WEBVTT - SYSK Selects: How Schizophrenia Works 0:00:00.240 --> 0:00:04.240 Hi everyone, It's Josh here and for this week's s 0:00:04.360 --> 0:00:08.840 Y s K Selects, I've chosen our episode on schizophrenia. UM. 0:00:08.880 --> 0:00:12.320 First of all, please excuse the rampant use of the 0:00:12.320 --> 0:00:17.520 word schizophrenic. We know better now, UM, and delight in 0:00:17.600 --> 0:00:21.360 a clip of Wesley Willis's rock and roll McDonald's. If 0:00:21.400 --> 0:00:24.599 you've never heard of Wesley Willis, co check him out, UM, 0:00:24.640 --> 0:00:26.880 as I clearly want you to do throughout this episode. 0:00:27.480 --> 0:00:32.239 And UM. Also note that there is a rare corrections 0:00:32.400 --> 0:00:35.960 rather than listener mail correction segment that apparently just didn't 0:00:36.000 --> 0:00:38.440 take off, probably because we would have just ended up 0:00:38.479 --> 0:00:41.800 doing nothing but corrections for episodes at any rate. I 0:00:41.840 --> 0:00:46.440 hope you enjoy this one. It's a good one. Welcome 0:00:46.479 --> 0:00:56.040 to Stuff you should know from House Stuff Works dot com. Hey, 0:00:56.080 --> 0:00:58.680 and welcome to the podcast. I'm Josh Clark with me 0:00:58.720 --> 0:01:03.120 as always Charles W. Chucker's Chuck Chuck Tran Chuck a 0:01:03.200 --> 0:01:07.040 luck Right? How you doing? I'm great. I'm going to 0:01:07.080 --> 0:01:10.600 see Bob Dylan tonight. People are gonna be like, I 0:01:10.640 --> 0:01:12.840 mean times, is Bob Dylan playing Atlanta? Have you ever 0:01:12.880 --> 0:01:18.400 seen David Bowie? It's good I have not. Um, Yes, 0:01:18.480 --> 0:01:20.679 you are, Chuck. I know you're very excited. I am. 0:01:20.720 --> 0:01:22.479 I've seen him a few times, but it's always good. 0:01:22.720 --> 0:01:27.360 Really yeah, too short though he buzzes through like fifteen songs. 0:01:27.400 --> 0:01:30.240 He's out of there. Is he short? Oh? Well, he's 0:01:30.280 --> 0:01:33.120 also short? But yea is he really? I was just kidding. No, 0:01:33.200 --> 0:01:37.080 he's short. I guess those um Bell bottomed long pants 0:01:37.120 --> 0:01:39.520 that he wore in the sixties on his album Like 0:01:40.200 --> 0:01:45.520 Bottoms made him look kind of tall. Yeah. Um, alright, 0:01:45.560 --> 0:01:48.520 so enough about Bob Dylan for the second time. I'm 0:01:48.560 --> 0:01:53.120 not a big Dylan fan myself. It Um, let's talk 0:01:53.120 --> 0:01:56.840 about schizophrenia instead. Okay. So I was looking for an 0:01:56.880 --> 0:01:59.800 intro for this, and I mean there's plenty of stuff, 0:01:59.800 --> 0:02:02.320 but it's all like pretty, you know, research heavy Astra 0:02:02.440 --> 0:02:08.320 Zeneca was marketing Sarah quil off label and just settled. Um, 0:02:08.400 --> 0:02:13.079 let's see what else Jared Lofner as being medicated against 0:02:13.080 --> 0:02:17.520 as well. The guy who shot Gabrielle Gifford's Okay, really, yes, 0:02:17.639 --> 0:02:23.600 he's he's been diagnosed as schizophrenic. Um. Finally uh and 0:02:23.639 --> 0:02:27.079 then um, there was a homeless man in Los Angeles 0:02:27.440 --> 0:02:33.080 who was beaten to death by the police yesterday or today. Um, 0:02:33.800 --> 0:02:36.240 and all of this is kind of I realized like 0:02:36.280 --> 0:02:38.320 there wasn't any one thing that I was like, well, 0:02:38.320 --> 0:02:40.440 here's the intro. But I realized like all of it 0:02:40.480 --> 0:02:45.920 together gives a pretty good overview of you know, schizophrenia 0:02:45.919 --> 0:02:50.839 as it stands right now, which is it's misunderstood, it's 0:02:50.840 --> 0:02:56.280 heavily prescribed, underfunded, and um. Yeah, and there's a lot 0:02:56.320 --> 0:03:00.679 of people out there who aren't necessarily getting help who 0:03:00.720 --> 0:03:04.000 need it. Yeah. In fact, I got a stat if 0:03:04.000 --> 0:03:05.480 you want to go ahead and go there. You got 0:03:05.520 --> 0:03:08.760 a bunch of stats you said for this, right I do. Um, 0:03:08.840 --> 0:03:10.639 if you want to talk about people getting help and 0:03:11.080 --> 0:03:14.960 and or needing help and not getting it. Uh, six 0:03:15.000 --> 0:03:19.120 percent of six schizophrenics are homeless. Yeah, six percent are 0:03:19.160 --> 0:03:23.359 in jail or prison, ten percent in nursing homes with 0:03:23.400 --> 0:03:29.360 a family member or independently living supervise housing. So and 0:03:29.360 --> 0:03:31.960 and it makes sense, Chuck to that these makes sense 0:03:31.960 --> 0:03:34.640 because first of all, you have all of this crazy 0:03:34.680 --> 0:03:38.040 stuff going on to you. That's your reality. So you're 0:03:38.120 --> 0:03:44.040 having trouble dealing with reality as it stands. Um. It's secondly, 0:03:44.320 --> 0:03:47.760 a lot of times schizophrenia comes on, Um, during times 0:03:47.800 --> 0:03:50.000 when you learn how to hold down a job or 0:03:50.200 --> 0:03:53.280 take care of yourself or do whatever. So you might 0:03:53.360 --> 0:03:56.640 never learn how to do this because you're dealing with 0:03:56.640 --> 0:04:00.880 your schizophrenia. Here's the shocking one. Okay, at any given moment, 0:04:00.920 --> 0:04:04.800 there are more people with untreated severe psychiatric illnesses living 0:04:04.800 --> 0:04:07.600 on the streets than there are receiving care. Well, they 0:04:07.640 --> 0:04:10.440 outweigh that people that are actually getting help. That's that 0:04:10.560 --> 0:04:15.800 is shocking, but not surprising. Somehow agreed. Wow, so you said, 0:04:15.920 --> 0:04:19.520 what was that last one? Severe psychiatric illnesses? That's an 0:04:19.600 --> 0:04:24.360 umbrella term. Obviously that schizophrenia falls in under that for sure, 0:04:24.960 --> 0:04:29.040 But prior to the beginning of the twentieth century, it 0:04:29.160 --> 0:04:34.200 was pretty much thought of as generalized illness, like the 0:04:34.360 --> 0:04:37.200 mental illness was mental illness, and maybe there is a symptom, 0:04:38.080 --> 0:04:41.400 your symptoms were different, but really you're mentally ill, which 0:04:41.440 --> 0:04:44.680 was a huge step up from the spirit possession that 0:04:44.960 --> 0:04:48.080 had you know, it had previously been ascribed to or 0:04:48.480 --> 0:04:52.760 millions of years. Yeah, um, so it was. It's a 0:04:52.839 --> 0:04:58.080 fairly recently classified mental illness. It wasn't until that. Um. 0:04:58.120 --> 0:05:03.599 A German psychiatrist name Emil Crapelin classified schizophrenia as a 0:05:03.640 --> 0:05:07.440 mental illness, and uh, he missed classified it as a 0:05:07.560 --> 0:05:11.880 form of dementia early and early type of dementia. And 0:05:11.920 --> 0:05:16.520 then in nineteen eleven a Swiss psychiatrist named Yugen Bleuler 0:05:17.200 --> 0:05:20.280 came up with the name schizophrenia. That's right, Josh, and 0:05:20.400 --> 0:05:23.279 he uh got that word from the Greek words for 0:05:23.360 --> 0:05:27.760 split and mind, which contribute somewhat to the misconception that 0:05:27.920 --> 0:05:31.560 it is a split personality disorder. But what he meant 0:05:31.680 --> 0:05:35.560 was there's a disconnect with reality, right, the mind splits 0:05:35.560 --> 0:05:39.080 from reality, which today we still that's how you still 0:05:39.120 --> 0:05:42.520 perceive um schizophrenia, but rather than split, we use the 0:05:42.560 --> 0:05:44.880 word break. There's a psychotic break. Yeah, and we should 0:05:44.880 --> 0:05:47.680 go ahead and just uh, since that is a common misconception, 0:05:48.200 --> 0:05:51.400 it is entirely different than split personality disorder, which they 0:05:51.400 --> 0:05:55.720 call disassociative identity disorder. Now, and if you know the 0:05:55.760 --> 0:05:58.440 movie the show United States of Terra, have you seen that? No, 0:05:58.520 --> 0:06:00.200 I know what you're talking about though, with Tony let 0:06:01.200 --> 0:06:04.720 she is has split personality disorder on that show. And 0:06:04.760 --> 0:06:06.359 that's the one that you've always seen in the movies 0:06:06.400 --> 0:06:09.320 where you have multiple personalities and they don't know about 0:06:09.320 --> 0:06:12.800 each other, and one dominates the other. And uh, and 0:06:12.880 --> 0:06:16.159 then what all about Eve was about? I never saw 0:06:16.200 --> 0:06:20.480 that sybil civil Yeah for sure, but it's not schizophrenia. 0:06:20.520 --> 0:06:22.200 That they have done nothing to do with each other 0:06:22.200 --> 0:06:25.360 other than they're both types of mental illness, and um, 0:06:25.440 --> 0:06:30.320 Hollywood is fascinated by them, that's right. Um. So yeah, well, 0:06:30.360 --> 0:06:35.040 and that's that's a pretty good example, like of medicines 0:06:35.120 --> 0:06:39.200 is starting to get ahold of what schizophrenia is, what 0:06:39.360 --> 0:06:42.480 mental illnesses you know, in general, and then the public 0:06:42.520 --> 0:06:47.560 at large still just being completely under educated about it. Um, 0:06:47.760 --> 0:06:51.040 so let's educate people about it. Yeah. I want to 0:06:51.080 --> 0:06:54.400 say too that this is like a lot of conditions 0:06:54.800 --> 0:06:58.520 UM and disorders that developed later in life. To me, 0:06:58.640 --> 0:07:02.400 that's this one of the ski areous things that can happen, 0:07:02.960 --> 0:07:07.920 like your cruising along at years old and you think, 0:07:08.040 --> 0:07:10.600 like you know, I'm all good, and you can develop 0:07:10.680 --> 0:07:14.160 schizophrenia like a boom in a matter of weeks. Sometimes. Yeah, 0:07:14.880 --> 0:07:18.080 it can either come on gradually or very suddenly in 0:07:18.120 --> 0:07:21.680 an acute manner. Um And like you said, later in 0:07:21.720 --> 0:07:26.960 life with men, schizophrenia usually develops UM in the late 0:07:27.000 --> 0:07:30.360 teens or early twenties is when it starts UM or 0:07:30.400 --> 0:07:33.600 in women, it's the mid twenties or the early thirties. 0:07:33.880 --> 0:07:36.960 So yeah, by the time, by the time I was thirty, 0:07:37.280 --> 0:07:40.400 I certainly didn't think I was going to become mentally ill. No, 0:07:40.560 --> 0:07:43.320 you thought, I know my demons. You can write them 0:07:43.320 --> 0:07:45.920 down in a list. I can quit them anytime I want. 0:07:46.080 --> 0:07:48.640 And that's what they are, their self imposed demons, right, 0:07:48.800 --> 0:07:51.640 this this is it wasn't something that was beyond my 0:07:51.720 --> 0:07:55.280 control that happened to my mind. And yeah, that's how 0:07:55.400 --> 0:07:58.360 schizophrenia hit you hit you later in life, and it 0:07:58.400 --> 0:08:01.920 can happen all at once or gradually. And this is 0:08:01.920 --> 0:08:04.120 not to scare the crap out of you if you're 0:08:04.280 --> 0:08:07.960 in your teens or twenties, because there's only about a 0:08:08.000 --> 0:08:13.200 one percent chance schizophrenia. It depends if if you're part 0:08:13.240 --> 0:08:15.440 of the general population, there's a one percent chance. But 0:08:15.720 --> 0:08:18.920 as we'll see that there are risk factors that increase 0:08:18.920 --> 0:08:22.160 your chances of having schizophrenia. And no, we're not trying 0:08:22.240 --> 0:08:26.240 to scare you. But then I guess kind of the 0:08:26.280 --> 0:08:30.440 newest forms of treatment or newest thoughts about treating schizophrenia 0:08:30.640 --> 0:08:33.360 is to make people aware of it, uh so that 0:08:33.400 --> 0:08:35.640 they will be able to recognize it early on, and 0:08:35.679 --> 0:08:38.960 apparently early treatment leads to a better success rate. I 0:08:38.960 --> 0:08:41.800 think we'll talk about that across the board. But chuck, um, 0:08:41.840 --> 0:08:45.760 there's two kinds of symptoms of schizophrenia and they're positive 0:08:45.800 --> 0:08:48.800 and negative. And it's not like positive symptom means you 0:08:48.840 --> 0:08:52.400 hallucinate bunnies, where negative symptom means you hallucinate like a 0:08:52.440 --> 0:08:56.480 hell demon. Instead, positive symptom is like an exaggeration of 0:08:56.520 --> 0:08:59.720 normal behavior. So like I see you, I hear things, 0:09:00.200 --> 0:09:03.120 but I don't see you with horns, and I don't 0:09:03.160 --> 0:09:07.040 hear Kermit here talking to me. Right, Um, So a 0:09:07.080 --> 0:09:12.920 positive symptom is an exaggerated behavior. Negative symptom is the 0:09:13.000 --> 0:09:17.040 absence of normal behavior, like you lack affect or the 0:09:17.080 --> 0:09:22.480 ability to experience any emotion um or you you basically 0:09:22.520 --> 0:09:26.240 are just generally apathetic, right and so it so those 0:09:26.240 --> 0:09:30.120 are that's positive symptoms and negative symptoms. Yes, and uh, 0:09:30.320 --> 0:09:34.480 certain negative symptoms are cognitive that deal a lot with 0:09:34.520 --> 0:09:38.640 attention span and memory. Um, lack of memory an ability 0:09:38.760 --> 0:09:42.400 to like plan anything or organize anything. Right. And then 0:09:42.559 --> 0:09:46.320 another form of negative I should say, is called evolition. Um. 0:09:46.720 --> 0:09:52.720 It's basically I think crippler the guy who first classified schizophrenia, 0:09:52.960 --> 0:09:55.600 call it the annihilation of the will, where you're just 0:09:55.640 --> 0:09:58.480 so withdrawn you can't. You no longer engage in gold 0:09:58.480 --> 0:10:02.760 directive behavior, from brushing your teeth to paying your bills 0:10:02.800 --> 0:10:06.800 to doing anything. You just totally withdrawn. So that's that's 0:10:07.240 --> 0:10:10.720 that's not the form of schizophrenia you usually hear about, 0:10:10.720 --> 0:10:15.680 but apparently it's fairly common. Yeah, so get diagnosed. Uh, Josh, 0:10:15.760 --> 0:10:19.040 you have to um, exhibit a certain number of these 0:10:19.040 --> 0:10:25.000 symptoms over at least six months without stopping. Right. Yeah, um, 0:10:25.040 --> 0:10:29.920 if you have uh, is it schizophrenic form? Is like 0:10:29.960 --> 0:10:34.240 a shorter it's schizophrenia, but it lasts less than six months. Yeah, 0:10:34.280 --> 0:10:38.920 that's schizophrenic form. Good point. But if you according to 0:10:38.960 --> 0:10:40.600 the d s M, and we should say like this 0:10:40.679 --> 0:10:43.680 is you know, it's based on clinical observations or whatever, 0:10:43.760 --> 0:10:46.040 but this is the d s M saying six months, 0:10:46.640 --> 0:10:49.720 it may be you may have schizophrenia and you just 0:10:49.760 --> 0:10:53.440 haven't reached the six months you know period yet, but 0:10:53.520 --> 0:10:57.520 you're still schizophrenic. But to be diagnosed by a psychiatrist 0:10:57.600 --> 0:11:00.280 or a psychologist who's a member of the a p A, 0:11:00.520 --> 0:11:03.040 you have to have X number of symptoms for six 0:11:03.080 --> 0:11:04.680 months or more. Yeah, and they have to do that 0:11:04.760 --> 0:11:06.880 because it's like the same as the cops when they say, 0:11:06.880 --> 0:11:08.800 you can't find a missing person's report unless they've been 0:11:08.800 --> 0:11:11.680 gone for twenty four hours. And it's not like that, 0:11:11.720 --> 0:11:13.800 but it's sort of like that. Now there's like a law, 0:11:13.880 --> 0:11:16.440 I think in Michigan called Kaylee's Law or something that 0:11:16.440 --> 0:11:18.920 they're introducing where if you're a parent and you don't 0:11:19.400 --> 0:11:22.600 report your kid missing after twenty four hours is a felony. Really, 0:11:23.400 --> 0:11:25.000 what kind of parent wouldn't do that? The parent that 0:11:25.120 --> 0:11:29.280 Casey Anthony, Yeah, made the kid go away allegedly alleged. 0:11:29.640 --> 0:11:35.040 Not In general. Uh, schizophrenia apparently, as how it's pronounced, 0:11:35.080 --> 0:11:38.240 can take a few forms. Uh. One you've probably heard 0:11:38.240 --> 0:11:41.840 about most is paranoid schizophrenia, which is when you have 0:11:42.000 --> 0:11:46.400 the full on delusions and hallucinations and uh, then there's 0:11:46.480 --> 0:11:51.760 disorganized that is disorganized thinking. Uh, your behavior is probably incoherent. 0:11:51.880 --> 0:11:55.240 It's also called hypophrenic. Really and you you probably don't 0:11:55.280 --> 0:11:59.120 exhibit a lot of emotion. Yeah. Well, usually like there's 0:11:59.120 --> 0:12:05.199 a negative simp them coupled with um disorganized behavior, so 0:12:05.640 --> 0:12:07.480 it's almost like two separate things. I think you can 0:12:07.480 --> 0:12:13.880 be hypophrenic without being negative. There's catatonic um that means 0:12:14.120 --> 0:12:18.280 you move around and talk excessively. Um. Yeah, that was 0:12:18.320 --> 0:12:21.120 a surprise to me. I always thought, you know, catatonic 0:12:21.160 --> 0:12:24.080 state where you're just like's not a thing too. But 0:12:24.120 --> 0:12:26.760 it also says they may become still an uncommunicat so 0:12:26.800 --> 0:12:28.240 it can be one or the other. Yeah, but I 0:12:28.240 --> 0:12:30.280 guess it has to do with motion or movement or 0:12:30.400 --> 0:12:35.520 lack of. It's catatonic. Undifferentiated means that it's just sort 0:12:35.520 --> 0:12:37.480 of the umbrella term for when you have a mix 0:12:37.480 --> 0:12:39.320 of symptoms and they don't want to classify you as 0:12:39.320 --> 0:12:43.080 one specific kind. And then residual is if you have 0:12:43.120 --> 0:12:47.840 a history um of schizophrenia but you have a long, 0:12:47.960 --> 0:12:50.880 extended period of time with no negative I'm sorry, with 0:12:50.920 --> 0:12:55.200 negative but no positive symptoms, they'll classify you as residual, 0:12:56.280 --> 0:13:00.640 which you know, I guess that's better than paranoid schizophrenia 0:13:01.760 --> 0:13:04.920 in a way. I don't think any form of schizophrenia 0:13:04.960 --> 0:13:08.560 is right. It would that would be it would be horrible. 0:13:09.160 --> 0:13:12.600 This is a horrible disease. That's like the curb your enthusiasm. 0:13:12.600 --> 0:13:16.199 When Larry asked if that some one had Good Hodgkins 0:13:17.640 --> 0:13:19.559 from the Party of five episode is what he was 0:13:19.600 --> 0:13:22.200 referencing when Charlie got sick. He had quote unquote good 0:13:22.240 --> 0:13:24.800 Hodgkins and they were like, they were so offended. There 0:13:24.960 --> 0:13:27.200 there's no good Hodgens. He's like, yeah, but one's better 0:13:27.240 --> 0:13:29.040 than the other, right, And they were just like, you're 0:13:29.080 --> 0:13:34.920 such a jerky never seen anything like that, Yeah, pretty much. Uh. 0:13:34.960 --> 0:13:38.439 And then we mentioned schizophrenic form, which is an abbreviated 0:13:38.559 --> 0:13:42.400 version of schizophrenia, and then this one has to be 0:13:42.440 --> 0:13:47.000 just horrible schizo effective disorder. It's any kind of schizophrenia 0:13:47.400 --> 0:14:19.400 couple with the mood disorder like depression. All right, so um, 0:14:19.480 --> 0:14:25.600 we should probably say there's delusions and there's hallucinations, uh, 0:14:26.040 --> 0:14:31.360 mixed in together often with schizophrenic symptoms, and they're often confused. 0:14:31.360 --> 0:14:36.040 But a delusion is a false belief and and hallucination 0:14:36.160 --> 0:14:39.280 is a false sensation like Hey, I'm Jesus Christ. That 0:14:39.280 --> 0:14:43.440 would be a delusion, or hey there's Jesus Christ on 0:14:43.480 --> 0:14:46.760 top of that subway car, that would be a hallucination. Yeah, 0:14:47.640 --> 0:14:50.080 and you can extend that to anything. It doesn't have 0:14:50.160 --> 0:14:54.720 to be Jesus or a subway car. Um. But the 0:14:54.720 --> 0:15:00.600 there's just studying hallucinations and delusions are really really interesting 0:15:00.640 --> 0:15:06.520 in my opinion. Um, the most common hallucination is auditory 0:15:06.600 --> 0:15:11.560 among schizophrenics, and the most common auditory hallucination is our voices. Yeah, 0:15:11.600 --> 0:15:15.960 they hear voices that can come from anywhere from this kermit, 0:15:16.000 --> 0:15:18.600 the frog could start talking to me, or it could 0:15:19.040 --> 0:15:22.280 come from thin air, or it could come from the 0:15:22.320 --> 0:15:28.360 electrical outlet in the wall. Um and uh, the voices say. 0:15:29.160 --> 0:15:31.560 Usually it's like one word, a couple of words, there's 0:15:31.560 --> 0:15:37.480 an implication of word. Sometimes it's indistinct mumbling. Um. On occasion, 0:15:37.640 --> 0:15:42.160 very rare occasions, will the voice like ramble on coherently 0:15:42.880 --> 0:15:46.840 where the patient understands, like long sentences, but um that 0:15:47.000 --> 0:15:50.120 they also maybe commenting on what the person is doing 0:15:50.240 --> 0:15:54.840 is very um common. Yeah, Usually it's um, not a 0:15:54.920 --> 0:15:57.760 voice that they recognize, although that can happen as well. 0:15:57.960 --> 0:16:00.440 Yeah right, Uh. And then sometimes there's more than one 0:16:00.520 --> 0:16:04.040 voice and even more disconcerting, lee, the voices will argue 0:16:04.120 --> 0:16:10.560 about the patient, which that's wow, Well those I mean, 0:16:11.280 --> 0:16:13.600 there's a guy on Martha that I see that and 0:16:13.640 --> 0:16:15.240 a lot of people that you see that are walking 0:16:15.240 --> 0:16:19.080 down the streets screaming out out loud. They there's probably 0:16:19.120 --> 0:16:21.800 a pretty good chance that they might be paranoid schizophrenics, 0:16:21.880 --> 0:16:23.600 and they are yelling at the voice in their head. 0:16:23.800 --> 0:16:25.560 That reminds me of the stand up that I saw 0:16:25.560 --> 0:16:28.200 when I was a kid in the eighties. Uh. This 0:16:28.240 --> 0:16:31.160 guy was like this. This comedian said he was walking 0:16:31.160 --> 0:16:33.040 down the street and he walked past this guy was 0:16:33.120 --> 0:16:36.760 talking to himself and it's just mumbling, sounded so angry, 0:16:36.800 --> 0:16:40.120 and the comedian goes and I thought, man, that guy 0:16:40.240 --> 0:16:43.520 is really crazy. He's talking to himself. And then I thought, wait, 0:16:43.520 --> 0:16:48.560 who am I talking to? Yeah, it's a good point. Yeah, 0:16:48.680 --> 0:16:50.840 I talked to myself all day long. I have arguments 0:16:50.840 --> 0:16:55.360 in my head. But of course it's not the same thing. No, um, no, 0:16:55.720 --> 0:16:58.440 you don't have two voices arguing over what you're doing 0:16:58.520 --> 0:17:00.840 at that moment and what's best for you or whether 0:17:00.880 --> 0:17:03.520 you should hurt somebody or hurt yourself. Not making light 0:17:03.560 --> 0:17:07.240 of that. Uh. And the reason that a percentage of 0:17:07.720 --> 0:17:11.159 frightening percentage of schizophrenics kill themselves is a lot of 0:17:11.200 --> 0:17:13.520 times because the voice in their head may command them 0:17:13.560 --> 0:17:16.120 to do so. Right there, there, there's such a thing 0:17:16.320 --> 0:17:21.280 as um commanding hallucinations. Which is sometimes they could be 0:17:21.320 --> 0:17:27.480 suggestive like, um, maybe we should go outside for a while, 0:17:27.800 --> 0:17:31.000 or they could be like go outside, you know. And 0:17:31.000 --> 0:17:33.280 it's not always scary, like they just point out. Sometimes 0:17:33.280 --> 0:17:35.600 it's uh, hey you need to shave again, right, and 0:17:35.600 --> 0:17:37.879 you'll go shave again. Yeah, it can be innocuous, but 0:17:37.920 --> 0:17:41.000 it can it can lead to violence, or it can 0:17:41.119 --> 0:17:44.479 urge violence. Apparently the vast majority of people who suffer 0:17:45.720 --> 0:17:50.720 uh dangerous command hallucinations are able to suppress them. But 0:17:50.840 --> 0:17:53.399 it's a struggle and you know this is going on 0:17:53.440 --> 0:17:56.560 in this person's head. Yeah, and rarely. And I wondered 0:17:56.560 --> 0:17:58.320 about this too before I got to that point in 0:17:58.320 --> 0:18:01.120 the article that you sent me early. Do you hear 0:18:01.960 --> 0:18:05.200 like a really great things, like you're doing great today 0:18:05.240 --> 0:18:09.160 and you should go and smell it. You know. It's 0:18:09.200 --> 0:18:13.359 interesting that it usually takes a dark turn and they 0:18:13.359 --> 0:18:18.359 don't know why. No, they don't. Um. There's also hallucinations 0:18:18.359 --> 0:18:23.040 of touch haptic hallucinations, which sound pretty awful. Um, things 0:18:23.080 --> 0:18:25.560 are crawling on you, things are inside of you trying 0:18:25.560 --> 0:18:30.720 to get out. Your bowels are shriveling. Um, you're being 0:18:30.800 --> 0:18:34.120 jolted by electricity is a very common one. And then 0:18:34.600 --> 0:18:38.280 delusions obviously, or any like any false belief. There's some 0:18:38.480 --> 0:18:42.960 that like you are Jesus Christ. That's a delusion, right, um. 0:18:43.000 --> 0:18:47.120 But there's there was one subcategory that caught my attention 0:18:47.119 --> 0:18:50.320 that I wasn't aware of. It's called delusion of reference. Yeah, 0:18:50.359 --> 0:18:52.960 tell me about that. Well. It's basically like every single 0:18:53.000 --> 0:18:57.760 thing that goes on in life is full of meaning. Right. So, 0:18:57.840 --> 0:19:01.200 like in this Brown University sheet I sent you, there's 0:19:01.240 --> 0:19:05.439 a like a waiter leaving a chroma on the table. 0:19:05.960 --> 0:19:08.560 That's purposeful. It's an insult to the patient, like the 0:19:08.880 --> 0:19:11.800 the busboy or the waiter did that on purpose as 0:19:11.840 --> 0:19:16.240 an insult or Um. The street lights coming on all 0:19:16.240 --> 0:19:18.080 of a sudden, it is a signal for everybody to 0:19:18.119 --> 0:19:20.640 swarm on you and finally take you away or kill 0:19:20.680 --> 0:19:24.639 you or whatever. Like everything in life has meaning and 0:19:24.680 --> 0:19:28.200 it's making you. It's it's fueling this paranoia. Your mind 0:19:28.240 --> 0:19:33.240 is turning against you. It's pretty awful. We said, it's awful. Yeah, okay, yes, 0:19:33.359 --> 0:19:38.000 it is quite awful. Um, But people live with this. Yeah. 0:19:38.040 --> 0:19:39.920 I mean we painted a dark picture because it is 0:19:39.960 --> 0:19:44.000 a dark disorder, but the majority of people in fact 0:19:44.320 --> 0:19:48.679 stet time. Uh after ten years. If you want to know, 0:19:49.160 --> 0:19:56.439 after ten years of diagnosis with schizophrenia completely recover are 0:19:56.520 --> 0:20:01.240 much improved and relatively independent. And percent are improved but 0:20:01.400 --> 0:20:07.359 require a pretty extensive support network. So that's of people 0:20:07.400 --> 0:20:10.959 after diagnosis after a decade, are are dealing with it 0:20:11.240 --> 0:20:15.120 fairly well. Um, that's it's very hopeful. That's not bad. 0:20:15.920 --> 0:20:21.240 Are unimproved. Ten percent, unfortunately, are dead, probably by suicide. Yeah, well, 0:20:21.320 --> 0:20:25.600 ten percent at least of UM schizophrenics commit suicide, which 0:20:25.640 --> 0:20:30.480 is incredibly high because in the general population of the 0:20:30.560 --> 0:20:36.000 United States, point zero one percent of people commit suicide 0:20:36.560 --> 0:20:38.879 to point zero one percent. Yeah, and that's people who 0:20:39.080 --> 0:20:41.359 are successful. They think it could be attempts could be 0:20:41.400 --> 0:20:44.320 as high as f people that try to kill themselves. 0:20:45.440 --> 0:20:47.920 Just uh, I mean imagine sometimes the voices say to 0:20:47.960 --> 0:20:51.320 do it, and sometimes it's just a fine piece. Yeah. 0:20:51.359 --> 0:20:57.520 I was wondering what the breakdown between those two is. UM. 0:20:57.600 --> 0:21:02.400 And then violence is often attendant with schizophrenics, at least 0:21:02.400 --> 0:21:07.360 in the public mind, right, but you're dangerous. Apparently studies 0:21:07.359 --> 0:21:10.080 have shown I remember reading about this when we talked 0:21:10.080 --> 0:21:15.240 about latent inhibition. Um that if you are typically violent 0:21:16.400 --> 0:21:21.000 when these uh, when the symptoms set when you're like 0:21:21.040 --> 0:21:24.320 early twenties or whatever. Um, you're going to possibly be 0:21:24.359 --> 0:21:27.160 a violent schizophrenic. If you're not a very violent person, 0:21:27.200 --> 0:21:31.320 you're it's just not part of your personality before the 0:21:31.400 --> 0:21:33.760 symptoms set in. Then you're not going to be a 0:21:33.840 --> 0:21:38.800 violence schizophrenic unless you abuse drugs or alcohol, which apparently 0:21:39.440 --> 0:21:43.560 vastly increases the chances that you may be a violence schizophrenic. Yeah, 0:21:43.600 --> 0:21:45.960 and even then, I think the violence is generally either 0:21:46.000 --> 0:21:49.679 self inflicted or it takes place inside the home, like 0:21:49.760 --> 0:21:52.800 against your family, which is not good. But the point is, 0:21:52.840 --> 0:21:55.240 if you're walking down the street and sadly you see 0:21:55.280 --> 0:21:59.960 the homeless man screaming out loud, you don't necessarily need 0:22:00.000 --> 0:22:03.000 to be afraid that he's about to, you know, attack 0:22:03.080 --> 0:22:05.840 you in a violent manner. Right, that's probably not going 0:22:05.880 --> 0:22:08.600 to happen, Chuck. Let's say you do want to talk 0:22:08.640 --> 0:22:11.800 to that schizophrenic homeless man over there, but you don't 0:22:11.800 --> 0:22:15.359 want to make things worse for him, right, But you 0:22:15.359 --> 0:22:18.919 don't want to ignore him. He's another human being. Um. 0:22:19.000 --> 0:22:24.760 The National Institutes of Mental Health have UM suggestions I 0:22:24.800 --> 0:22:28.480 guess for talking to schizophrenics and specifically with their families 0:22:28.760 --> 0:22:32.240 who have to deal with delusions and hallucinations all the time, 0:22:32.320 --> 0:22:38.919 specifically delusions. Um, apparently you don't. You don't contest what 0:22:38.960 --> 0:22:41.200 they're saying. Yeah, you don't want to say you're not 0:22:41.520 --> 0:22:44.640 Jesus Christ what you're talking about. Yeah, you don't. Definitely 0:22:44.640 --> 0:22:49.200 don't know. You say, um, I respect your right to 0:22:49.240 --> 0:22:51.760 believe different things, and I hope you'll respect my right 0:22:51.840 --> 0:22:55.920 to believe different things. But I I, you know, politely disagree. 0:22:56.040 --> 0:22:57.960 And what you also don't want to do is agree 0:22:58.000 --> 0:23:01.400 and say I know, honey, you are Jesus. Right, You're okay, 0:23:01.440 --> 0:23:04.040 you're Jesus and it's fine. Yes. A lot of people 0:23:04.119 --> 0:23:07.080 probably take that tack in the family, you know, well, yeah, first, 0:23:07.200 --> 0:23:08.879 I mean, at the very least, because it's it's just 0:23:09.000 --> 0:23:12.439 easier after a while, it's like yes, yes, or you 0:23:12.480 --> 0:23:14.480 get so frustrated you're like no, you're not, and you 0:23:14.480 --> 0:23:18.960 want to shake the person. Um. But yeah, apparently, And 0:23:18.960 --> 0:23:22.639 I wonder how hard it is to say, well, I 0:23:22.880 --> 0:23:25.760 respectfully disagree with you. Yeah. I bet it's hard, you know, 0:23:25.840 --> 0:23:27.760 and if it, if it does go over as well 0:23:27.800 --> 0:23:32.359 as as it seems like it that it suggested it should, right, 0:23:32.560 --> 0:23:35.280 you know, all right, Josh, I think this was really interesting, 0:23:35.359 --> 0:23:38.960 the recovery in the Third World part. Yeah, Apparently the 0:23:39.000 --> 0:23:42.520 World Health Organization did a study in the nineteen sixties 0:23:43.280 --> 0:23:46.520 and uh I found that the recovery rate for schizophrenia 0:23:46.560 --> 0:23:51.080 and developing nations is higher by a full third than 0:23:51.119 --> 0:23:53.959 it is in the industrialized world. And then they did 0:23:54.000 --> 0:23:58.720 a follow up study even to correct possible selection biases, 0:23:58.800 --> 0:24:01.920 and they confirmed the original all finding, and I thought 0:24:01.920 --> 0:24:05.080 that was really interesting. And they There's a lot of hypotheses, 0:24:05.080 --> 0:24:08.320 but one of them is that a there might not 0:24:08.400 --> 0:24:12.160 be a stigma like in the industrialized world, and they're 0:24:12.200 --> 0:24:15.200 just more readily accepted. And the other is that they 0:24:15.280 --> 0:24:17.760 might be able to have a job that they can 0:24:18.040 --> 0:24:22.320 do successfully. And here in the West, farming or digging, 0:24:22.600 --> 0:24:24.560 you know, digging the trench for the farm or whatever. 0:24:25.160 --> 0:24:27.960 Here in the West were very competitive. Yeah, it's hard 0:24:28.000 --> 0:24:31.639 to get a job that a schizophrenic can maybe successfully complete, right, 0:24:31.720 --> 0:24:34.160 And I mean, the rest of us are paranoid enough 0:24:34.200 --> 0:24:36.199 as it is about losing our jobs. If you are 0:24:36.280 --> 0:24:40.600 clinically paranoid schizophrenic, then it's probably going to be very 0:24:40.640 --> 0:24:43.280 difficult to keep your job true or do it in 0:24:43.320 --> 0:24:45.240 a way that will help you keep your job. That's 0:24:45.320 --> 0:24:49.119 very true. But Josh, there have been some successful stories 0:24:49.280 --> 0:24:53.400 of people that are afflicted with schizophrenia. Well, some some 0:24:53.440 --> 0:24:58.080 more successful and some Sid Barrett was successful, but I 0:24:58.119 --> 0:25:00.080 don't know if you call him a success story. Was 0:25:00.280 --> 0:25:02.680 up in a mental institution for the rest of his life. Yeah, 0:25:02.720 --> 0:25:06.360 said Barrett, founding member of Pink Floyd schizophrenic, and they 0:25:06.359 --> 0:25:08.960 believe that massive amounts of drugs that he used made 0:25:08.960 --> 0:25:12.280 it worse, way worse. John, he is he is the 0:25:12.359 --> 0:25:15.800 crazy Diamond. Yeah, shine on you, Crazy Diamond. I love 0:25:15.840 --> 0:25:19.080