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Comment by sxp | Hacker News Reader

The author should have defined the term "schizoid" since it colloquially refers to Schizophrenia rather than Schizoid Personality Disorder. The former involves hallucinations and is also a pejorative used to imply that someone is "crazy". The latter is an extreme form of introversion: https://en.wikipedia.org/wiki/Schizoid_personality_disorder

DSM-5 criteria:

  - Neither desires nor enjoys close relationships, including being part of a family.
  - Almost always chooses solitary activities.
  - Has little, if any, interest in having sexual experiences with another person.
  - Takes pleasure in few, if any, activities.
  - Lacks close friends or confidants other than first-degree relatives.
  - Appears indifferent to the praise or criticism of others.
  - Shows emotional coldness, detachment, or flattened affectivity.

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The author did not need to define schizoid because:

1. It is their blog, and they probably assume their audience is educated in what schizoid means or is capable of looking it up.

2. Schizoid does not colloquially refer to schizophrenia, and schizophrenia is not a pejorative for "crazy," these are both real and distinct (but related) disorders that do not require anyone talking about them to dichotomize them from what you might assume people misconstrue their false definitions as.

Also, it's not an "extreme form of introversion" - it's much more than that, and putting it that way minimizes the serious nature of the disorder.

You're incorrect on point 2. In many communities, schizoid/schizo does refer in a derogatory/shorthand manner to schizophrenia and many more people are familiar with schizophrenia than schizoid disorder, so that is more likely to be the immediate assumption.

> 2. Schizoid does not colloquially refer to schizophrenia

It often does colloquially refer to schizophrenia, I've heard people use the word this way for as long as I can remember. General purpose English dictionaries document this colloquial meaning, I checked several to be sure:

"(archaic) schizophrenic" https://en.wiktionary.org/wiki/schizoid

"characterized by, resulting from, tending toward, or suggestive of schizophrenia" https://www.merriam-webster.com/dictionary/schizoid

"suffering from or behaving as if suffering from schizophrenia" https://dictionary.cambridge.org/dictionary/english/schizoid

"Informal. of or relating to schizophrenia or to multiple personality." https://www.dictionary.com/browse/schizoid

"Someone who is schizoid has schizophrenia" https://www.collinsdictionary.com/dictionary/english/schizoi...

Schizophrenia also has disaffected response and reduced emotional affect, btw. Folks who have schizophrenia sometimes considers this more debilitating than hallucinations, because they don't respond to antipsychotics.

The dilemma with these sorts of discussions always seems to come back to where the line is drawn between the personality and the disorder. Clearly there are some pathologies whose features manifest in ways that are dangerous (..to one's self and/or others) but it's not clear to me which of the criteria above rise from being facets of ordinary personalities and become truly pathological.

This seems to also coincide with other literature that describes those with SPD as being among the least likely to seek treatment.

The sexuality part is interesting to me, because gross biomechanics aside, it's one intense merging with someone else emotions. I'd be very happy to find places or people to discuss the neuropsy or neurobiology of this.

I assumed that it was a reference to D&G's Anti-Oedipus, that definition seems to make a bit more sense.

If you're uncomfortable with the term 'schizoid,' you can try medicating the heck out of it and calling it ADHD.

These are different things. They may share some overlapping symptoms, perhaps even some similar brain changes, but the internal phenomenology of them are quite different. They are not exclusive, but nor are they the same thing.

No, they're just different words and different times. Schizoids have a false mask they use to interact with others. If we could have, we would have medicated them back then so that they're always presenting with the false mask instead of their "wrong" asocial presentation. That's what ADHD is. We didn't suddenly stop having schizoids and start having a bunch of ADHD people.

No, they are different things. I am honestly quite confused as to how you could think that they were the same thing. They both exist as a constellation of separate diagnostic criteria, for example, and the internal phenomenology of both is different. You can have one, but not the other, or you could have both.

For example, here's a quora where someone with both talks about it: https://www.quora.com/What-is-the-difference-between-ADHD-an...

Or if you prefer a more 'scientific' source, here's one examining the comorbidity of ADHD and certain disorders, among which Schizoid Personality Disorder is one: https://www.elsevier.es/en-revista-revista-psiquiatria-salud...

They find a correlation, yes, but they are certainly not one and the same.

I mean, do you think ADHD is new? Did it just not exist before 1990 or whenever it was made up? Do you think any medical condition before then covers what ADHD is/was?

Lance Armstrong when he is biking and Lance Armstrong when he is recovering are not the same either. But Lance can take drugs to get more of the biking time and less of the recovering time. This is how SPD and ADHD work. ADHD is just a medicated false mask that a schizoid person can maintain for longer periods of time than usual, without episodes of hermitude to recharge. They're doping.

Failure to maintain the mask looks like a breakdown in attention/focus. People do long, focused work because of the expectations of others. Schizoids don't experience that, but instead basically run on obsession. They stop working when that fizzles out. On pills, though, they can work forever.

The 'scientific' people serve the people making the pills and nobody else. They rename everything every few years to sell more pills. If you want a proper take on SPD, look up Millon and his subtypes. Most of the "knowledge" of conditions in the zeitgeist comes from prescription drug commercials.

I'm rusty but ADHD was HKD (hyperkinetic disorder) in the olden times and had a much, much tighter criteria pre DSM-5? Think incident rates in Europe is approx. <2% under ICD-10 vs >10% in America due to DSM.

The major diff. iirc was no comorbidity in the case of HKD. If you were depressed or anxious you couldn't also have ADHD whereas in America we can just top up amphetamines with benzos and treat them both.

Make of that what you will $$.

I think you're being overly cynical. Of course over time as science advances we will recognize more subtle distinctions between things which we used to perceive as the same. That's how science works. Just because two separate things are similar and sometimes found together doesn't mean they are identical.

Whether something is a "disorder" or not is somewhat subjective and opinionated, for sure. But as someone diagnosed with ADHD, I often find that the expectations of modern society can be debilitating. Whether the disorder lies in me or in an unaccommodating society is an interesting question, but it is a separate one.

Please email me and take my personality test! Please. Y'all are like Bigfoot. You drop a wonderful comment like this and then disappear into the ether.

SPD has the worst outcomes of anything in the DSM. Only someone with SPD could possibly ever see it as the non-broken state, or as not a disorder. You're exactly the type of person I'm talking about. Do you see your vocabulary? Please contact me! I'm a philosopher working on a new model and could really use your point of data.

I don't think that your assertion makes sense in its own context. What you are saying is that "SPD" exists, and "ADHD" is just a modern rebranding of it. But why do you decide that "SPD" is the spot at which scientists got it right? Were they free from the corruption that you imply?

I agree with a general skepticism of the pharmaceutical industry. I disagree that all of neurology and pharmacology have been completely subsumed by that industry. It is not entirely free of it either, but there is more nuance here than you seem to be allowing.

The first prescription drug commercial aired in 1983. I discard everything after that.

I suppose that's one way to do it. I don't think that it makes any sense, but you're entitled to it. I do believe, however, that you are disregarding tens of thousands of principled researchers who have spent their life on this, and substituting outdated knowledge for it.

If you are at all interested in testing your belief, a highly accessible discussion can be found here: https://www.alieward.com/ologies/adhd

Millon's subtypes of schizoid don't at all resemble ADHD. Millon's subtypes are:

* aloof

* lethargic

* barren (intellectually)

* flat

* complacent or lifeless

None of these reflect ADHD, which is a dysregulation disorder resulting in the inability to form socially expected task-reward feedback loops. This means forgetting to do small chores once they leave one's sight even under the strong desire to do those chores, having strong emotional responses, needing higher levels of stimulation, and strong sense of impulse. None of ADHD has anything to do with whether or not one is displaying apathy or lack of interest in engagement broadly.

SPD is not a disorder of obsession. You might be thinking of the related-but-very-different Schizotypal, whose strange beliefs, sensory disruptions, and emotional impropriety I can see as potentially looking like ADHD.

You said it: Socially expected. They're failing to complete the loop because they're schizoid and social rewards aren't inherently motivating.

How do ADHD people act when their attention breaks? It's in the same ways Millon described. If you look at a schizoid person you can say that's the person and they have a masked state. Or you can see them as an ADHD person that has a checked-out state. But you're describing the same condition and the same person.

The ADHD approach is to medicate the patient so they can maintain the masked state for more of their waking hours. And avoid that terrible checked-out state! Except that's their real, schizoid personality. It's just less socially acceptable than the mask.

I didn't say it was a disorder of obsession. That's just their only tool for doing focused work if they don't have pills. If anything they struggle with maintaining obsessions. I'm familiar with schizotypal PD too and not accidentally talking about something else.

No, I don't think you understand ADHD. ADHD people do not behave in the way you describe when their attention "breaks". Their attention doesn't "break". Their attention is simply not regulated and so they will fail to perform tasks, which is not the same as having uninterest in those tasks which characterizes schizoid personality disorder. What you're describing as a checked out state is actually a reaction to frustration and distress that the ADHD person experiences as a result of being unable to regulate their attention long enough to perform tasks they want to do, which is not schizoid personality disorder characterized by not having a desire to form relationships and integrate with society. They're essentially completely unrelated conditions.

This also doesn't explain sensitivity to rejection or impulsive behavior typical of ADHD.

Again, ADHD is the mask state, it's not SPD. It appears opposite of SPD in order to mask it.

The frustration and distress are both there in SPD too.

Schizoids are indifferent to praise or criticism. Do you see how that's the opposite of sensitivity to rejection? Do you see how the schizoid's listlessness is the opposite of ADHD's impulsiveness? The mask is a compensatory state, like the narcissist's super-confident persona.

You have no idea what you're talking about, and yet you go on, and on, and on, speaking complete nonsense.

Knock it off.

Who are you?

SPD shares more similarities to Narcissitic Personality Disorder than it does with ADHD -- not in terms of effect and imposition on other people, but rather in the lived experience of self and other, self and world. I don't think SPD (or NPD) are something you can medicate.

Perhaps long acting oxytocin.

If we're going that route, I think it's more likely we'll see clinical outcomes with therupeutic use of psilosybin or MDMA.

I don't think it is so much that the brain needs to be tweaked, but that experiencing self, other, and world in a different ways can transform those in a way that does not require ongoing medication.

They're also kinda opposites. The cure for NPD is isolation and the cure for SPD is being around people (agreed-- neither are in pill form yet). They both have immutable internal status, but the narcissist's is very low while the schizoid's is very high.

The best example IMO of a cured narcissist is Larry Lawton, who faced a long period of isolation in prison. He's on Youtube.

That sounds like advanced depression

I see it as "depression with an onset in early life, probably from neglectful parenting".

pardon me for bringing the lineage argument, very often a neglecting person was neglected.. so on and so forth

Sounds like someone who has been betrayed one to many times.

Schizoid doesn't colloquially refer to schizophrenia.

It kind of does, even if mistakenly. People use "schizo" as a derogatory way to refer to schizophrenic and "schizoid" isn't a commonly used term; I have seen people use it this way.

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