The Mystery of Urban Psychosis
theatlantic.com
theatlantic.com
I wonder how much of this mystery is based on spurious correlation -- people with mental problems fleeing rural areas and moving to cities, other (social) factors that are more common in cities and influence the probability of developing a mental illness.
> But none of this conclusively proves that cities cause schizophrenia and some argue the causal arrow actually goes round the other way. People with psychosis, the alternative explanation goes, are just more likely to end up living in poor city neighborhoods—something first labeled the ‘social drift’ hypothesis.
[...]
> . But we know this can’t explain what we see in modern studies because time spent in the city is also associated with your future chance of developing these experiences. A recent study led by Joanne Newbury at King’s College London even found this effect in children, who have little say where they live.
The 'molecular genetic data' there refers to using schizophrenia GWAS hits to directly measure genetic schizophrenia risk and using individuals' genes to predict drift:
> Third, we investigated to what extent polygenic risk scores for schizophrenia predicted residence in deprived neighborhoods during late adulthood using the TwinGene sample (n=6796)...the association between polygenic risk for schizophrenia and neighborhood deprivation was statistically significant (R2=0.15%, P=0.002). Our findings are primarily consistent with a genetic selection interpretation where genetic liability for schizophrenia also predicts subsequent residence in socioeconomically deprived neighborhoods.
Since schizophrenia genes cause getting diagnosed with schizophrenia, and also predict living in deprived urban areas, at least some of the common causation must be people's genes.
I like Sariaslan's paper a lot, because of how overkill it is: he uses three independent methods and large datasets (one population-sized) to triangulate the same unexpected & unpopular result - it's pretty much impossible to dispute the drift hypothesis now.
As GWASes continue to identify SNPs and create powerful polygenic scores, you can expect to see more of this: parallel confirmation of long-standing behavioral genetics results.
Yes, although it is not easy, perhaps it is easier to live as a person with schizophrenia in an urban environment. Although inadequate, there are more likely to be some mental health services, and urbanites tend to encounter and tolerate a broader variety of human behaviors.
I'm not familiar wit the the term social threat. Is anybody able to elaborate on the meaning on this term in the given context, or link to an explanation.
There's a strong case that Toxoplasma gondii, a communicable parasite, can contribute to schizophrenia or other mental illnesses:
http://www.cbsnews.com/news/cat-parasite-toxoplasma-gondii-l...
Other viruses have been posited as contributors to mental illness, and there's a relationship between schizophrenia and season-of-birth that may indicate prenatal/youthful infection with some otherwise mild seasonal illness (like flu) might increase the risk of schizophrenia later.
I started writing this in response to @Gibbon1's comment: Might be people suffering an episode of mania in a rural area pass unnoticed by the various authorities.
Which raises the question: which is better, to be noticed by the authorities, or to have your episode of mania / psychosis, and then return to your (slightly more?) centre way of being?
Presumably once you've had one episode that gets noticed by the authorities you then probably get 'treatment'. Yet do we even know what these conditions really are, and do the treatments work? If the definition of the treatment worked is that the person is too dulled or numbed to function well enough to have another episode then, in my opinion, we aren't really treating the condition, we don't understand it well enough to heal it.
The troubling thing is when the episode results in harm, or risk of harm, to others. With reference @Hydraulix989 comment, perhaps the ominous house up the road is a better place to be an in a city crawling with cops and psychiatrists. There are, or tend to be?, fewer 'services' for mental in rural areas, but maybe that's a good thing because I'm not convinced who the services serve.
Urban mental health services are a form of institutionalisation of people with mental health issues. The overwhelming dogma of the medical field is that mental health needs treatment of some sort. More recently we're seeing that treatment can include things like dietary or gut flora therapy, relaxation meditation, that sort of thing.
I was adopted, I met my biological parents when I was 22. Biological father went to high security prison for a home invasion and drug dealing / growing pot, biological mother lost access to her children for a good deal of time due to her wayward lifestyle. I ended up being charged with drug trafficking myself, and only just avoided a sentence when the charges were dropped due to the police's illegal methods. I have a couple of assault charges up my sleeve. I've experienced several 6 month periods of injecting methamphetamine 4 days out of 7, and longer periods of lesser usage. This one time I stayed awake for 6 days, my housemate was awake for 7 days. I have seen my own child a handful of times since it was born.
I've always made it a point to be very careful who I talk to about my internal experience, you don't want to reveal that sort of thing to the wrong sort of people and end up on a court ordered medication program. Ordinarily I'm quite normal and well behaved.
Through a set of pretty terrible circumstances I've moved away from the city I lived in, stopped contact with almost everyone I knew, and now live in a smaller city where I've had a stable well paying job for nearly 3 years, have had pre-approval for finance to purchase a house, and just put in an offer to buy a place. I would hope that, rather than end up on medication, or in a cycle of treatment and poverty, I become that ominous house up the road - I think that would be a better outcome for me. But perhaps I can live a relatively normal life if I make the enough of the right choices enough of the time.
I'm lucky that, given regular sleep, good nutrition, and plenty of exercise, and having avoided all of the doctors medications, and never spent a day in psychiatric care or prison, nor suicided, I can maintain my composure fairly indefinitely, I hope.
I'm not very good at intimate relationships, they seem to be a trigger for, or lead to a set of circumstances where I become unhinged, and having written all of this down for the first time I think I'm going to make a commitment to stay out of them.
That's one of the worst things about the war on some drugs in my opinion, it creates a social underclass with a massively increased chance of reoffending.
Good luck with everything and thanks for telling your story.
I tried to protect my girlfriend from the mental health profession, but made two little mistakes... The treatments are indeed quite harmful.
My comment on this topic from 6 days ago:
http://www.altruists.org/static/files/The%20Metropolis%20and...
>Our psychic activity still responds to almost every impression of somebody else with a somewhat distinct feeling. The unconscious, fluid and changing character of this impression seems to result in a state of indifference. Actually this indifference would be just as unnatural as the diffusion of indiscriminate mutual suggestion would be unbearable. From both these typical dangers of the metropolis, indifference and indiscriminate suggestibility, antipathy protects us. A latent antipathy and the preparatory stage of practical antagonism effect the distances and aversions without which this mode of life could not at all be led.
tl;dr: there is too much going on in the city to give a shit.