the Outfit

Good Morning

Work was nice and mind-occupying. I received many letters of support yesterday as well as one non-supportive letter from a family member. Mental illness as I said is tough on family. I am sorry I lost it, I am also sorry for your bad luck having Brian’s Morning Newsletter in your life.

In some ways I’m glad I finally wrote about Jack’s illness. Writing does something amazing for me and plus that I get  responses and the concern, when I really needed it. Thank you all again. I will go back over what I wrote  and double-check that I wasn’t rude to family, but I suspect it has more to do with publicly discussing family’s mental illness.

I’m not scholarly, I admit I don’t know anything about mental illness other than my own short experience with depression.

I don’t know anything about a lot of things and this makes me want to learn more.

I have titled this BMN “Waking.” Hopefully it is my awakening. I can not believe I have lived with a family member who suffers from schizophrenia for decades and I know absolutely nothing about the disease. This is a pathetic situation. I was so proud of my father who was scholarly, in part because he advocated counselling for everyone. What I now see from just reading about schizophrenia for a couple of hours is dear old dad and I have something else in common; we both swept the severity of  Jack’s disease under the proverbial carpet.

I suspect other people do a lot of this type of sweeping. Ten minutes of reading about schizophrenia and I’m beginning to wake up to useful information.

I feel hope.

Again I am sorry if I hurt people’s feelings or crossed the line of what can be spoken of publicly.   Enlightenment shouldn’t have a price tag, but it does. I don’t know why my father never spoke to me about my brother’s condition. I have no idea if he read specifically of mental illness. Much like me, except several levels higher, Henry spent much of his time searching for  answers about his own mind. Hopefully we all try and learn about why we think the way we do.

Why, I still wonder are people not searching for answers about mental illness in our own families? If they are researching schizophrenia why not talk about it?  Knowledge won’t make us catch mental illness, neither will ignorance I suppose, although the latter appears more prevalent.

Here are more excerpts which helped to enlighten me:

These are from: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

About 1% of Americans have this illness.

Genes and environment. Scientists have long known that schizophrenia runs in families.

Different brain chemistry and structure. Scientists think that an imbalance in the complex, interrelated chemical reactions of the brain involving the neurotransmitters dopamine and glutamate, and possibly others, plays a role in schizophrenia.

Signs & Symptoms

The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms.

Positive symptoms

Positive symptoms are psychotic behaviors not seen in healthy people. People with positive symptoms often “lose touch” with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following:

Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. “Voices” are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.

Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.

Delusions are false beliefs that are not part of the person’s culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called “delusions of persecution.”

Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called “disorganized thinking.” This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called “thought blocking.” This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder might make up meaningless words, or “neologisms.”

Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available.

Negative symptoms

Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:

• “Flat affect” (a person’s face does not move or he or she talks in a dull or monotonous voice)
• Lack of pleasure in everyday life
• Lack of ability to begin and sustain planned activities
• Speaking little, even when forced to interact.

People with negative symptoms need help with everyday tasks. They often neglect basic personal hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.

Cognitive symptoms

Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when other tests are performed. Cognitive symptoms include the following:

• Poor “executive functioning” (the ability to understand information and use it to make decisions)
• Trouble focusing or paying attention
• Problems with “working memory” (the ability to use information immediately after learning it).

Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress.

<Brian writes> On top of these symptoms are the side-effects of the anti-psychotic medications

Treatments

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments.

Antipsychotic medications

Antipsychotic medications have been available since the mid-1950′s. The older types are called conventional or “typical” antipsychotics. Some of the more commonly used typical medications include:

• Chlorpromazine (Thorazine)
• Haloperidol (Haldol)
• Perphenazine (Etrafon, Trilafon)
• Fluphenazine (Prolixin).

In the 1990′s, new antipsychotic medications were developed. These new medications are called second generation, or “atypical” antipsychotics.

One of these medications, clozapine (Clozaril) is an effective medication that treats psychotic symptoms, hallucinations, and breaks with reality. But clozapine can sometimes cause a serious problem called agranulocytosis, which is a loss of the white blood cells that help a person fight infection. People who take clozapine must get their white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment with clozapine difficult for many people. But clozapine is potentially helpful for people who do not respond to other antipsychotic medications.

Other atypical antipsychotics were also developed. None cause agranulocytosis. Examples include:

• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Ziprasidone (Geodon)
• Aripiprazole (Abilify)
• Paliperidone (Invega).

What are the side effects?

Some people have side effects when they start taking these medications. Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:

• Drowsiness
• Dizziness when changing positions
• Blurred vision
• Rapid heartbeat
• Sensitivity to the sun
• Skin rashes
• Menstrual problems for women.

Atypical antipsychotic medications can cause major weight gain and changes in a person’s metabolism. This may increase a person’s risk of getting diabetes and high cholesterol. A person’s weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical antipsychotic medication.

Typical antipsychotic medications can cause side effects related to physical movement, such as:

• Rigidity
• Persistent muscle spasms
• Tremors
• Restlessness.

Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can’t control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication.

TD happens to fewer people who take the atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.

How are antipsychotics taken and how do people respond to them?

Antipsychotics are usually in pill or liquid form. Some anti-psychotics are shots that are given once or twice a month.

Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement.

However, people respond in different ways to antipsychotic medications, and no one can tell beforehand how a person will respond. Sometimes a person needs to try several medications before finding the right one. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.

Some people may have a relapse-their symptoms come back or get worse. Usually, relapses happen when people stop taking their medication, or when they only take it sometimes. Some people stop taking the medication because they feel better or they may feel they don’t need it anymore. But no one should stop taking an antipsychotic medication without talking to his or her doctor. When a doctor says it is okay to stop taking a medication, it should be gradually tapered off, never stopped suddenly.

How do antipsychotics interact with other medications?

Antipsychotics can produce unpleasant or dangerous side effects when taken with certain medications. For this reason, all doctors treating a patient need to be aware of all the medications that person is taking. Doctors need to know about prescription and over-the-counter medicine, vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other drug use with their doctor.

To find out more about how antipsychotics work, the National Institute of Mental Health (NIMH) funded a study called CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness). This study compared the effectiveness and side effects of five antipsychotics used to treat people with schizophrenia. In general, the study found that the older typical antipsychotic perphenazine (Trilafon) worked as well as the newer, atypical medications. But because people respond differently to different medications, it is important that treatments be designed carefully for each person. More information about CATIE is on the NIMH website.

<from me>  Holy sheep shit.

What is extremely scary and dumbfounding to me is after four decades I don’t know what my brother is taking or took. On the bright-side whatever he was taking must have been working fairly well.

I mean it is totally possible that I was isolated and self-centered, but there is no excuse for spending that much time with a family member and not monitoring these type of dangerous medications, and this goes for my parents as well.

Now I ask myself, was my parents’ reluctance to discuss my brother’s mental illness similar to ours? I have the utmost faith in the Internet community. Our community continually helps me cope with life and what must appear to be continual drama and trauma around here. I think my positive outlook and good mental health are attributable to my Internet relationships.

I take responsibility for marginalizing my brothers condition. I’m naive, no doubt.

Was it the fact that I blew a gasket and posted a tabu subject on the Internet which awakened me to this situation? No. I think I would have been a whole hell of a lot worse off if I hadn’t.

I do  have a large Internet personality and some personal information leaks through from time to time, I still believe we all need to speak to family on a one to one basis, often. Thank god for you guys is all I can say, you saved me, and possibly my brother too, because I may have metaphorically strangled him if my ignorance had gone on much longer.

Anyway, I titled this BMN “Waking,” as I mentioned. I want to clarify, that I am by no means implying I’m awakened. Just the beginning part of waking up, I still have far to go. For example I still haven’t a clue as to what I can do to help get through to my brother, or if it is even possible, but the point is I now see many layers of personal and emotional baggage if you will which are not relevant and pretty much useless.

Now I need to begin scraping off this layer so that I may get closer to being a care-giver at least part-time, and hopefully keep from being pissed off  like any of this is someone’s fault

Again sorry about breaking a tabu any writing about a family members sickness.

I yam what I yam. I hope it ain’t so bad

Thanks again to Ana for being there for Jackson and keeping his mean-old brother informed too. You are the most amazing woman, thank you

Brian Rodgers