannot be fully understood without actually experiencing it. People with illnesses and injuries, people like myself, aren’t placated into inaction. It’s not as if we don’t strive for the same things you do. It’s not as if we don’t want to excel. It’s that, to no fault of our own, one day we were thrust into a world inept to meet our challenges. This world wasn’t designed for us. The dreams we once had are dashed when we are told what we won’t ever be able to do again.

After my diagnosis of Schizophrenia, it was a death sentence. I’d never do anything worthwhile for the rest of my life. Called ‘profoundly disabled’. It was suggested that I live in a group home until I might end up in the hospital for a long-term stay. But almost four years later I’ve bought my own house and work part-time. I’m a student about to embark on a four-year program to a masters degree. I’m a published author and advocate for other people with psychotic disorders.

I’ve come so much further than any doctor would’ve dare predict. I am not afraid and in fact, I feel powerful. Like I have power over myself and a mind which doesn’t have my best interest at heart. Battles waged against ourselves are often the scariest. And certainly, they are the most difficult. But, when we face ourselves we experience a transformative journey. One which spurs us onward to wellness. That journey wasn’t easy for me and at times I lost myself. Those closest to me, those who were with me at my worst, know that at times I came close to losing the light. But I’m here now and ready to help those who find themselves on the edge like I once did. People with Schizophrenia are told there is no recovery. But I beg to differ. Hard work, harder work than you’ve ever done before, determination, and support dictates your own journey. Everybody’s recovery may look different in the end. But what’s most important is that you didn’t give up. Even when your symptoms were at their worst. And that you pushed yourself as hard as you possibly could.

The message here isn’t just, “don’t give up!” It’s, “recovery is possible, don’t lose hope.”

How the Placenta May Play into the Development of Schizophrenia

A new glance into our neurodevelopment poses that the placenta may play a key roll in a heightened risk for developing Schizophrenia. This study suggests that complications of the placenta may help to ‘turn on’ some of the genes that have been associated with diseases of the brain. Ones like ADHD, Autism, and Schizophrenia. For years now brain development has been the key hypothesis that points to the likelihood that Schizophrenia is actually a neurodevelopmental disorder. As opposed to a mood or personality disorder. Unfortunately, the biomechanisms on how this change occurs in the growing brain has remained misunderstood.

“While the subject of myth and ritual in many cultures, the placenta remains a scientifically neglected human organ, despite its essential role for supplying nutrients and chemicals critical for normal prenatal development. Indeed, the placenta is the only organ removed from a human body that is not routinely sent to the laboratory for examination.

For over a quarter of a century, brain development during pregnancy and shortly after birth has remained central to a hypothesis that Schizophrenia is a neurodevelopment disorder. However, the biological mechanisms involved were poorly understood. Previous studies have shown that genetic variants alone increase the odds of developing Schizophrenia by only a fraction, while early life complications during pregnancy and labor can increase the risk by up to two-fold. The Lieber Institute investigators studied over 2800 adult individuals, 2038 of whom had Schizophrenia, of various ethnic backgrounds from four countries, including the USA, Europe, and Asia. All had undergone genetic testing and were surveyed for obstetrical history information.”

Researchers have found a prominent link between genetic variations in Schizophrenia and serious pregnancy complications.

These hypotheses begin to help us understand the larger male than female ratio in developmental behavioral disorders, a list in which Schizophrenia is included. Males have a two to four times greater risk of developing these type of disorders and this study may help us see why. It’s become partly clear that placenta complications are more abundant in male birth.

Finding ways to understand the why and how people go on to develop something as serious as Schizophrenia can help us to intervene with high-risk individuals. This research, though at its beginning, could help us immensely in the future.

 

Burness. “Genes, environment, and schizophrenia: New study finds the placenta is the missing link: “Placenta may also hold the key to why neurodevelopmental brain disorders are more common in males.”

ScienceDaily. ScienceDaily, 28 May 2018.
www.sciencedaily.com/releases/2018.18052812400.htm

Common Device May Lead to Inexpensive and Accessible Test for Schizophrenia

People with Schizophrenia may have reduced electrical activity in the retina. Doctors have now begun testing this theory and it’s proving to be true. The RETeval is a handheld device used to record electrical activity from the retina. When testing patients experiencing acute psychosis, as compared to those who are experiencing none, the RETeval is allowing doctors to diagnose Schizophrenia. A test like this, which is both non-invasive and fast, could lead to a quick method for diagnosing psychosis. Something so simple would also be more affordable and fast acting. Allowing those in the most critical care access to the benefits of early intervention.
And while biomarkers in the eyes is a new way to look at psychiatric disorders, it is a promising one. Many people who have Schizophrenia often face years of psychosis and profound disability before a diagnosis. And for some waiting years after the onset makes treatment difficult or even ineffective. More seriously, many people living with undiagnosed Schizophrenia will die by suicide. Schizophrenia is the second most deadly mental illness and has the highest rates of suicide. Nearly one in ten people diagnosed will die by suicide, more than that will attempt. You can see why early intervention is a critical factor in the life expectancy of some with this disease.
Though the RETeval isn’t going to become a diagnostic tool any time too soon. It does promise hope for an accessible, affordable, and quick solution to the current layover time from onset to diagnosis.

 

Docia L. Demmin, Quentin Davis, Matthew Roche, Steven M. Silverstein. Electroretinographic anomalies in schizophrenia.. Journal of Abnormal Psychology, 2018; 127(4): DOI: 10.1037/abn0000347

Rutgers University. (2018, May 30). Promise of faster, more accessible schizophrenia diagnosis: Researchers explore eye function in schizophrenia as a window into the brain. Science Daily. Retrieved June 30, 2018 from:

wwww.sciencedaily.com/releases/2018/180530113131.htm