A friend of mine sent me a question this week that I’d like to throw out to the wider community. Her son has been offered a job that requires a physical. There are now two concerns of hers that center on disclosure and stigma. The family doctor refuses to sign off on the medical form because her son was hospitalized for three weeks at this time last year, he is no longer on meds and the doctor feels he will have relapse.
My friend understands the doctor’s position from a legal standpoint, but is upset that the diagnosis will follow him around wherever he goes. She objects to the fact that he was “diagnosed” after a 45 minute interview by a doctor. Many job forms ask about mental health history.
We are all in this boat. Frankly, I’ve been avoiding this issue because I know it will rear its ugly head when Chris eventually gets around to being employed or needing insurance. I’m just hoping that things are not as negative as they sometimes look.
Can someone get “undiagnosed?” Or, can someone go to their doctor and demand a downgrade of their diagnosis? Since medical records are private, if someone is asked on an employment form (insurance forms are more serious if falsified) what their mental health history is, what’s the matter with saying “depression?” Now that antipsychotics are being turned into antidepressants, where’s the harm in claiming you were suffering from depression? Who’s going to know? What about getting a driver’s license for the first time?What legal recourse is there from a discrimination point-of-view?
What have we not thought of? What words of advice can you offer us?
I am discouraged of late that schizophrenia isn’t getting the press it deserves. More people (1 in a 100) have schizophrenia than autism (now 1 in 150), though autism seems to be catching up fast. Autism is a relatively recent phenomenon. The term “infantile autism” was coined by Dr. Leo Kanner in the 1930s. Schizophrenia has been around since the dawn of time.
Schizophrenia has built-in problems that might prevent it getting a full campaign à la Jenny McCarthy’s with autism. Schizophrenia occurs in adults. Autism attracts attention because it happens to children (and yes, it is a devastating problem). Money pours into children’s causes. Adults, let’s face it, are a harder sell. Another problem: Nobody wants to admit publicly to having schizophrenia. Better to be bipolar. Bipolar seems to be enjoying a wave of popularity right now, right up there with depression. The distinctions between bipolar and schizophrenia are artificial and tend to fold into each other over time. The drugs to treat them are the same. I wasn’t at all surprised to hear rumours that Britney is bipolar. Schizophrenia is a career killer. Britney is still out there and trying her best, even if she has her off days.
Where is the outrage? Schizophrenia has a natural recovery rate of 30%. Imagine that a little dedicated effort could double that rate and make recovery happen sooner. By dedicated effort I do not mean more meds. I mean less meds or no meds. My celebrity would endorse a holistic approach to health and talk openly about helping people to help themselves. My celebrity would speak about the value of vitamins, diet, family support, love, and provide a more balanced view of the role of medications than what we have been hearing up until now. I would love it if a little pill could cure our ills without creating more problems, but I gave up on that fantasy a long time ago. The real discrimination in schizophrenia is that people are not being helped to get better in bigger numbers sooner. Mentally ill people will have limited access to employment and other opportunities many of us take for granted as long as they remain mentally ill.
Jenny McCarthy was outraged. She did something about it. I read her book Louder Than Words. I was turned off at first. She throws four letter words around like rice at a wedding. This detracts from her message. But I looked past that and I realized that she was absolutely right to be outraged and to not accept the bleak prognosis her son was handed. She did her homework and she got going. So did the gay rights lobby. Back in 1973, homosexuality was dropped from the Diagnostic and Statistical Manual of Mental Disorders as a mental illness. Psychiatrists were not at all happy about that because they still considered homosexuality a mental illness. But they could not withstand the onslaught of the gay rights movement picketing their offices and conventions. A mental illness wiped out by the stroke of a pen. The success of the gay rights lobby raises interesting questions about the nature of mental illness and of how it is determined and it shows what outrage will do.
In the 1950s, Dr. Abram Hoffer, together with Dr. Humphrey Osmond, successfully treated hundreds of schizophrenic patients at the Saskatchewan Hospital, with supplements aimed at correcting the body’s biochemical imbalances, a treatment approach later termed “orthomolecular medicine.”
Dr. Osmond and his student Dr. John Smythies noticed that schizophrenic hallucinations are like hallucinations suffered by otherwise normal people who have taken a bad mescaline trip. Mescaline belongs to a family of psychedelic compounds known as phenethylamines. It is present in several cactus species of the American Southwest and the Andes mountain range of South America and used by native American tribes in certain religious and mystical practices. Adrenaline, which is naturally produced in the body, is similar in its properties to mescaline.
Drs. Hoffer and Osmond hypothesized that schizophrenics produce an excess amount of an amino acid similar to adrenaline (which they called “adrenochrome”); this amino acid is also produced naturally in the body. Dr. Hoffer determined that adrenochrome belongs to a different family of psychedelic compounds known as “indoles.” (LSD is an indole.) Dr Hoffer prescribed niacin in high doses to reduce adrenochrome levels. It works.
Dr. Hoffer defines recovery from schizophrenia as threefold: The person is able to function well with friends and family, is free of signs and symptoms, and is able to pay income tax.
Dr Hoffer is still in the minority of doctors and institutions who think so optimistically about schizophrenia. The standard medical opinion is that the most one can expect is managed recovery, quality of life, and part time work if any. Dr Hoffer expects more. Why are most so-called experts setting the bar so low? It surely has something to do with the word “cure”. Many people shudder at the use of the word cure” in the context of schizophrenia. A cure simply means that someone with an illness has become healthy again or it can be the solution to a problem. If you rely solely on pharmaceutical solutions, curing schizophrenia is difficult, if not impossible.
Be wary of institutions that talk about ending discrimination of the mentally ill, e.g. the problem with mental illness is “stigma”. No, the problem with mental illness is that people are not getting well in sufficiently large numbers. The mentally ill have been discriminated against because they haven’t been seriously helped to get well. Most institutions promote mental illness as chronic and hopeless. Let’s not set the bar so low. Why, for heaven’s sake, instead of celebrating people whom they seem to regard as chronically disabled, don’t these organizations say that they are dedicated to helping people with serious mental illness get over it and get on with their lives? Why not, indeed?