How Can Two Such Radically Different Experiences Both Be Called “Schizophrenia”?

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In The Lancet Psychiatry, psychiatrist Jose Andres Saez Fonseca disposes with the language of “the diagnostic manuals,” and intimately describes two troubled people he once knew, and the very different inner worlds each of them lived within. He then laments that “schizophrenia” seems to be a poor and misleading label for either of these people’s experiences, let alone for both of them.

“Comparing Jacks’ and Mr B’s cases, they seemed to me to be completely at odds with one another,” writes Saez Fonseca. “To me at this point in time, the term schizophrenia is the worst possible compromise. It does not seem to describe the disorder well enough to account for how radically it can change the reality someone lives in. Additionally, I believe it can prevent people from thinking…”

(Free registration) The wood for the trees (Saez Fonseca, Jose Andres. The Lancet Psychiatry. January 2015. DOI: http://dx.doi.org/10.1016/S2215-0366(14)00139-4)

7 COMMENTS

  1. Some patients have crushing chest pain with a myocardial infarction. Some feel indigestion. Others have shortness of breath as their primary symptom – yet, their pathology is the same. A single pathological entity may have multiple presentations.

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    • From Wikipedia:

      The main ways to determine if a person has had a myocardial infarction are electrocardiograms (ECGs) that trace the electrical signals in the heart and testing the blood for substances associated with damage to the heart muscle. ECG testing is used to differentiate between two types of myocardial infarction based on the appearance of the tracing. An ST section of the tracing higher than the baseline is called an ST elevation MI (STEMI) which usually requires more aggressive treatment. If this is not the case, the diagnosis is confirmed with a blood test (usually troponin)

      So what would be the psychiatric equivalent for determining if a subject has “schizophrenia”?

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  2. The etiology of “schizophrenia” can also be Wellbutrin withdrawal, worsened with a Voltaren overdose, and a very occasional dose of Ultram – mixed in with disgust at 9.11 and a cover up, via bullying by a pastor then also doctors, of the abuse of one’s child and a “bad fix” on a broken bone.

    What’s good is this is an iatrogenic form of “schizophrenia,” not a “life long incurable genetic mental illness,” as me and my family had been misinformed by many, many doctors. And it means it’s a curable form of “schizophrenia.” One just needs to get off the drugs and away from the child molestation covering pastors and doctors. And all the additional tranquilizers, “mood stabilizers,” “antidepressants” these doctors gave me, did nothing but make me sick. But of course they had lots of “major drug interactions warnings,” so these “medical professionals” who claimed to “know everything about the meds” should have expected their drug cocktails to make me sick, or kill me.

    Now this exact same iatrogenic pathway to “schizophrenia,” is also an iatrogenic pathway to “bipolar,” and “schizo-affective disorder,” and “adjustment disorder,” and “you don’t have a mental illness, and you’re really good at medical research, so you should probably go back and get your masters in public health” disorder.

    “I keep going back to what Thomas Insel, director of the US National Institute of Mental Health, said in 2023: ‘The strength of each of the editions of DSM has been ‘reliability’ – each edition has ensured that clinicians use the same terms in the same ways … It’s weakness is its lack of validity. Patients with mental disorders deserve better.’ I do not think schizophrenia is valid.”

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    • “I don’t think schizophrenia is valid.” I don’t think “schizo-affective” is valid. I don’t think “bipolar” is valid. I don’t think “adjustment disorder” is valid. I don’t think “ADHD” is valid. I don’t think “depression” is a valid disease, it’s an emotional state of being.

      The DSM is neither reliable, nor are any of its “disorders” valid. The DSM is not a “bible,” it’s a dictionary of stigmatizations. Or in other words, it’s a list of medical terms used to defame and discredit patients.

      Perhaps the U.S. medical community, who still largely claims to place full faith in the DSM, while using these stigmatizations for nefarious purposes, needs some insight from a real “bible”? “Do to others as you would have them do to you.”

      Is it time for some worldwide Neuremburg trials yet? “In a time of universal deceit, telling the truth is a revolutionary act.”

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  4. A friend of mine “diagnosed” himself with schizophrenia – he had all the “negative symptoms” and a few “positive” ones. In fact he just had a baby of his being born and a new job and he was constantly exhausted and lacking sleep. Fortunately that “diagnosis” was tongue in cheek and he knew better than to go and “seek help. Interestingly lack of sleep and stress very often come up as “symptoms” associated with states psychiatrists like to label as schizophrenia. It could be that many of psychiatric diagnosis of people in their young 20s are due to lack of sleep issues caused by stressful environment and demands of university or work life. A similar thing can be true for “post-partum psychosis”.

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