Seeing articles like this gives me hope that there is momentum in an eventual trend that will cure mental illness, or treat it with a method that isn't antipsychotics.
I personally believe that in the US, our society is quick to demand people seek treatment, even forcibly. Yet the treatment available is insufficient, incredibly destructive and often ineffective.
> I personally believe that in the US, our society is quick to demand people seek treatment, even forcibly.
As far as I can tell, the US is unusually permissive of people with mental health issues. Entire cities have thousands of people who are visibly unwell and free to do whatever they want.
In San Francisco I saw a naked homeless man sitting in a wheelchair shove a dildo in and out of his anus right on a sidewalk. Even though I looked away the exact moment I realized what I was seeing I will never forget it despite really wishing I could.
This is due to a lack of resources to commit everyone. There are still plenty of people that are committed, such as the main character of this article.
Those resources were explicitly redirected to community based nonprofits that spend most of their budgets facilitating the lives of the aforementioned people who would previously be in locked institutions. You've got cause and effect backwards.
You're right. They still commit some people though.
And I didn't mean to say specific policies are in play. It's the outcry of the surrounding communities that have a loud but powerless group that want people forcibly locked up. (Seattle here)
While funding is an issue, we used to do it. Attitudes changed. There's simply not a lot of support for involuntary psychiatric care outside some immediate emergency.
I'm not so sure it was due to attitudes changing. At least here in Ontario funding for many long term facilities was scrapped in the 1990s as governments slashed budgets for non-essential services to cut costs while higher levels of government downloaded services to lower levels. Smaller municipalities simply cannot afford to fund social services when property taxes are their primary source of funding. The effect was the same as the higher level of governments canceling many of these programs, albeit without having to take as heavy a political hit.
The same thing happened to many low income housing programs in Canada as well. Few people remember that there were once federal programs to provide affordable housing which were also part of the 1990s cost cutting exercises.
Locally we have a few long term retirement homes that are municipally funded, but capacity is very limited with long wait times.
Everyone I talk to in the US is in favor of reopening the institutions. Seeing a man with a gangrenous leg shitting himself while having a conversation with his “invisible CIA handlers” is enough to undo the Reagan era effects of seeing/reading one flew over the cookoos nest
I live in San Francisco but am familiar with Denmark where it's relatively straightforward for a physician to involuntarily commit someone for ~a month at a time and the state to extend it in six month increments. To contrast, LPS in California limits involuntary holds to 72 hours and makes it very hard to hold anyone longer than that even despite recent reforms.
The same people who pay to keep mentally unwell people housed in residential hotels with inconsistent (but expensive) social worker based health treatments, their ER visits, Medicaid, etc. in the United States. Big cities spend huge amounts per capita on public health. The difference in results isn't explained by the purse.
If you ever want to experience pure hell, go on antipsychotics for a month. They totally eviscerate your ability to be creative. I was given them during a misdiagnosis of mental health issues and I think I'd rather choose to be homeless instead of going back on them for any reason. Also don't make the mistake I did and quit them cold turkey. If you don't taper them off, you can have seizures. Not fun.
Not to take away from your own experience at all, but you can't make sweeping statements about psychiatric medication like that. As far as I know most of them are very personal, and it's quite common for any given medication to be a terrible experience for some while it's a life saver for others.
I'm sorry you had a bad experience with them, but that wasn't my experience. The antipsychotic I am on helps me immensely in not being sucidal and being able to live some semblance of approximating a normal human life.
This is noted as a common and serious side effect that many people experience. Unfortunately it's also noted as a symptom of the common diseases these medications treat. It's seemingly a mess of figuring out what parts of suffering are medication related or disease related. This is why this discovery in the article is so fascinating - science doesn't even know what causes this in the first place, thus it's impossible to decipher which is which. We just know it can address some symptoms in some people and in general some feel the tradeoff is better.
Your ability to be creative is a distant second to being able to take care of yourself.
You are not the only consideration, there is also the rest of the population. It’s not like we have some endless “West” you can go to and be by yourself.
When problematic people get put away, historically, it’s jail. Psychiatric institutions were considered an alternative that was better. Yes, way back in the day they quickly became really bad places, but if done better, are a far better alternative than what we do today.
I used to live near one. I remember they had extensive gardens because gardening was therapeutic for some of the patients, low cost, time consuming, had a reward, etc.
There is a lot of hope; I've had a pet "notion" for years that about every decade we look back at the previous one and wonder how we lived in such barbaric times, at least in terms of medicine.
'rituximab, the immunosuppressant. “I have a new working theory,” she texted Angie, in May, 2024. “Theoretically her chemo could have incidentally cured” her.
Christine found a handful of recent case studies that documented drastic psychiatric recoveries after people were treated with drugs that dampen immune activity. '
I highly doubt there'll ever be research in this area, but I'm very curious about whether it'll ever be possible to induce schizophrenia for a time, similar to how psychedelics or dissociatives can induce altered mind states.
My friend in highschool did a solid week on lots of acid and mushrooms, and ended up in the hospital with a schizophrenia diagnosis - this was 20yr ago, but they said he was likely to get it eventually but he triggered something or otherwise sped up the process.
So you're probably right, but on both points sadly. To this day he still sends me complex CAD drawings of nothing.
Mushrooms and LSD have high tolerance from 24-96h where higher doses will not reproduce the same effects w/o abstinence. I find it hard to believe that a week's worth of exposure was the sole cause.
>but they said he was likely to get it eventually but he triggered something or otherwise sped up the process.
OP did address that. But
Lots of folks attribute things like schizophrenia to hallucinogen use, when in reality, people make questionable decisions in their late teens and early twenties; this is the time that these disorders tend to manifest. So a lot of coincidence leads to a casual relationship in popular culture.
I agree, most medications will create/change tolerance to more of the same. In some respect that's the purpose of taking some medications in the first place, but it can lead to poor long term outcomes. Take enough melatonin exogenously and your endogenous production stops completely.
“I took five people, and we locked ourselves in a building for three weeks, and we took 400 micrograms of LSD every four hours. That is 2400 micrograms of LSD a day.… We finally were just drinking out of the bottle.… We were very high.”
From Be Here Now - Ram Dass/Richard Alpert
Interestingly he was the guy involved in giving psilocybin to priests back at Harvard in the 1960's.
On the other hand, one single dose of a psychiatric medication can ruin peoples lives. They get brain shocks, sexual dysfunction or anhedonia for life. One dose of marijuana can effect similar outcomes.
I know immunosuppresants are whole separate part of medicine, but its a playing with fire risk/reward where its too early to establish reasonable probabilities. But at least we can begin the cause-effect discovery process.
I found a copy of Be Here Now in a thrift store that had a pressed marijuana leaf in it. First time I'd ever seen one. Bought the book and read it, pretty hard to digest and hippy trippy stuff but an entertaining read.
It's genetic predisposition to schizophrenia that enables psychedelics to activate it. Without the genetic predisposition you'd be lucky to get psychosis (or unlucky, as it were). That's why people with a family history of schizophrenia or related mental disorders are particularly encouraged to avoid psychedelics.
Psychedelics are known to occasionally activate schizophrenia in genetically predisposed individuals, so this is definitely not unheard of. Given how often I take LSD though, I'm fairly certain I'm not genetically predisposed to schizophrenia, otherwise I probably would've been in the 12th inner circle of schizophrenia by now.
(I've been trying to impact the stability of my brain for years. I just want a way to destroy rational thought but that isn't lethally addictive (benzos), or irreversibly neurotoxic (deliriants), or literal poison (alcohol). Harm reduction is such a drag, I just want to safely explore unsafety!!)
> I highly doubt there'll ever be research in this area, but I'm very curious about whether it'll ever be possible to induce schizophrenia for a time, similar to how psychedelics or dissociatives can induce altered mind states.
It is not possible, by definition; here’s a portion of the DSM 5 definition of schizophrenia:
“ The disturbance is not attributable to the physiological effects of a substance (e.g., a
drug of abuse, a medication) or another medical condition”
Hard to find a publicly accessible DSM link, but here is an excerpt
I use schizophrenia to refer to the experience, not to the diagnosis. I'm not sure what to call the experience of schizophrenia other than schizophrenia, given it's not synonymous with psychosis. (Though, granted, I would also want to try psychosis someday; even if it's a terrible experience and I never want to do it again, I want to truly know what it's like. Hopefully without permanent brain damage though. That stipulation heavily limits my options.)
This is true, but I wonder if GP spoke naively about inducing symptoms that are similar enough that we can learn about what triggers those symptoms in otherwise healthy individuals.
Kind of like how we were "lucky" to get a guy with a railroad spike through his brain to learn about how brain damage affects personality and impulsiveness..
oh it was definitely for selfish reasons, I just want to feel it for myself. But I do have a feeling that it would advance science as well, that'd be a cool bonus I guess.
I actually have done this (not by choice though), and I guess I might've gotten close to something like psychosis. Maybe I'll push it further when I'm in a less stressful environment. I neglect basic needs too much as it is, hah.
If you want to experience another personality and/or view on things the better thing is Ketamine. Don't fuck with your sleep for some burnt out euphoria experience.
Always respect your sleep, it's the only thing keeping you from cooking your brain at 30. Anecdotal but my mate's mom got Alzheimers when shes like 55, an overworked overstressed, never sleeping woman.
Taking ketamine sucks. I actually tried with the nasal sprays before and I literally threw the spray bottle in the garbage because of how miserable that was. I didn't even get a meaningful experience out of it, but I burned the ever living fuck out of my throat from how bitter the stuff was. I heard IM injection works far better, but it's probably gonna take a long time for me to work up the courage for that.
(Also, I have DID so I experience other personalities all the time!)
I'm genuinely surprised, for me it's been doing medative self reflecting work for ages. I buy the shitty powder on $monerosite and systematically prepare a bunch to get into the "pre hole state" with banger ket music in the headphones and closed eyes.
It brings 5d chess into my psychology or something
I don't think the nasal route is good for me. Brain doesn't like it, body doesn't like it, it just feels extremely miserable. I think I tried it before the ketamine spray, but it would just dry out my nose and it was really painful and it just felt so awful that I couldn't manage to dose myself enough to have a good effect before I just couldn't bear to take any more. It's awful and terrible and I hate it.
Which sucks, because I really feel like dissociatives would be nice. I've taken memantine orally and it was nice, although it took really long to wear off, and also after a while it made me throw up all over my expensive tech, which was very not fun. Ketamine though I haven't found an adequate way to take.
I've never had ketamine. I've had memantine, but its half-life is ridiculous.
I self-medicate a variant of what's now available in the USA as 'Auvelity' but is just a ratio'd mixture of dextromethorphan and bupropion. The bupropion is there to slow down the metabolism of the DXM via its CYP2D6 pathway, but bupropion gives me anxiety/insomnia so I use something called berberine phytosome which isn't as effective but still works on CYP2D6 at a lower level, but no side effects.
All the other anti-depressant classes never worked for me but still gave me extremely shitty side effects.
There's a lot of anecdotal reports on DXM/Auvelity for both prescribed (variable outcomes, but for some people its the first thing that's ever worked), and recreationally its been around for ages sometimes referred to as the poor mans ketamine...
Not DID here, but schizo-affective. I've read things like meditation can actually have negative affects on dissociative disorders. Dissociating in order to re-integrate to a better place seems a somewhat reasonable strategy but I think mental-health/medication effects and understanding of how differently the same medications can affect different people is only just beginning to be realised by psychiatry now.
At least now there's even genetic testing for Auvelity - if you're already a poor CYP2D6 metaboliser due to a shortened version of a gene on a specific chromosome, they won't prescribe it to you. On the other hand you could be an ultra-metaboliser.
That’s not the redneck version, that’s the everybody version. You don’t need the LSD even, just pick a stimulant of choice, legal or not (meth, coke, adderral, vyvanse, Ritalin). Ingest it for days, you’ll be in psychosis in no time.
You're absolutely right, I'm quite liberal myself but I've never done more than "two days" for obvious reasons. We're evolutionary designed around earth's rotation so better not fuck too much with it.
I was drunk for almost two days once and at the end I couldn't comprehend conversation!
Definitely seems like the sort of thing that MKUltra would have looked at. Those folks were big into ideas like creating specific mental states in people.
I hope one day there'll be branches of medicine for each neurotype rather than just giving up whenever a drug's effects aren't consistent in trial. there needs to be more studies into everything ever
Keto was invented for the treatment of seizures in children, actually. There's a guy I know that killed 2 people with his car when he had a seizure. He's been seizure-free (and obviously not driving, btw) for years since starting keto
A woman developed what we call schizophrenia. She hid it reasonably well, but eventually was hospitalized for it.
Later they found cancer. While treating the cancer, her schizophrenia "magically" disappeared. Seemingly for good.
The article points that this isn't a unique case, and that schizophrenia, as a "hopeless disease," doesn't get enough attention... And there's no real sub classification to determine what lead to a set of symptoms (which is the only current diagnostic criteria).
So the speculation is that autoimmune treatments might cure or help some forms of schizophrenia.
Read the full article if this story sounds interesting!
I think the article is far more interesting than you make it out to be.
There is pretty clear evidence that some subset of schizophrenic diagnosis are due to autoimmune issues. If we can use antibodies in the spinal fluid to detect when autoimmune treatments can be effective in treating schizophrenia, that alone will be huge.
However, the even bigger insight to be drawn from all of this is the potential for other psychological problems that psychiatry has struggled to treat, to also have autoimmune causes. When you try to treat something that has multiple, quite different causes, with a single treatment, it makes sense that it would be hard to find that treatment that works reliably (as is the case for many psychiatric medicines.)
I predict we may eventually see immune antibody tests (or some functional successor) become a standard part of all mental health care.
For my money Rachel Aviv is the best and most interesting writer currently on the New Yorker staff (give or take a David Grann, who is pretty much just writing books these days it seems). I go out of my way to read whatever has her byline.
Immune antibody tests are already a standard part of a lot of mental health care, particularly psychosis. My wife tells me depending on the centre it may be mandated for all new diagnoses of psychosis. It is called an "organic screen".
I'm guessing that "organic screen" doesn't currently usually include antibody testing of CSF from a lumbar puncture since the article implies that only a limited number places do that screening currently.
> To find psychiatric patients who might benefit from immunotherapy, researchers have set up centers, roughly similar to the one at Columbia, at Baylor University Medical Center, in Texas; King’s College London; Uppsala University, in Sweden; and the University of Freiburg, in Germany, among other places. Some of the best research into the phenomenon has been conducted in Germany, where it’s more common for patients in a first episode of psychosis to have lumbar punctures to access their spinal fluid, which can reveal the presence of antibodies.
She did not have "schizophrenia" in the first place. The the DSM criteria may have overlapped, but bonafide schizophrenia comes with gray matter changes seen over fMRI.
The biggest clue is that she was never responsive to antipsychotics.
What we think of as schizophrenia today is almost certainly multiple underlying disorders.
Historically autism was lumped under schizophrenia and before that they were both lumped under dementia. Symptomatically similar with insufficient diagnostic precision or theory to differentiate.
Many things cause psychosis. Drugs are a good example. When first discovered LSD was often characterized as causing temporary chemically-induced schizophrenia. A useful metaphor but not accurate.
These clearly state in the abstract that there is gray matter loss in differing stages of schizophrenia, however it is unclear if it is as a result of common medications or the disease itself. It doesn't indicate that you can scan a person without any other knowledge and diagnose them with the disease. Gray matter loss can happen for other reasons as well.
i wonder if that has anything to do with putting someone with paranoid delusions into a loud machine that you explicitly state is going to scan their brain? maybe that's why there's no good imaging studies prior to drug intervention?
further i am having a hard time coming up with medical conditions that have a single test pass/fail like this.
Maybe, but I don't think most psychiatric patients are in a constant psychotic state that they would take such a strong stand on this. Maybe a few Ken Kesey characters depicted in a cartoonish manner.
But as the article mentions it's not a single pass/fail test they seek but any biological marker at all.
> And there's no real sub classification to determine what lead to a set of symptoms (which is the only current diagnostic criteria).
Is this not true of all things in the DSM, though? there's no "easy" test for ADHD or depression, for examples; fMRI might be able to distinguish, if the literature is to be believed. But generally you have to rely on what a patient self-reports, what caretakers/professionals observe, and what effects, if any, medication has on the symptoms.
The article is mostly about how there are now recognized to be certain schizophrenia-like conditions that are clearly autoimmune diseases. Mentioned in the article are anti-NMDA-receptor encephalitis, which responds to immunotherapy, and a previously published case of a woman mid-diagnosed with catatonic schizophrenia fully recovering after being treated for lupus with immunosuppressive therapy.
Based on this, the article suggests that the rituximab Mary was given along with chemo was the key. However, they were unable to test conclusively for antibody evidence of this theory after the fact.
I have a family member with an incidence of autoimmune encephalitis secondary to other conditions (my entire family is an autoimmune cluster) who is actually hospitalized for it now. This almost matches my experience to a tee, though anti-NMDAR was tested for and not found. The neurologists wanted to discharge prior to attempting immunotherapy and thankfully we were able to ensure they tried (pulse steroids).
It's certainly an area which can be characterized as rare disease, whether paraneoplastic or otherwise.
Probably why we keep looking at electroconvulsive ‘therapy’ again and again. Triggering the body’s systems to do something often cleans up other situations at the same time.
There was a phenomenon where sometimes a high fever would cure STDs like syphilis. We generally use antibiotics now that we have them, because they are less dangerous.
https://archive.ph/BTttE
Seeing articles like this gives me hope that there is momentum in an eventual trend that will cure mental illness, or treat it with a method that isn't antipsychotics.
I personally believe that in the US, our society is quick to demand people seek treatment, even forcibly. Yet the treatment available is insufficient, incredibly destructive and often ineffective.
> I personally believe that in the US, our society is quick to demand people seek treatment, even forcibly.
As far as I can tell, the US is unusually permissive of people with mental health issues. Entire cities have thousands of people who are visibly unwell and free to do whatever they want.
In San Francisco I saw a naked homeless man sitting in a wheelchair shove a dildo in and out of his anus right on a sidewalk. Even though I looked away the exact moment I realized what I was seeing I will never forget it despite really wishing I could.
This is due to a lack of resources to commit everyone. There are still plenty of people that are committed, such as the main character of this article.
Those resources were explicitly redirected to community based nonprofits that spend most of their budgets facilitating the lives of the aforementioned people who would previously be in locked institutions. You've got cause and effect backwards.
You're right. They still commit some people though.
And I didn't mean to say specific policies are in play. It's the outcry of the surrounding communities that have a loud but powerless group that want people forcibly locked up. (Seattle here)
While funding is an issue, we used to do it. Attitudes changed. There's simply not a lot of support for involuntary psychiatric care outside some immediate emergency.
I'm not so sure it was due to attitudes changing. At least here in Ontario funding for many long term facilities was scrapped in the 1990s as governments slashed budgets for non-essential services to cut costs while higher levels of government downloaded services to lower levels. Smaller municipalities simply cannot afford to fund social services when property taxes are their primary source of funding. The effect was the same as the higher level of governments canceling many of these programs, albeit without having to take as heavy a political hit.
The same thing happened to many low income housing programs in Canada as well. Few people remember that there were once federal programs to provide affordable housing which were also part of the 1990s cost cutting exercises.
Locally we have a few long term retirement homes that are municipally funded, but capacity is very limited with long wait times.
Everyone I talk to in the US is in favor of reopening the institutions. Seeing a man with a gangrenous leg shitting himself while having a conversation with his “invisible CIA handlers” is enough to undo the Reagan era effects of seeing/reading one flew over the cookoos nest
It’s not. There are lots of “rights” people have to live untreated on the street
Where do you live and what happens to mentally unwell people in your society? [Just curious]
I live in San Francisco but am familiar with Denmark where it's relatively straightforward for a physician to involuntarily commit someone for ~a month at a time and the state to extend it in six month increments. To contrast, LPS in California limits involuntary holds to 72 hours and makes it very hard to hold anyone longer than that even despite recent reforms.
Who pays to keep a mentally unwell person at a hospital for six months at a time in Denmark?
The same people who pay to keep mentally unwell people housed in residential hotels with inconsistent (but expensive) social worker based health treatments, their ER visits, Medicaid, etc. in the United States. Big cities spend huge amounts per capita on public health. The difference in results isn't explained by the purse.
You already know the answer to that. It's the same for all social services.
Taxes
If you ever want to experience pure hell, go on antipsychotics for a month. They totally eviscerate your ability to be creative. I was given them during a misdiagnosis of mental health issues and I think I'd rather choose to be homeless instead of going back on them for any reason. Also don't make the mistake I did and quit them cold turkey. If you don't taper them off, you can have seizures. Not fun.
Not to take away from your own experience at all, but you can't make sweeping statements about psychiatric medication like that. As far as I know most of them are very personal, and it's quite common for any given medication to be a terrible experience for some while it's a life saver for others.
I'm sorry you had a bad experience with them, but that wasn't my experience. The antipsychotic I am on helps me immensely in not being sucidal and being able to live some semblance of approximating a normal human life.
This is noted as a common and serious side effect that many people experience. Unfortunately it's also noted as a symptom of the common diseases these medications treat. It's seemingly a mess of figuring out what parts of suffering are medication related or disease related. This is why this discovery in the article is so fascinating - science doesn't even know what causes this in the first place, thus it's impossible to decipher which is which. We just know it can address some symptoms in some people and in general some feel the tradeoff is better.
Your ability to be creative is a distant second to being able to take care of yourself.
You are not the only consideration, there is also the rest of the population. It’s not like we have some endless “West” you can go to and be by yourself.
When problematic people get put away, historically, it’s jail. Psychiatric institutions were considered an alternative that was better. Yes, way back in the day they quickly became really bad places, but if done better, are a far better alternative than what we do today.
I used to live near one. I remember they had extensive gardens because gardening was therapeutic for some of the patients, low cost, time consuming, had a reward, etc.
Should be obvious, but ability to function triumphs ability to be 'creative'. Hell with creativity in fact. It comes last in the list of priorities..
Not if your ability to make money is predicated on your ability to be creative.
I can tell you're not an artist
There is a lot of hope; I've had a pet "notion" for years that about every decade we look back at the previous one and wonder how we lived in such barbaric times, at least in terms of medicine.
'rituximab, the immunosuppressant. “I have a new working theory,” she texted Angie, in May, 2024. “Theoretically her chemo could have incidentally cured” her. Christine found a handful of recent case studies that documented drastic psychiatric recoveries after people were treated with drugs that dampen immune activity. '
The part I cared about, buried deep
Relatedly, I’m really curious to see if this will get more traction in the coming years. Seems like it’s worth some analysis: https://stephenskolnick.substack.com/p/schizophrenia
You can also have psychosis / schizophrenia type symptoms triggered by UTIs (urinary tract infections), this is not uncommon in the elderly.
I highly doubt there'll ever be research in this area, but I'm very curious about whether it'll ever be possible to induce schizophrenia for a time, similar to how psychedelics or dissociatives can induce altered mind states.
My friend in highschool did a solid week on lots of acid and mushrooms, and ended up in the hospital with a schizophrenia diagnosis - this was 20yr ago, but they said he was likely to get it eventually but he triggered something or otherwise sped up the process.
So you're probably right, but on both points sadly. To this day he still sends me complex CAD drawings of nothing.
Mushrooms and LSD have high tolerance from 24-96h where higher doses will not reproduce the same effects w/o abstinence. I find it hard to believe that a week's worth of exposure was the sole cause.
[s]: https://www.sciencedirect.com/science/article/abs/pii/B97801...
>but they said he was likely to get it eventually but he triggered something or otherwise sped up the process.
OP did address that. But
Lots of folks attribute things like schizophrenia to hallucinogen use, when in reality, people make questionable decisions in their late teens and early twenties; this is the time that these disorders tend to manifest. So a lot of coincidence leads to a casual relationship in popular culture.
I agree, most medications will create/change tolerance to more of the same. In some respect that's the purpose of taking some medications in the first place, but it can lead to poor long term outcomes. Take enough melatonin exogenously and your endogenous production stops completely.
“I took five people, and we locked ourselves in a building for three weeks, and we took 400 micrograms of LSD every four hours. That is 2400 micrograms of LSD a day.… We finally were just drinking out of the bottle.… We were very high.”
From Be Here Now - Ram Dass/Richard Alpert
Interestingly he was the guy involved in giving psilocybin to priests back at Harvard in the 1960's.
Recent source: https://tripsitter.substack.com/p/ram-dass
On the other hand, one single dose of a psychiatric medication can ruin peoples lives. They get brain shocks, sexual dysfunction or anhedonia for life. One dose of marijuana can effect similar outcomes.
I know immunosuppresants are whole separate part of medicine, but its a playing with fire risk/reward where its too early to establish reasonable probabilities. But at least we can begin the cause-effect discovery process.
I found a copy of Be Here Now in a thrift store that had a pressed marijuana leaf in it. First time I'd ever seen one. Bought the book and read it, pretty hard to digest and hippy trippy stuff but an entertaining read.
It's genetic predisposition to schizophrenia that enables psychedelics to activate it. Without the genetic predisposition you'd be lucky to get psychosis (or unlucky, as it were). That's why people with a family history of schizophrenia or related mental disorders are particularly encouraged to avoid psychedelics.
Psychedelics are known to occasionally activate schizophrenia in genetically predisposed individuals, so this is definitely not unheard of. Given how often I take LSD though, I'm fairly certain I'm not genetically predisposed to schizophrenia, otherwise I probably would've been in the 12th inner circle of schizophrenia by now.
(I've been trying to impact the stability of my brain for years. I just want a way to destroy rational thought but that isn't lethally addictive (benzos), or irreversibly neurotoxic (deliriants), or literal poison (alcohol). Harm reduction is such a drag, I just want to safely explore unsafety!!)
> I highly doubt there'll ever be research in this area, but I'm very curious about whether it'll ever be possible to induce schizophrenia for a time, similar to how psychedelics or dissociatives can induce altered mind states.
It is not possible, by definition; here’s a portion of the DSM 5 definition of schizophrenia:
“ The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition”
Hard to find a publicly accessible DSM link, but here is an excerpt
https://floridabhcenter.org/wp-content/uploads/2021/03/Pages...
> It is not possible, by definition
I use schizophrenia to refer to the experience, not to the diagnosis. I'm not sure what to call the experience of schizophrenia other than schizophrenia, given it's not synonymous with psychosis. (Though, granted, I would also want to try psychosis someday; even if it's a terrible experience and I never want to do it again, I want to truly know what it's like. Hopefully without permanent brain damage though. That stipulation heavily limits my options.)
This is true, but I wonder if GP spoke naively about inducing symptoms that are similar enough that we can learn about what triggers those symptoms in otherwise healthy individuals.
Kind of like how we were "lucky" to get a guy with a railroad spike through his brain to learn about how brain damage affects personality and impulsiveness..
oh it was definitely for selfish reasons, I just want to feel it for myself. But I do have a feeling that it would advance science as well, that'd be a cool bonus I guess.
This attribution criteria might be subject to revision based on research like this: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
We'll probably get it along with all the other artificially induced injuries: https://antifandom.com/hitchhikers/wiki/Pseudo-fractures
The redneck version: Take LSD and stimulants without sleep for days.
My understanding is that the Liver King, Brian Johnson, is basically doing that right now.
Not to be confused with "Don't Die", Bryan Johnson who wants to outlive everyone, and preferred 5-MeO-DMT.
Interestingly, he uses immunosuppresants as part of his anti-aging medicine/supplement regime.
https://medium.com/@x3em/from-depression-to-superhuman-bryan...
https://www.netflix.com/au/title/81757532
I actually have done this (not by choice though), and I guess I might've gotten close to something like psychosis. Maybe I'll push it further when I'm in a less stressful environment. I neglect basic needs too much as it is, hah.
If you want to experience another personality and/or view on things the better thing is Ketamine. Don't fuck with your sleep for some burnt out euphoria experience.
Always respect your sleep, it's the only thing keeping you from cooking your brain at 30. Anecdotal but my mate's mom got Alzheimers when shes like 55, an overworked overstressed, never sleeping woman.
Taking ketamine sucks. I actually tried with the nasal sprays before and I literally threw the spray bottle in the garbage because of how miserable that was. I didn't even get a meaningful experience out of it, but I burned the ever living fuck out of my throat from how bitter the stuff was. I heard IM injection works far better, but it's probably gonna take a long time for me to work up the courage for that.
(Also, I have DID so I experience other personalities all the time!)
I'm genuinely surprised, for me it's been doing medative self reflecting work for ages. I buy the shitty powder on $monerosite and systematically prepare a bunch to get into the "pre hole state" with banger ket music in the headphones and closed eyes.
It brings 5d chess into my psychology or something
I don't think the nasal route is good for me. Brain doesn't like it, body doesn't like it, it just feels extremely miserable. I think I tried it before the ketamine spray, but it would just dry out my nose and it was really painful and it just felt so awful that I couldn't manage to dose myself enough to have a good effect before I just couldn't bear to take any more. It's awful and terrible and I hate it.
Which sucks, because I really feel like dissociatives would be nice. I've taken memantine orally and it was nice, although it took really long to wear off, and also after a while it made me throw up all over my expensive tech, which was very not fun. Ketamine though I haven't found an adequate way to take.
I've never had ketamine. I've had memantine, but its half-life is ridiculous.
I self-medicate a variant of what's now available in the USA as 'Auvelity' but is just a ratio'd mixture of dextromethorphan and bupropion. The bupropion is there to slow down the metabolism of the DXM via its CYP2D6 pathway, but bupropion gives me anxiety/insomnia so I use something called berberine phytosome which isn't as effective but still works on CYP2D6 at a lower level, but no side effects.
All the other anti-depressant classes never worked for me but still gave me extremely shitty side effects.
There's a lot of anecdotal reports on DXM/Auvelity for both prescribed (variable outcomes, but for some people its the first thing that's ever worked), and recreationally its been around for ages sometimes referred to as the poor mans ketamine...
Not DID here, but schizo-affective. I've read things like meditation can actually have negative affects on dissociative disorders. Dissociating in order to re-integrate to a better place seems a somewhat reasonable strategy but I think mental-health/medication effects and understanding of how differently the same medications can affect different people is only just beginning to be realised by psychiatry now.
At least now there's even genetic testing for Auvelity - if you're already a poor CYP2D6 metaboliser due to a shortened version of a gene on a specific chromosome, they won't prescribe it to you. On the other hand you could be an ultra-metaboliser.
https://www.pharmgkb.org/gene/PA128/prescribingInfo
That’s not the redneck version, that’s the everybody version. You don’t need the LSD even, just pick a stimulant of choice, legal or not (meth, coke, adderral, vyvanse, Ritalin). Ingest it for days, you’ll be in psychosis in no time.
You're absolutely right, I'm quite liberal myself but I've never done more than "two days" for obvious reasons. We're evolutionary designed around earth's rotation so better not fuck too much with it.
I was drunk for almost two days once and at the end I couldn't comprehend conversation!
Definitely seems like the sort of thing that MKUltra would have looked at. Those folks were big into ideas like creating specific mental states in people.
I hope one day there'll be branches of medicine for each neurotype rather than just giving up whenever a drug's effects aren't consistent in trial. there needs to be more studies into everything ever
There is also some hope that a Ketogenic diet can help treat schizophrenia, maybe acting by a similar mechanism (reducing inflammation)
There are studies that going gluten free has positive health outcomes for schizophrenic patients. I could see keto working by the same mechanism.
Keto was invented for the treatment of seizures in children, actually. There's a guy I know that killed 2 people with his car when he had a seizure. He's been seizure-free (and obviously not driving, btw) for years since starting keto
Chemo could have modified her gut microbiome.
People went on keto diets etc... to heal their psychichiatric issues.
Eg the son of the Roblox founder healed his bipolar with a keto diet.
https://www.youtube.com/watch?v=ZwXKh7cjALw
This is a long read, so to summarize:
A woman developed what we call schizophrenia. She hid it reasonably well, but eventually was hospitalized for it.
Later they found cancer. While treating the cancer, her schizophrenia "magically" disappeared. Seemingly for good.
The article points that this isn't a unique case, and that schizophrenia, as a "hopeless disease," doesn't get enough attention... And there's no real sub classification to determine what lead to a set of symptoms (which is the only current diagnostic criteria).
So the speculation is that autoimmune treatments might cure or help some forms of schizophrenia.
Read the full article if this story sounds interesting!
I think the article is far more interesting than you make it out to be.
There is pretty clear evidence that some subset of schizophrenic diagnosis are due to autoimmune issues. If we can use antibodies in the spinal fluid to detect when autoimmune treatments can be effective in treating schizophrenia, that alone will be huge.
However, the even bigger insight to be drawn from all of this is the potential for other psychological problems that psychiatry has struggled to treat, to also have autoimmune causes. When you try to treat something that has multiple, quite different causes, with a single treatment, it makes sense that it would be hard to find that treatment that works reliably (as is the case for many psychiatric medicines.)
I predict we may eventually see immune antibody tests (or some functional successor) become a standard part of all mental health care.
For my money Rachel Aviv is the best and most interesting writer currently on the New Yorker staff (give or take a David Grann, who is pretty much just writing books these days it seems). I go out of my way to read whatever has her byline.
Immune antibody tests are already a standard part of a lot of mental health care, particularly psychosis. My wife tells me depending on the centre it may be mandated for all new diagnoses of psychosis. It is called an "organic screen".
I'm guessing that "organic screen" doesn't currently usually include antibody testing of CSF from a lumbar puncture since the article implies that only a limited number places do that screening currently.
> To find psychiatric patients who might benefit from immunotherapy, researchers have set up centers, roughly similar to the one at Columbia, at Baylor University Medical Center, in Texas; King’s College London; Uppsala University, in Sweden; and the University of Freiburg, in Germany, among other places. Some of the best research into the phenomenon has been conducted in Germany, where it’s more common for patients in a first episode of psychosis to have lumbar punctures to access their spinal fluid, which can reveal the presence of antibodies.
She did not have "schizophrenia" in the first place. The the DSM criteria may have overlapped, but bonafide schizophrenia comes with gray matter changes seen over fMRI.
The biggest clue is that she was never responsive to antipsychotics.
What we think of as schizophrenia today is almost certainly multiple underlying disorders.
Historically autism was lumped under schizophrenia and before that they were both lumped under dementia. Symptomatically similar with insufficient diagnostic precision or theory to differentiate.
Many things cause psychosis. Drugs are a good example. When first discovered LSD was often characterized as causing temporary chemically-induced schizophrenia. A useful metaphor but not accurate.
A large point of the article is that the search for biological markers of the disease have turned up nothing.
Unique biological markers, specific to schizophrenia. iiuc everyone with a mental health diagnosis has elevated markers for inflammation.
> but bonafide schizophrenia comes with gray matter changes seen over fMRI
According to who?
These clearly state in the abstract that there is gray matter loss in differing stages of schizophrenia, however it is unclear if it is as a result of common medications or the disease itself. It doesn't indicate that you can scan a person without any other knowledge and diagnose them with the disease. Gray matter loss can happen for other reasons as well.
i wonder if that has anything to do with putting someone with paranoid delusions into a loud machine that you explicitly state is going to scan their brain? maybe that's why there's no good imaging studies prior to drug intervention?
further i am having a hard time coming up with medical conditions that have a single test pass/fail like this.
Maybe, but I don't think most psychiatric patients are in a constant psychotic state that they would take such a strong stand on this. Maybe a few Ken Kesey characters depicted in a cartoonish manner.
But as the article mentions it's not a single pass/fail test they seek but any biological marker at all.
> further i am having a hard time coming up with medical conditions that have a single test pass/fail like this.
Famously, pregnancy...
The GLP-1 drugs are strong auto-immune regulators and neuroprotective and show promise with related disease:
https://www.mdpi.com/1422-0067/26/6/2741
https://aaic.alz.org/releases-2024/glp-drug-liraglutide-may-...
https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz...
https://pmc.ncbi.nlm.nih.gov/articles/PMC11242057/
Some promise for autism and depression, though little with schizophrenia:
https://www.psychiatrist.com/pcc/efficacy-glp-1-agonists-psy...
https://www.news-medical.net/news/20250511/GLP-1-receptor-ag...
Alzheimer's disease is not schizophrenia.
> And there's no real sub classification to determine what lead to a set of symptoms (which is the only current diagnostic criteria).
Is this not true of all things in the DSM, though? there's no "easy" test for ADHD or depression, for examples; fMRI might be able to distinguish, if the literature is to be believed. But generally you have to rely on what a patient self-reports, what caretakers/professionals observe, and what effects, if any, medication has on the symptoms.
I also wonder if just that microglia are activated during chemo. Maybe this is just the most useful case of 'chemo brain' ever.
The article is mostly about how there are now recognized to be certain schizophrenia-like conditions that are clearly autoimmune diseases. Mentioned in the article are anti-NMDA-receptor encephalitis, which responds to immunotherapy, and a previously published case of a woman mid-diagnosed with catatonic schizophrenia fully recovering after being treated for lupus with immunosuppressive therapy.
Based on this, the article suggests that the rituximab Mary was given along with chemo was the key. However, they were unable to test conclusively for antibody evidence of this theory after the fact.
I have a family member with an incidence of autoimmune encephalitis secondary to other conditions (my entire family is an autoimmune cluster) who is actually hospitalized for it now. This almost matches my experience to a tee, though anti-NMDAR was tested for and not found. The neurologists wanted to discharge prior to attempting immunotherapy and thankfully we were able to ensure they tried (pulse steroids).
It's certainly an area which can be characterized as rare disease, whether paraneoplastic or otherwise.
Probably why we keep looking at electroconvulsive ‘therapy’ again and again. Triggering the body’s systems to do something often cleans up other situations at the same time.
There was a phenomenon where sometimes a high fever would cure STDs like syphilis. We generally use antibiotics now that we have them, because they are less dangerous.
> would cure STDs like syphilis.
And sometimes certain cancers.
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It seems like we still have a lot to learn in this field of science.
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