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Comment by m_0x | Hacker News Reader

Pardon my ignorance and prejudice, but how are you not a danger to the people that surround you?

Or is schizophrenia a spectrum very much alike as autism?

Schizophrenia can be more or less severe. A schizophrenic with very mild symptoms, a stable life, access to food and shelter, no unhandled trauma, etc. can function and even thrive without medication. The disease can also get better with age.

Consider: you can hear voices and choose not to respond to them. You can have delusional beliefs and not act on them. There's no functional difference between talking with your mom on the phone and talking with an alien that has replaced your mom on the phone if you're willing to play along or simply acknowledge "hi schizophrenia, funny idea, that".

On point. Many people know that they have this problem and can act before it manifests in reality, through action.

"Or is schizophrenia a spectrum very much alike as autism?"

It is exactly that. There are a lot of people with pcychosis-related symptoms who go about their lives without treatment.

They experience attacks once in a blue moon, but that is just about it. A few calming words or moments alone help.

Adding to this, I've experienced a few psychotic episodes but am not (for now) diagnosed schizophrenic.

Even during my first episode, which was by far my worst while having the least experience, I was aware that what I was experiencing (hearing voices/feeling watched) was likely me experiencing psychosis. While I still 'went along' with the episode, I was doing everything in a way that minimised harm to myself and others. I eventually called an ambulance, thinking that either I'm going through psychosis (and need an ambulance), or what I was hearing was real (and having ambulance/police on scene would help).

Once the ambulance arrived I had 'confirmation' that I was going through psychosis, and could then 'ignore' the voices to the point that I wouldn't act on whatever I was hearing. My symptoms continued for a couple weeks, but at no point did I even consider these to be real (despite them feeling very, very real).

Going forward, I've had a couple other episodes, all of which I've noticed early on and been able to act accordingly (reaching out to friends or professionals). While some of these episodes were equivalent in intensity to my first episode, none of them had me acting on the symptoms (beyond calling my psych and saying I'm having an episode).

I was briefly on anti-psychotics, but as I'm yet undiagnosed, my psych wasn't comfortable with me being on them long term. Instead I've been able to manage it through exercise, sleep management, mindfulness, and better management of my anxiety.

That said, I'm only discussing my own experiences with psychosis/potential of having another episode. I'm not medicated but don't worry about it (potential harm to myself or others) in my day to day, though I make sure to mention it to those that could be affected (flatmates or friends/family).

Thanks for sharing your experience.

I remmember hearing voices a few times, but they would not last more than a day.

They were telling me to reach out to one person (that would be awkward at the time) or to harm someone close. I've felt fear but knew those voices weren't real.

The voice sounded like me talking to myself.

Normally mine last 2 - 3 days, with maybe a couple days of ramp up. These ones sound very real, exactly like the voice of a friend or relative etc. The thing that makes them especially feel real, the voices always have some 'spatial' element to them, like I'm overhearing a conversation from the other room. They also get quieter (or disappear entirely) if I walk away from the source.

The other form of voices I get, which are much more frequent + longer lasting, sound like my internal monologue. They can be different voices, but always sound like I'm 'thinking' them (rather than overhearing). These tend to last 2~ weeks after an episode, and come back when my anxiety or insomnia gets worse. Luckily these are pretty ignorable, if not a helpful sign that I'm nearing an episode. I'd compare them to anxious/intrusive thoughts (though a bit more intense).

I haven't had an episode in almost a year and have learnt to easily manage the intrusive thoughts (/possible start of an episode). This hasn't even impacted my lifestyle all that much, if anything it's taught me to manage my work/life balance.

Schizophrenics are less violent than the general population. In general, schizophrenia is not dangerous to others around, even untreated. People who are in a psychotic episode act oddly, which can scare others, but the perception of danger comes from that erratic action, not from actual danger.

"Individuals with schizophrenia are 4 to 7 times more likely to commit violent crimes, such as assault and homicide [4,5], and 4 to 6 times more likely to exhibit general aggressive behavior, such as verbal and physical threats [10,11], compared with the general population."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852683/

That isn't to say that schizophrenia necessarily causes the violent behavior: the two variables might not have any causal relationship at all. But the correlation is there.

Huh! Thanks for the reference. I think that my perception was based on one of the studies the review mentions that found schizophrenics weren't more violent. Wasn't aware of this other research.

I've read disengenuous claims that they're less violent, but omit any mention of per capita risk.

hey, that was a pretty, uh, stigmatizing statement. schizophrenics are no more of a danger to others than the general population. It is because society treats them like shit and so they take drugs to cope that makes them violent.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852683/

"Patients with schizophrenia without comorbid substance abuse have only a slight increased risk of violent crime compared with the general population, suggesting that substance abuse plays a mediating role."

What proportion of the general population's violent crime is caused by substance abuse? If around 40% is attributable to substance abuse[0][1] then you're comparing clean schizophrenics, for whom 0% of crime is attributable to substance abuse, to a population where 40% is.

Note that "attributable" doesn't mean causation, but in reality it usually indicates it to some degree.

[0] https://pubmed.ncbi.nlm.nih.gov/33739484/

[1] https://www.aic.gov.au/publications/tandi/tandi439

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