Monthly Archives: March 2010

Schizophrenia and Violence: Media versus Madness

Persons with schizophrenia, especially those who have paranoid delusions, are often depicted in the media as being overtly violent and dangerous. While it is true that some persons with this disorder have committed violent acts, the vast majority of the over 2.2 million Americans with this disorder are in fact not violent. In truth, we tend to be withdrawn and avoid overly stressful situations (like violent confrontation) at almost any cost.

Here are some ideas to ponder:
  1. Most persons who commit violent crimes do not have schizophrenia; most persons with schizophrenia do not commit violent crimes.
  2. As mentioned above, we tend just to want to be left alone. Because of our passive nature, we are more often the victims of violent crimes than the perpetrators of such. Quite possibly because of our lack of social power and prestige and due to our resistance or ability to report crimes against us, reports of violent acts against us go unreported or underreported.
  3. When we do act upon our violent fantasies, that violence usually takes place at home and is most often directed at family members and/or friends.
  4. There are three predictors of violence: a history of violent behavior; substance abuse; and noncompliance with medication (not taking one’s medication). The first two of these three are the strongest predictors. These predictors hold true for the general population as well as for those who suffer from schizophrenia.
  5. As a group, we are much more likely to commit a violent act upon ourselves (suicide) than upon others.
The great stigma of schizophrenia, one that is preached in many media outlets, is that we are violently dangerous. The truth is that, while we do have more violent fantasies than most, we are not as violent as the general population. In the past ten years (going back to 2000), can you count on both hands the number of stories you have heard of someone with this disorder committing acts that directly resulted in someone’s death? I can think of a few off-hand. Now, think about the number of times you have heard of someone from the general population doing the same. How many of those can you count?  You’d need more than your fingers and toes, wouldn’t you?
I’m not saying to go find a person who is actively psychotic and befriend them. Obviously, that would be irresponsible on my part. What I am saying is that the next time you meet someone who has been diagnosed with schizophrenia, try not to dismiss him. You might be surprised that, if you have some things in common, you may have just made a new friend, and that will change two people’s lives…yours and his (or hers).

My loved one has been diagnosed with schizophrenia! What do I do now??

Some of you may have faced this dilemma, are facing it or will face it in the future. Here are some of my thoughts on dealing with the question posed in this blog post’s title

First, remember that no one grows up, thinking: “Boy, you know when I grow up I want to have schizophrenia!” I know I didn’t. And, I would venture to guess that none of you, whether or not you suffer from it, did also. So, nobody wants it. However, that doesn’t change the fact that your loved one now has it. So, what can you do?

Let’s begin with what not to do. Some people I have met, either on the Internet or in person, have the misguided notion that their loved one can “will” himself to think or behave in a certain, usually culturally acceptable manner. This may not always be true. If your loved one has this disorder, chances are very good that he or she simply lacks the ability to think or behave appropriately.

An analogy may help you to understand your loved one a little better. Imagine that your loved one has been in a tragic car accident. This accident left your loved one paralyzed from the waist down; he is now paralyzed and requires a wheelchair. Would you confront your loved one and say: “Get out of your wheelchair! I know you can walk if you wanted to walk badly enough!” I hope you wouldn’t say that.

The same goes for someone who suffers from schizophrenia. No matter how much you beg, plead, cajole, and confront your loved one, there are things he simply can’t do. The difference between physical disability and a mental one (actually mental illness is a physical disability, involving the most important organ in your body) is that you can’t “see” it. Except that you can see it. Your loved one’s disability is noticeable in her thoughts, emotions, and behaviors.

The aggravating part for many of us — caregivers and afflicted alike — is that from an early age we are taught that we can control our thoughts, emotions, and behaviors. While this may be true to a certain extent, it isn’t true to a larger extent (at least not in my opinion). You, the caregiver, lack the ability to think, feel, and behave like someone who has schizophrenia and who is suffering from paranoid delusions or auditory hallucinations or the lack of the ability to socialize well with others. Likewise, especially if untreated, we lack the ability to think, feel, and act in appropriate ways.

So, given this situation, what can you do?  I have come up with 5 ways of helping your loved one. Notice I did not say “cure.” To date, there is no cure for schizophrenia. These 5 things are, in my opinion, the best things you can do to (a) help your loved one live as stress-free as possible, something that I addressed in my last blog post, and (b) give your loved one the best possible chance of getting or continuing with treatment. Here they are:

  1. Realize that your loved one is sick. He or she may be very sick, especially if he is not seeking help/treatment. Congruent with this disorder, your loved one may not be aware that he or she is ill, and the more that you push or pressure your loved one, the less likely he or she will get help, quite possibly because he will fear that his treatment team will act (or react) to him in a manner that is similar to your actions/reactions. So remember, your loved one is sick.
  2. Play with your loved one. Take 15-30 minutes a day and simply play with her. Find something she enjoys doing, and spend some time doing that with your loved one. And, please be sure to do it in a non-confrontational, nonjudgmental manner. This isn’t the time to try to get your loved one help. It’s a time to build trust in your relationship.
  3. Educate yourself about your loved one’s disorder. With education comes understanding; with understanding comes patience, a precious commodity when dealing with this disorder. There are plenty of good books and online resources out there.
  4. Take breaks. Go for a walk, get some ice cream, something, anything. Even if this personal time doesn’t totally take your mind off of your situation, it will help you gain some much-needed perspective. That will not only help you; it will also help your loved one.
  5. Remember, you are going to make mistakes. Everyone makes them. When you make a mistake, don’t make too much of a big deal about it. If you feel it appropriate, a simple “I’m sorry for doing…” or “I’m sorry for not doing…” will go a long way in helping your loved one realize that you did not mean anything personally malicious about your comments/actions.

Repeat Steps 1-5. Practice them. Notice yourself getting better at communicating with and behaving around your loved one. Like I said, this will not cure your loved one, but it will give your loved one the best opportunity to seek help and will help your loved one and you live together in an atmosphere that is as stress-free as possible. And, that is always a good thing.

Best wishes…


What Stress Feels Like For Me

What does stress feel like for me? How is this feeling any different than what “normal” people experience? Does stress really affect me more than the average, mentally healthy person? What do I do to mitigate and recover from the effects of stress?

To answer the first question, I think it’s important to note what it feels like for me when my bad stress levels are low…even to the point of being near nil. Obviously, the answer to this question is: It feels great! And, it really is that simple. I am much more creative during these times, and my interactions with others tend to be happy ones.

Then, oftentimes without notice, some bad stressor occurs, triggering a cascade of thoughts and feelings that at the very least throw me into a depressive state and at the very most brings back my psychotic symptoms (paranoia, for sure, and even auditory hallucinations at times). To say the least, this ain’t no fun. My brain goes on lockdown. I have trouble discerning what is real and what is not real. It is as if my brain has been overtaken by an icy fog. I feel encroached upon by people. Any slight from anyone feels like a personal attack, the magnitude of which is akin to a wrecking ball slamming into a skyscraper.

I feel everyone encroaching upon me, and I struggle to keep my personal boundaries afloat. Keeping my personal boundaries intact, something that most people take for granted is a mighty and tiresome struggle for me…not unlike a paraplegic relearning how to walk after a tragic car accident. The struggles of my unseen disability are that great. And, to compound matters, I feel as though I must hide those struggles because some people will take advantage of my weaknesses.

I don’t know how “normal” people experience stress…at least not on a “gut” level. I do know on a cerebral level that some people thrive on stress. It’s good that there are people in the world who are like that. I’m not one of those people. There are a couple of old sayings that I think are appropriate:

“What doesn’t kill me makes me stronger.”

“No pain, no gain.”

While these sayings may sound good and may even pertain to a section of the population, they definitely have no place in my world, and I am pretty sure not in most people’s who suffer from my disorder. While some thrive on stress and while it does create a sense of personal growth for some, it has no growth factor in my world. I do not get stronger from stress; I gain nothing from its pain.

Does stress really affect me more than the average, mentally healthy person? Yes. I think I’ve outlined that well enough not to go into it any further.

What do I do to mitigate and recover from the effects of stress? Mitigating stress is difficult. Since I am continuously trying to keep my personal boundaries intact. It is a 24/7 job. I’m not so sure I do a great job of mitigating stress; more often than not, stress gets to me, and instead of mitigating it, I have to devise ways of recovering from it. More often than not, I physically try to separate myself from the stress. Hopefully, this gives me time to recover and allows me to gain a better perspective on my stressors. If this doesn’t work, let’s say because I can’t physically get away from my stress or the stress continues or gets worse, I will eventually shut down. My brain will cease to problem-solve. During these times, I spend quite a bit of time in bed. On rare occasions, I will get angry. I try not to do this since anger isn’t the best option. In fact, anger usually backfires and causes my stress levels to skyrocket. If I feel myself getting to this point, I try with all of my might to suppress my anger and separate myself from the situation until I have gained a better perspective on things.

In closing, I would like to iterate that, even though I can write a fairly coherent post, even though I can hold a decent conversation (sometimes), and even though I may seem “okay” on the outside, I still have a severe mental disorder, one that affects me daily. To put things bluntly, this disorder sucks. There are silver linings, however, for the most part, I would rather not have it.

A final note: A quick “Thank you!” to Dr. Nancy Merbitz, Ph.D. for encouraging me to write this post. Her guidance and encouragement have helped me tremendously.

Stress and Schizophrenia

“Stress seems to be particularly harmful for those suffering from the psychiatric disorder schizophrenia. For a patient with schizophrenia, the death of a parent or other loved one, a change in therapist, moving from one apartment to another; these events can trigger acute anxiety, depression and psychotic episodes, which may lead to hospitalization. Even seemingly mildly stressful events such as a job interview or a date can have a devastating effect.”


As the above quote suggests, stress can have a pretty significant impact on people who have schizophrenia. The reasons for this are outlined in the article cited, and if you are interested in learning more, I would encourage you to read the full article and/or look for other articles by keying in “stress and schizophrenia” into your browser’s search engine.

How has stress affected me? As any good psychologist will tell you, there are good stressors and bad stressors. Let’s talk first about the good ones. For me, this includes reading, writing, doing crossword puzzles, giving talks about my experiences with schizophrenia, and enjoying a nice meal. It almost always includes being somewhere quiet.

I have found that doing something I enjoy and being able to do something are virtually identical. If I don’t enjoy doing something, it is very difficult to do it. The stress of doing something unenjoyable oftentimes increases my anxiety, depression, and even some of my psychotic symptoms. Let’s take a couple of examples. In the area of bad stressors, there are two extremes. The one extreme is a relatively benign bad stressor like having an IV put into one of my veins. I don’t tend to do well with being poked with a needle. It causes me some anxiety and even a bit of paranoia. This experience doesn’t last too long, so soon after it is over, I can dismiss it as a necessary evil.

A very bad stressor is one that causes me a great deal of anxiety and depression and one that aggravates my psychotic symptoms (usually paranoia). This occurs every now and then but happened to a great extent when, a couple of years ago, I worked at a large department store during the Christmas holiday season. Working retail was not the best job for me, and anxiety and depression were the least of my worries. After several weeks, I began becoming suspicious of my co-workers and customers. I was sure that they were plotting to harm me and I began hearing voices that were telling me so. I was so convinced of this that I had to quit.

One of the kickers about bad stress is that it can affect the things I enjoy doing. If there is enough bad stress, I have difficulty reading, writing, giving talks, etc. Because of this, I try to do the things I enjoy doing (and therefore can do) and avoid the stress that is not beneficial to me. Right now, I am going through some bad stress (family issues mostly). That is why I have put off writing this blog post until late this evening, and it is why I don’t feel like I have been able to do a very good job with this particular post.


In case, you hadn’t already noticed, I tend to be a pretty analytical person. Pieces get put in their logical places, and a puzzle emerges, one that tends to (theoretically anyway) solve the problem. That “feels” good to me. It’s reassuring, even to the point of comforting.

Life rarely works that way, though, right? Feelings are a prime example of something with which I have some problems. Just ask my wife! 🙂 Feelings are like magic tricks to me. Just when I think I’ve figured them out, they disappear…only to reappear somewhere else. Que sera sera.

What I will attempt to do here is to capture some of my emotions and feelings long enough to talk about them. Here they are (in no particular order):

Happiness: Hugs from people who are close to me make me feel happy. I enjoy them and will oftentimes go so far as to chase someone down (e.g. wife, daughter, stepson) to get one. It’s fun to tease them. That makes me happy.

Sadness: My grandpa died recently. The day before he died, I visited him in his hospital room. Weakened, struggling to breathe, and barely aware of what was going on around him, when he heard my voice, he raised his head and gave me a kiss. Later that week, I spoke at his funeral. I couldn’t hold back the tears.

Anger/Frustration: This happens a lot of times when I have trouble understanding something. I’d like to think that I am working on this, and it has gotten better. When it comes to maturing, I had quite a bit of catching up to do.

Pride: Pride is a double-edged sword for me. Too much and I get haughty. Too little and I begin to downplay what I have already accomplished. Like the bed that was “just right” in Goldilocks and The Three Bears, there is a balance that feels “just right.”  When I hit that “just right” area, I feel pretty good about things.

Inferiority/Superiority: For me, this is closely linked to pride. There are times when I’m in that “just right” area, and at these times, I feel pretty good about myself. There have been and to a much lesser extent still are times when I feel superior. This usually happens when I have not been around people (other than immediate family) for a couple of days. I struggle with inferiority. When I was actively psychotic, I felt superior 99.999% of the time.

One of the few drawbacks of medication and psychotherapy is that this pseudo-confidence was exposed for what it was: fraudulent. As a result, I became more realistic about my place in the world. I realized I’m not as superior as I once thought. There was a rebound effect for me. Upon coming to this realization, my self-esteem took a nose-dive, and even though I am better than I used to be, I still struggle with this, especially when it comes to dealing with others who are either going to school or who have a job. For some reason, I feel as though I’m not as good as others because I am not contributing to society in a productive manner. Instead, I am a drain on society’s resources. With that comes a good deal of guilt and feelings of inferiority.

I think I will end my list of feelings there. I think I have done a pretty good job of analyzing my feelings. Can’t get away from the analyzing thing, can I?

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