Pre-psychosis: Things start getting a little strange

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Friday, February 24. 2012

Pre-psychosis: Things start getting a little strange

Remember how Russell Crowe in Beautiful Mind gradually slid into a paranoid psychosis, letting the audience experience some of the reality-confusion along the way? Ron Howard depicted this process well in that movie; the creepy feeling that things are getting a little strange.

It may not be a general-interest topic, but it is an issue which Psychiatrists are frequently presented. You consult with a late teen or young adult, usually on the urging of a parent, who has shown some decline in functioning and has some new anxieties and some peculiar symptoms.

A seasoned shrink thinks "Hmmm. This smells sort-of pre-psychotic but of course I might be wrong." (Much of medical care is as much art and experience as it is science. Never, ever go to a young doctor.)

Apparently our instincts in this area are right at least 50% of the time, which isn't very good.

This article at Neuroanthropology is excellent: Slipping into psychosis: living in the prodrome.

Posted by Dr. Joy Bliss in Our Essays, Psychology, and Dr. Bliss at 20:22 | Comments (6) | Trackbacks (0)

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Sorry but this is a little off-topic: some time ago one of the bloggers on Maggie's Farm raved about a book on geology and I was hoping you could repeat the title for me. If you could email me the title or respond here, I'd appreciate it.

I'm reading "An Accidental Sportswriter" right now but I think I'm going to finish it within a week or so.

Thanks! Eric

#1 Eric (Link) on 2012-02-24 21:48 (Reply)

Dr. Bliss, I recently watched a friend go around the bend into mania or delusion or psychosis. It's a sad sight to see.

#2 bill on 2012-02-25 00:49 (Reply)

If nobody goes to young doctors, where will the experienced old doctors come from?

#3 Hedberg on 2012-02-25 00:58 (Reply)

"At what point does our interpretation of the world become so fixed that it no longer matters “what almost everyone else believes”'

That point, every time and always precisely exactly at that singular (every time) point, is where.

Right there.

And the most important thing is to spend all your time arguing about what fits that point (you define) and what doesn't fit that point and why: Get paid.

#4 notquiteunBuckley on 2012-02-25 04:23 (Reply)

When I started in the field, the young schizophrenics tended to identify the CIA as the source of their troubles. The older ones sometimes focused on radio waves. Then the Godfather movies came out and the newly delusional thought the Mafia was after them. Later it was drug dealers, satellites, computers, and now belief in implanted chips is very big. Through it all, there are always a few focused on the Illuminati, or the TV talking to them.

All this to say, people pick up whatever is convenient in the environment around them to explain their odd perceptions. The brain seeks explanations, which is a strength, and a lot of how we have survived as a species. But what explanation can there be for impossible things? Only impossible explanations.

It is true that specific parts of the brain - the hippocampus certainly, but the anterior cingulate gyrus as well - all relating to memory, narrative, and comparison - are impaired and create anosognosia*, the inability to have insight. It is not stubbornness or denial which can be freed up by gentle speech and exploratory therapy. It's broken.

For those interested, I recommend Xavier Amador's videos or books. Sample: http://greatdanefilm.dk/web/Janssen-cilag/npa2011_13012011/npa_09.html

*If the word seems familiar but out-of-place, it is from neurology, describing the condition when people believe an amputated limb is still present, or do not recognise a body part as belonging to them.

#5 Assistant VIllage Idiot (Link) on 2012-02-25 21:57 (Reply)

I watched my husband slip into psychosis (but only had the term for it in hindsight). It doesn't only happen to young people as I found out, however it is rarer. My last words to him before our trip - "I think you need to spend 3 days in the Psych ward!" How I wish I had listened to myself.

#6 Jean55 on 2012-02-28 16:16 (Reply)

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Friday, February 24. 2012

Pre-psychosis: Things start getting a little strange