I really recommend people interested in Schizophrenia to read the book “Hidden Valley Road”. I saw it recommended in a HN comment previously.
The book follows an American family who gave birth to 12 children, 6 of whom were later diagnosed with schizophrenia in their teens.
It’s interesting because the book gives lots of insight into the historical to modern research on the condition. In the past psychologists thought schizophrenia was caused by the environment and/or bad childhood. But most of the research right now is pointing towards a genetic cause.
I can't speak to its validity, but the way it was explained to me from a neuroscientist a few years ago is that the general hypothesis now is that some people have a genetic predisposition to schizophrenia and that predisposition sort of lies dormant until triggered. That would explain how both could be true: it could be genetic and triggered by environment/trauma.
There are enough cases of identical twins where one twin gets it and the other doesn't that we are certain it can't just be genetic. We are also certain that genes matter. We even know roughly which genes and that many of the variants that increase the risk are de novo mutations. We don't know much more than that, though.
My grandmother’s twin sister developed schizophrenia, while my grandmother did not (though she did eventually suffer from Alzheimer’s). I have a moderately elevated genetic risk, and it’s something I do keep in mind. I believe her sister developed schizophrenia shortly after the 2 were separated from each other when my grandmother left for college, which is interesting timing.
> There are enough cases of identical twins where one twin gets it and the other doesn't that we are certain it can't just be genetic.
Strictly logically speaking, this is consistent with it being genetic + random chance (where the odds are determined only by your genes) - meaning no identifiable environmental factors. Not saying it is (nor would I know).
I would not be surprised if the "dormant until triggered" explanation is true for most conditions.
This seems to be pretty compelling observations for various disorders like Alzheimer's, various autoimmune conditions, etc. being caused or exacerbated by previous infections.
It was the case for me. I apparently have the genes for a semi-rare autoimmune condition (Guttate Psoriasis) that was triggered after a bout of some kind of viral illness. Typically, step throat is the trigger for many with the disorder, but that was not the case for me.
> That would explain how both could be true: it could be genetic and triggered by environment/trauma.
With siblings it is likely both generics and environment are similar.
In terms of trauma and episode triggering events, imagine the stress of living with a large family where several are schizophrenic.
Interestingly, schizophrenia is really rare in accounts before the 1800s. It appears to be a modern disease, which would make it seem like it would be environmental.
Another interesting thing about schizophrenia is it's much more common in cities, even after controlling for drug use and ethnicity[1]. Which again makes it seem like something that was rare in the past.
Schizophrenia didn't exist as a concept until the early 20th century. There were various attempts to categories and label insanity in the late 19th, but before then people were either "mad", "not mad", or "occasionally mad" - perhaps with some sense of being religiously inspired in their madness.
So it's impossible to say if schizophrenia is a modern environmental illness.
FWIW I find it hard to imagine that modern life, even in cities, is more stressful than the life of a peasant in medieval Europe - someone who would be constantly torn between instinct and the threat of eternal agony in hell, and would also be terrorised by the very real threats of war, starvation, plague, and more mundane but still deadly illnesses.
Not that modern homelessness and poverty, workplace aggression and bullying, relationship breakdowns, and the threat of physical violence aren't stressful in their own way.
If there is an environmental component I'd guess it's at least as likely to be chemical as social. But maybe there's some difference in social stress types that everyone has missed.
It's a complex function involving social and environment stressors which effect progression, and social and cultural context which effect manifestation, and there's also feedback between manifestation and progression.
I think it's widely accepted, albeit in a somewhat loose way, that the reason "schizophrenia" was not previously attested is because society explained the behaviors differently and often in less negative terms such that there was less positive feedback that negatively effected progression and manifestation. An archetypal example would be that someone who experienced hallucinations might be understood to be highly spiritual, a mystic, or just quirky. Moreover, people lived in more tightly knit family and social groups, so someone who had trouble taking care of themselves would be more likely to live with or near compassionate family members. And if someone did become a poorly kempt recluse, that didn't by itself turn them into complete social pariahs, so they could more easily have some minimal normative social relations. OTOH, if someone just completely fell apart and died from exposure, or antagonized the wrong person and was killed, the cause wouldn't have been attributed to a mental disease, per se.
And the effect of culture goes even deeper. Hallucinations among those living in modern, western societies tend to be more paranoid and violent; more likely to involve the threat of "the government" or "they" than, say, a beneficent god or playful tree fairy. Or more specifically, as seen in many recent anti-Asian assaults, acting out racial animus received from the culture. The increased negativity in hallucinations and behaviors feeds back into progression directly (more stress from the hallucinations) and indirectly (people are more afraid and wary of you, so you more quickly become separated from supportive social networks).
Possibly a disconnect from nature does something to trigger the condition. Cities are more man-made and artificial than being close to the wilderness. I don't know if that's the correlation, but it seems like you see quite a few more paranoid and hallucination episodes from people in cities than rural areas (if we're taking out drug use).
Genetic cause is often what is claimed of things that are not very well understood at all.
Myopia being one of them for instance. (it's actually often an adaptation process that is actually found to be reversible)
Wrt SZ, not only is it very badly understood but a lot of the symptoms can be attributed to biochemical disorders and that does not necessarily imply a genetic predisposition at all.
Caffeine can induce psychosis, so can THC. For instance, caffeine is an adenosine antagonist, which itself is a dopamine antagonist.
So from a DSM pov, a lot many people can be diagnosed SZ when in fact, the amplitude of the disorder is caused by repeated psychoactive substance abuse.
Even owning a cat (parasites) is thought to be a possible cause for schizophrenia.
Then again, who knows what lies in people heads too?
Perhaps that the thoughts they hear are real and some people just can't process it properly which drive them to do strange things. We discount people's experience but there are so little ways to non-intrusively explore people's internal state.
A true scientist wouldn't discount that possibility too.
> Then again, who knows what lies in people heads too? Perhaps that the thoughts they hear are real and some people just can't process it properly which drive them to do strange things. We discount people's experience but there are so little ways to non-intrusively explore people's internal state. A true scientist wouldn't discount that possibility too.
One of my best friends was schizophrenic and he described the experience as being in the back of the car with someone else driving. A literal observer to his own life. That kind of scared me because I have strong internal dialogues with myself, especially if I'm in conflict over something. He assured me it's nothing like thinking or hearing your own voice; these voices are in fact someone else and the state of your mind makes the experience feel real.
I think it's really like hearing an external sound, it's not something you consciously control. I feel like I heard a hypothesis somewhere that maybe there's something off about what you perceive as your own conscious thoughts. Obviously everything is coming from your own brain, so I would argue they are your own thoughts but we're just talking about the perception of being your own thoughts.
Related to this, some schizophrenics think that thoughts are being placed in their head by something external or that they perceive thoughts from other people. Telepathy is also a common rationalization.
For as long as I can remember I have this thing where I hear sounds, voices and sometimes see things depending on how tired I am. It almost never happens when moving around, it sometimes happen when sitting still and often happens when trying to sleep or wake up in the morning. But always goes away as soon as I move around or start using my brain somehow.
However when consuming THC these symptoms are heightened to something that feels like 50x and they occur even when awake and moving around.
The symptoms are also heightened a little bit when consuming alcohol and especially when trying to sleep.
If I stay up very late it's also a lot more intense when trying to sleep.
I consume a lot of caffeine in general, but I don't think it heightens my symptoms directly. Maybe indirectly it makes me stay up longer depending on when I consume.
That's interesting.
Usually, I would ask if you have ever had difficulties focusing your attention, some ADHD?
How do you grade your visualization? Can you create a scene in your head and control it 100%?
How often do you get a random song stuck in your head?
I think that more people are prone to this than they think but they are simply not aware.
Some people start realizing things when they end up trying some kinds of meditation practice and since they are not in control and somewhat clueless about what's happening internally, for some of them it sends them off the rails (hence the stories we hear about meditation triggering psychosis etc...)
Some people never experience such things as well. For some, it comes later.
Talking to oneself is fine. Feeling external thoughts, emotions and even minor loss of self agency in motor control is something else and I think that some rationalizations could make sense. But the current lack of understanding is leading people to handwave (not every scientist is so handwavy of course).
There is an issue of depersonalization such as seems to be the case with your friend. All these things are really not understood and the nervous system alongside the brain is quite inscrutable for now.
I have issues with attention, such that I easily get distracted when trying to focus on something.
I struggle holding a visual image in my head as it easily deteroitates, it's also very faint. I'm not sure what's normal here but I remember I could do this more easily when using THC, even when the effects start wearing down. It's also easier to do in the morning when I wake up before I start moving.
I feel like I have some song stuck in my head all the time. It's almost always a new song when I wake up from sleep.
I also have somatic tinnitus from what I understand. It's not like the beeping you get in your ear once in a while, it comes more from the center, is very high frequency with many overlapping frequencies and sounds a bit modulated. It also gets louder if I clench my teeth or stretch muscles.
No one is getting (properly) diagnosed with schizophrenia with incidents of drug induced psychosis, which is what you’re describing. Schizophrenia as a diagnosis relies on the presence of both negative and positive symptoms (as defined in the literature). Other people here have talked about the definition and fluidity of schizophrenia, things change but what does not change is schizophrenia is characterised by not only the positive and negative symptoms but also by being a degenerative condition.
As opposed to drug induced psychosis, which is reversible if you remove the aetiological agent.
But by changing the neuro-transmitter balance when treating psychosis with anti-psychotic medication, negative symptoms can also appear.
Depending on who establishes the diagnostic, you can be diagnosed as schizophrenic while you are simply in one of the phase (acute or post) of psychosis.
In general, if you repeatedly suffer from bouts of psychosis, you will get a diagnosis even though the real trigger has not been established.
Also, the presence of negative and/or positive symptoms differs from people to people so even that is not clear-cut.
Anyone here has reversed astigmatism? I've heard a lot about reversing myopia, and while I've seen a some stuff on the netz for astigmatism, I haven't found a good enough resource.
Did the study control for race then if genetics are a cause? ie other studies have shown those of ashkenazi descent are more likely to be schizophrenic.
I hope this isn’t taken the wrong way - id very much like to know if my genetic ancestry made me more or less susceptible to things like schizophrenia.
It could be environmental imprinting on genetics from previous generations. Of the people that I am familiar with that developed schizophrenia, there is often something traumatic in their family's past, and it is not always the previous generation (but may be from 2 or 3 generations previous).
The book follows an American family who gave birth to 12 children, 6 of whom were later diagnosed with schizophrenia in their teens.
It’s interesting because the book gives lots of insight into the historical to modern research on the condition. In the past psychologists thought schizophrenia was caused by the environment and/or bad childhood. But most of the research right now is pointing towards a genetic cause.