What Developing Acute Schizophrenia Feels Like | Hacker News Reader

What Developing Acute Schizophrenia Feels Like

vice.com

158 pointsshill73 comments

i had this same experience in mountain view just two years ago; i think it was caused in part by my startup collapsing and my mind trying to make sense of what happened.

i had the same problem with being unable to sleep; the same sense of conversations and thoughts being unfocused. it was like tripping 24/7. i felt imbued with purpose and meaning; this life was a dream.

i was working at game closure (now weeby) at the time, and i thought the whole company was a front - what we were REALLY doing was putting together a team that was going to mars together. that explained why everything changed and the plans were always in flux - it wasn't really about building games; it was to see if we could work together and still get along while constantly being frustrated by plans that would be started and then dropped.

things were made worse by the fact that this was late 2012 and i really believed the whole "mayan apocalypse thing" was actually going to happen. something internal took over in early december - around the time things were "supposed" to go down, and it felt like i was living in a combination of snow crash, anathem, and "city at the end of time" - another sci-fi novel.

my mind was interpretting everything that happened around me as having meaning at 300 different layers. i could see contrails around people as they moved, as if i were able to see the multiverse unfolding around me. it was exciting and terrifying at the same time.

i tried telling people that i sensed something was wrong, but nobody was sure what to do. i kept telling people around me that there was an 'cacophany of mental imagery' - but i guess my ability to hold it together convinced people i was fine, until i wasn't.

If you don't mind, can you talk about how you got help?

i tried flying to ohio to visit my family for christmas.

i made it onto the airplane without my drivers license (which i had lost) or my passport (which i had believed was stolen, turns out i had just lost it) - using my social security card and birth certificate as id. I thought this was like... some kind of trial... to prove that you could still use ancient forms of identification in the modern world.

i had a layover in dallas. i was in the airport, trying to stay calm while imaging the entire world was watching me, angry at what i was doing. i sketched out proofs of the pythagorean theorem to try and keep myself grounded. i felt like anyone who could see what i was doing would understand that i was rational - although imagine seeing some guy, rocking back and forth scribbling on paper in the middle of DFW airport.... i can't imagine how i didn't get arrested.

somehow i became convinced that i was an evil person and that the flight i was getting on was going to be shot down for my sins... i didn't want to endanger anyone on the flight, so i got the idea that i'd walk to ohio. i walked out of hte airport, managed to hitch a ride, engaged in some dialog with the driver and had a repeat of a conversation i felt like i had 40 times in the past two weeks - ending with the stranger saying "you are loved" and me feeling really scared.

the guy dropped me off at a hotel. my dad paid for my room that night over the phone, and i was planning on going to the airport to 'try again' the next morning, but i was just too damn scared of falling asleep. i went to the front desk and said i needed an ambulance, they took me to a hospital.

i spent a few days in recovery there, heavily sedated and on a bunch of medicines. they basically slow your mind down like crazy. after 5 or so days there, my dad made the drive from ohio to pick me up, and i spent christmas with my family.

i made it back to california - people were nervous - and i was enrolled some programs through kaiser. i ended up getting hospitalized twice during january 2013; everyone was ready to give up on me, but i kept going because i didnt' really have a choice, and my then-roommate now wife believed in me... i guess i'm still not sure why. i love her.

i managed to keep it sane and together to interview with google, facebook, and another company - electric cloud. i ended up taking the job at google because i wanted to be a tiny cog in a huge machine. i wanted to not matter for a while, so i could truly believe the world would keep doing its thing without me.

being in the startup i felt like the whole world was in my shoulders. this was clearly an exaggerated sense of self importance - which is both helpful in the short term because you can work harder, and wildly destructive in the long term. at google, it felt like nothign i did mattered, my job was boring and i knew i could be more productive, but it felt like the 'punishment' i needed after having been overstimulated for so long.

i managed to quit smoking weed - i'm almost to 1 year now - over the course of 2013, and now i'm doing far better. i ended up leaving google for electric cloud, and after a year of that, i left electric cloud for facebook. facebook has been awesome - by far the most supportive place i could be - but i think if i'd gone there in early 2013, i would have had a "false recovery" and been right back to overestimating my own importance and place in the universe.

Thanks for your story... I'm wondering if you felt or are people able to feel they start developing schizophrenia before they are unable to understand it? I have many bad symptoms, paranoia, have had few psychotic episodes (one was when i smoked mariujana a lot..) but i haven't gone out much in 5 years and haven't socialized much either but i cant remember many things I've done in past years.. I spend most of the time reading articles s, hacker news, do some programming i barely sleep..

yeah, i felt i was developing it too. marijuana was really, really not good for me. http://reddit.com/r/leaves really helped me quit.

Since what age or for how long until the reality was mixed up?! Thank you for the link but i dont have marijuana addiction, i just can't do it.. Unfortunately have and had other addictions

That sub's name is the best pun ever. ("Trees" is a slang term for MJ buds.)

Wow. That is quite the story.

I'm glad you're doing better, both mentally and career-wise!

thank you!

i feel like the 'end' of all this was the development of my prefrontal cortex. a little late - age 28 or so - but right around on schedule, maybe delayed a bit by the marijuana.

i finally got to a point where i was capable of focusing on and thinking more about how things _are_ than on how i wanted them to be. it's amazing what that does for a person.

here's an example of where my head was at the time:

https://plus.google.com/107304794162956058165/posts/LUDoquxe...

Sounds like hypomania triggered by the stress. You may be a mild case of bipolar. Definitely avoid marijuana.

It's interesting that both the author's story and one other in this thread so far both mention their significant marijuana usage.

While the "marijuana causes schizophrenia" hype is statistically exaggerated (and the opposite causality may actually be the case), it's still a good reminder to perhaps avoid or severely restrict usage if you have a family history of the condition.

Proof by anecdote, n=2. I'm not saying you're wrong, I'm just saying that two stories have little statistical significance, if any at all. Taking life decisions based on such information is, in my eyes, unjustified.

Reliance on anecdotes is driven by paucity of statistically meaningful data. Reminding people that the former is not as good as the latter is unhelpful. Anecdata is still data.

It's like saying "Everyone I know who got suicidal depression consumed alcohol - better stay away from alcohol" You'd be surprised how common it is for people to take THC in one form or another. It is literally meaningless to pull two stories together and derive a causation.

It's not at all proof by anecdote. He's saying that there's some evidence the two are linked, and that these anecdotes should remind us of this evidence and to use caution accordingly.

I too found this interesting. I wonder also whether this particular individual was misdiagnosed as schizophrenic. Sounds pretty similar to a bipolar episode of mania, and marijuana is a documented trigger for bipolar mania.

I'm not a doctor, but I have a friend who is schizophrenic, the feeling of hearing cacophony, as well as believing people are hiding in cameras, and things are always about to fall are pretty good indicators. So many mental health issues are on a spectrum where one or two bits overlap with other diagnoses, so it's often hard to pin just one.

I agree, I get the impression that this was a temporary psychotic episode possibly triggered through sleep deprivation, heavy use of cannabis, and maybe some underlying mental condition. Schizophrenia is typically a very chronic condition and doesn't manifest as only one psychotic episode per year.

I'm no doctor, psychiatrist, or psychologist, but I think his diagnosis is probably closer to "psychosis not otherwise specified".

However, he did mention that he is still taking the anti-psychotic medication, which can indeed inhibit the effects of schizophrenia for a long period of time. If he stops taking the medication and encounters psychotic symptoms again, then it probably is schizophrenia or similar.

It doesn't sound like a typical manic episode at all. Perhaps a mixed episode (mania and depression at same time, or dysphoric mania) with psychotic features.

"Schizophrenia" is a weird term and diagnosis, because it's probably many different diseases. I'd guess that most of these mental illnesses are symptom profiles related to dozens of different physical maladies. The symptoms were clearly psychotic (not all mania is psychotic, and hypomania rarely is, unless you include the benign religiosity) but I don't know (having experienced neither psychosis nor schizophrenia) if it's of the same character as what people with chronic schizophrenia experience.

Correlation is not causation.

Absolutely true! But it seems like playing with fire to use a powerfully psychoactive drug like hash when one has such symptoms. He doesn't seem to mention that he stopped smoking up. Common sense tells us that would probably be a good idea.

You sound like a completely sane person.

The use (abuse) of substances is widespread among large swaths of the majority of mental illnesses. Associating the use of marijuana specifically with schizophrenia is absurd-- schizophrenics also abuse alcohol, does that mean wine causes schizophrenia?

I speak not only as a person with a mental health disorder (bipolar) but a member of a family with several actual schizophrenics.

Correlation is not causation. Downvote as you will.

I strongly support the legalisation of all drugs.

> Associating the use of marijuana specifically with schizophrenia is absurd

It's not absurd. There's strong correlation between people who have a psychotic illness and previous cannabis use.

There are several different things people say about psychotic illness and cannabis.

i) smoking cannabis causes psychotic illnesses even in people with no underlying illness

ii) cannabis causes psychotic illness in people who already have a previously unseen underlying illness

iii) cannabis triggers episodes of illness in people who we know to have a psychotic illness

iv) cannabis has no effect either way

v) cannabis has high correlation because people are self medicating

vi) cannabis is protective

If you have a family history of psychotic illness it's probably a good idea to be cautious with drugs. That's not a controversial statement and it's intensely frustrating when people ignore any possibility of harm from cannabis. (The illegality of cannabis, and the ethics of research involving people with such a severe mental illness, mean that the research is not very good.)

(Also, if you're on certain meds you should stop smoking because the hydrocarbons in smoke interact with the meds).

http://www.nice.org.uk/guidance/cg178

> Offer people with psychosis or schizophrenia who smoke help to stop smoking, even if previous attempts have been unsuccessful. Be aware of the potential significant impact of reducing cigarette smoking on the metabolism of other drugs, particularly clozapine and olanzapine.

alternatively a desire to abuse cannabis might be a warning sign that you're developing a psychotic illness.

How does one abuse cannabis?

I don't ignore any possibility of harm from cannabis, but I do tend to frown on FUD like this about pretty much any substance. If this comment thread were about vaccines rather than something more traditionally controversial like marijuana, I think more people would feel the same way.

(Just for the record, I'm not a marijuana user.)

But we have so much evidence to show that vaccines are very safe. We do not have that evidence for cannabis. We do have strong correlations between people with severe mental illness and cannabis use and that has not been explained yet.

Letting people know that there is that strong correlation and suggesting that they be cautious, especially if they have a family history of mental illness, is totally different from vaccine-FUD which is nonsense.

It's a very good reason to investigate causation. This comment gets tossed around all too often by armchair scientists with a political agenda.

I think I had a taste of psychosis after smoking too much weed one time: I totally lost the sense of time, my brain was overflowing with all kinds of thoughts and fears, had some auditory hallucinations and totally misinterpreted people's behavior (everyone suddenly seemed hostile). Then a panic attack followed and I felt stuck in some crazy time loop that would never end. That's why i don't experiment with marijuana or other psychoactive substances, the effects are too similar to a mental illness in my case.

https://en.wikipedia.org/wiki/Derealization?

This is what happened when I smoke weed and because of it I avoid it.

Good for you (and dfischer) for recognizing this reaction and removing this item from your diet as a result.

I love weed (smoking some right now) and feel that I strongly benefit from having it in my diet, but I have a lot of respect for people who remove it to their own improvement.

Agreed - this is the biggest issue of cannabis legalization from a public health perspective, in my opinion. (I'm still for it, but with major safeguards in place). My brother developed acute schizophrenia after spending his late teens dabbling in psychedelics and smoking weed often, and I can't help but wonder if the absence of those triggers might have changed the course of the disease. Despite dabbling myself, if I ever have kids I'm going to try to make it clear to them what the stakes are for people with family histories like mine.

Sufferers of schizophrenia have also been shown to have a very strong preference for smoking tobacco, so the question still remains unanswered whether people with schizophrenic tendency merely have that similar preference for marijuana, and whether that use might also trigger or exacerbate the pre-existing mechanisms for schizophrenia in their brains.

Someone else mentioned bipolar disorder, and it's interesting to note that schizophrenia, schizoaffective disorders, and bipolar disorders share a similar relationship to dopamine, and so the primary method of action of many anti-psychotic medications is to block dopamine reuptake.

Also interesting is that things like alcohol withdrawal, amphetamines, and marijuana deplete dopamine while tobacco, heroin, and cocaine stimulate its production.

do you have a ref for the differential regulation of dopamine synthesis by amphetamine and cocaine?

I don't, and I see that I implied synthesis when I should have said that they only inhibit its reuptake, except for amphetamine, which also stimulates dopamine release.

Here's a general article on it: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC368179/

Good catch.

It happened to me at DEFCON. I was drinking a lot, and I ate an entire bag of marijuana popcorn, and probably some other stuff. I blacked out, but the stuff people told me I was doing was pretty weird. The stuff I remember about the crazy ward I woke up in involves sobbing, screaming, and being absolutely certain that the doctors were getting ready to remove my organs and sell them on the black market. I tried to escape but I couldn't figure out where the exit was. In the morning when I was finally sane again, I had huge cuts and bruises all over and bloody knuckles. I was told later I tried to punch a very pretty medic in the casino my friends were fireman-carrying me through, so I can't imagine what I might have done to whomever brought me to the hospital.

To this day i've never felt anything as extremely horrifying, and I also now know what it feels like to resign yourself to death. Incidentally, for months afterward, heavy drinking resulted in word salad. Once I drank too much at a club and tried to walk out of south beach, because aliens had taken over the island. There might have been other substances involved but I don't remember.

I've never done a study of my own experiments with pot, but generally speaking if I took it by itself, I was fine, with the usually documented side-effects. Other times i've tried marijuana (typically with alcohol) i've ended up like others have mentioned: misinterpreting behavior or intentions of others in potentially bad ways. Luckily by that point I was aware that my mind would simply make shit up when I was on drugs, so I would just hide myself until the effects wore off.

Don't do drugs, kids.

Watching my brother go through something similar has been one of the hardest things I've ever watched. He's pretty heavily medicated now and has struggles to maintain "normal" relationships or a work life... After years of taking care of him, though (and him actually graduating college and getting a job), I had to start focusing on my own life again. I still feel overwhelming guilt for moving away.

He's a veteran (did not go to war, though, discharged with the health issues) so it's been even harder watching him try to make sense of it all with a system like the VA.

My youngest brother was diagnosed with schizophrenia about 4 years ago (though it took over a year of him having symptoms before getting a diagnosis). It's been incredibly difficult -- he's had a couple runs through the hospital and it was terrifying to see him there, and to see the confusion in his face as to why he was there. Through the wonderful care of my Mother, he's been stable for the last two years and has insight into his illness, which means he takes his meds and generally is open about talking about when he's symptomatic. It's a constant battle, though, and it's hard to face the fact that he'll never get better.

My wife and I attended a 12-week NAMI course (taught by my Mom, actually) and it was incredibly beneficial. The course is designed for anyone coping with a family member with a mental illness. Check out http://www.nami.org/ for resources and to see if there is a course in your area.

Just had to chime in because my story is similar (and I rarely get the chance to talk about this stuff because, frankly, no one really enjoys talking about it). My younger brother also developed symptoms of schizophrenia about four years ago, and was recently diagnosed with it. Unfortunately he basically hasn't left my parents' house for the past 18 months or so (he had a psychotic episode that resulted in arrest/hospitalization and was forced to drop out of the Ivy League graduate program he had been in). We can't get him on any kind of medication because his religious mania causes him to reject western psychiatry.

My parents also recently started attending a NAMI course and it seems to be helping. I recommend it to anyone going through a similarly painful situation. The hardest thing for me is the lack of insight in my brother (in the psychiatric sense of the term) - how to convince someone they're insane? I have to assume that it'll come from him rather than us if it does, but he seems to be losing grip on reality more and more with each year. I'm curious if you or anyone else in a similar situation can talk about how that breakthrough happened and if there's anything to be done to encourage it.

Good thing he lived in a country with a sane healthcare system. Imagine getting this in the US and having poor or no health insurance and having no family nearby.

I didn't notice the article mention which country he lived in, did I miss it?

It's one of the tags at the bottom, the UK

They also mentioned NHS throughout the article.

One of the drugs for bipolar disorder is ~$1000 without insurance, $200 with. What is a person suppose to do?

When I was without insurance, I got by on places that offered sliding pay scales and drug samples. There's always options. But the far better option is to not let the population suffer without basic health care.

I am a forensic psychiatrist. What happens too often here in the US is that the person who needs treatment ends up doing something that gets them arrested. Then they may (or may not) get treatment through the justice/correctional system.

In the wake of the closing of thousands of psychiatric beds, we call this "trans-institutionalization." It has also become more difficult to hospitalize and treat people against their will. Both of these changes were well-meaning, and sought to curb abuse (some real, some imagined). Some old psychiatric hospitals were bad places, but after they were closed there has not been an effective replacement. That makes jail/prison the default result for far too many people.

My sister wasn't qualified for $1 Abilify, because it's refunded only for schizophrenia, not other related disorders. Full price was $130.

We were buying it second hand on internet (on classifieds site), for $15. So it's a good alternative.

Unfortunately when she learned about this site with drugs, she bought some barbiturates for suicide in forest. She was 4 days in coma but survived without any problems.

I'm glad she survived and is okay. Good luck to your family.

You mean like denying schizophrenics access to the best drugs?[1] Sure the article is from 10 years ago, but NICE does have the reputation for denying access to new drugs.

"Thousands of people with schizophrenia are being denied modern medicines on the NHS, according to campaigners."

[1]http://news.bbc.co.uk/2/hi/health/2538621.stm

You post a link to an article that has guidelines from NICE recommending the use of newer atypicals and health authorities not funding those and going against the NICE guidance.

I'm not sure how you get to "NICE deny access to latest drugs".

Do you have any examples where it was NICE not recommending latest drugs, and not health authorities failing to buy those drugs? Especially more recent than ten years ago, and especially if the meds work?

Sure! How about last August?

http://www.telegraph.co.uk/health/healthnews/11018039/Revolu...

That's a much better link.

Even though Breast Cancer Campaign receive funding from Roche they place the blame pretty squarely on Roche for unrealistic pricing.

Of course NICE rejected this medication - one of the functions of NICE is to drive costs of medication down. There was, and still is, a problem where drug companies make drugs that offer a few months of extra life and who then fund patient activist groups to advocate for those drugs to be prescribed. (This drug provides a bit less than six months of extra life so it's pretty good. Other drugs were about as expensive and it wasn't clear whether they offered a week or so extra life, or none.)

The drug is still available through the cancer drugs fund. And even if the price dropped to a point that NICE would recommend it it would still be so expensive that it would be available through specialist commissioning.

http://donate.breastcancercampaign.org/document.doc?id=82

Yep, that he had a healthcare worker visit him weekly after his diagnosis is huge. I have ADD, and when I get on new health care, the options they provide for treatment/care are really really poor. When I was at university, it was much different though, they offered weekly sessions with a psychologist as well as hands on time and task management training.

The larger health care options in the US are basically: go to a group meeting once every 4 months, and meet with a doctor maybe once a month at most, and receive a lot of suspicion. It's pretty shitty, hugely time consuming and offers very little in the area of actually improving my condition and behaviors.

You are oversimplifying the issue.

For instance, we actually have tried something like the NHS in the US, it's called the VA, and it's much, much worse than the regular US healthcare system.

Yes, it is much worse and poorly run, but the VA isn't exactly open to everyone - they only take Veterens. In contrast, NHS is open to everyone, though people do have the option to pay more for private care and/or private health insurance.

Its interesting, his descriptions of some of the early signs--inability to sleep with thoughts moving in odd directions, slow uptake of speech, disconnected situational awareness--are very similar to the sensations I get when (as a diabetic) I misjudge my insulin and my blood sugar drops dangerously low. I'm sure there in no relation, but I can sympathize. The first few time it happened to me were all in the space of a few days and I was convinced that I had a brain tumor or similar.

Yeah, hypoglycemia sucks. I was diagnosed hypoglycemic back in high school, after two episodes of blacking out between calculus and band class. I also feel spacey and disconnected and unable to process language when my blood sugar drops, and just before blacking out I'll usually start either laughing or crying uncontrollably. When blacked out I can still walk though. The second time I walked straight into a pole, according to my friends, though my memory stops a good 20 feet away from the pole, just after saying, "I think it's happening again," and starting to laugh even though I was terrified. I have a brief memory of standing in front of pole, then nothing again until a good ten minutes later, in front of a water fountain in the school office (which is where my friends steered me).

When it first happened I literally thought I was losing my mind, due to stress or a tumor or something. When the doctor calmly said, actually that just sounds like low blood sugar, let's schedule a glucose tolerance test, it was a huge relief. I was on "second lunch" due to my class schedule, and wound up getting permission to eat a protein bar during calculus so it didn't happen again in school.

Another really good read covering what it's like going through psychosis is "And Then I Thought I Was A Fish" by Peter Welch, covering a three year long psychotic break he had after taking LSD. (He's the writer of http://www.stilldrinking.org/programming-sucks, a hilarious blogpost I saw linked on HN a few months ago).

This kind of information is really good to know. I'm so glad some victims of schizophrenia have the courage to discuss what happened.

He really needs to lay off the illegal drugs and the constant TV, concentrate on his real life, and get a nice quite place of his own. As someone who hears voices occasionally (not that odd considering studies show auditory hallucinations can come from caffeine and lack of sleep), just a TV going somewhere in the house three rooms away can make it a lot worse. I can't even image what it is like for someone "with plenty of hash", diagnosed schizophrenic, and who mentions so many TV shows constantly being watched in the article and even by his parents. Marijuana and constant TV might be fine for some people, but if you are hearing imaginary voices, maybe you should lay off. The situations in TV and particularly the shows he mentions, like Breaking Bad, are really not the sort of things you want a paranoid schizophrenic mind to seize upon. You may wake up thinking the cops are after you just like your favorite TV show.

Hmm... lately I've had the "things falling over" sensation a lot. I'll jump and move towards an object because I think it's falling, but it's not. Does this happen to normal people too?

No.

But I wouldn't worry too much if that is the only symptom you share with the OP.

It's weird they have disabled voting of this story and it also disappeared from the front page(s) had to use history to find it..

It just means that enough people flagged the post that it set off the flame detector, which takes it off the front page and disables voting. It almost certainly wasn't anything one of the admins did.

Still, it's very sad that this community as a whole isn't open-minded or mature enough to discuss mental illness. I guess it's not surprising, but stories that make people feel uncomfortable are very frequently flagged off the front page.

That said, HN is still the source of some of the highest-quality discussions of various (non-controversial) topics on the web.

Similar story happened to a friend of mine, all of a sudden she starting seeing eastern-style patterns everywhere, on people like tattoos and so on. Too much pot.

I have noticed several posts related to mental illness recently. What is this in relation to? Deep learning? Productivity via mental health? Fill me in.

It's probably just curiosity about how our own brains work, and what they're capable of.

Growing public awareness and dialogue on issues that affect a lot of people. Plus high profile suicides and other incidences in the startup / tech industry.

I really wonder if his Mom making him go for a walk every day did more than the drugs. For me exercising EVERY day has more impact than all drugs.

OP: if you're reading, thank you for your courage.

Reply on news.ycombinator.com