According to the biological model of modern psychiatry, the term schizophrenia refers to a chronic, severe and disabling brain disease. It is characterized by several distinctive and predictable symptoms, including disordered thinking, delusions, and hallucinations. In many cases the so-called schizophrenic person may become withdrawn or paranoid, and act in ways that frighten and worry other people. People with schizophrenic behaviour often find it difficult if not impossible to function in the “work-a-day” world, and because of this, find their behaviour labeled as a disorder.
Schizophrenia is a condition that is thought to affect about 1% of the population at some point during their lives. It is a condition that is independent of culture, religion, or race, and is found all over the world. The signs and symptoms associated with schizophrenia appear to be equally distributed in both men and women, although the condition often appears earlier in men, usually in the late teens to early twenties. In women the condition typically appears somewhat later, sometime in the twenties to early thirties. While there is no known cause for schizophrenia several theories have been offered, some of which will be reviewed in this text.
Schizophrenia often has what appears to be a fairly rapid and dramatic onset, although schizophrenic people will often state that some elements of the condition extend far back into their childhood. At some point however, the symptoms experienced by schizophrenics intensify, and are noticed by family and friends as shocking changes in behaviour. The sudden onset of these symptoms are what psychiatrists call psychosis, a state of mental impairment characterized by multi-sensory hallucinations and delusional states. Other symptoms that may precede, accompany or follow these psychotic episodes include social isolation and withdrawal, and unusual speech patterns. Some people only ever experience one such psychotic episode, whereas others may experience these symptoms intermittently. Some people however are termed chronic schizophrenics, and never really display normal patterns of behaviour and usually end up being medicated or hospitalized for their entire lives.
The hallucinatory and supposedly delusion states of schizophrenics has been well-described by mental health practitioners over the years. What are termed distorted perceptions of reality cause the schizophrenic person to become confused, anxious, or frightened, leading to what others would typically observe as unusual and bizarre behaviours. The schizophrenic may become socially withdrawn and distant, sometimes sitting quietly or not moving for several hours. Alternately, the schizophrenic may become highly agitated, constantly moving about, wide-awake and alert. Schizophrenics will often speak of unusual sensory perceptions, hearing, smelling, seeing, feeling or tasting things that other others do not experience. They may hear voices and as a result carry on a conversation with themselves, leading observers to presume some kind of split-personality syndrome. In about a third of schizophrenics such alterations in perception lead to what are apparently delusional states, in which the schizophrenic believes that they are being persecuted, chased, or poisoned by other people. They may believe that they are someone extremely important, or that the function of the universe depends upon their actions. They may interpret what appear to be random events, such as a news report on television, a bird that lands in a tree next to them, or a book opening on a certain page as being highly significant. In many ways these states resemble those experienced by non-schizophrenics under the influence of psychoactive substances like LSD (d-lysergic acid diethylamide), DMT (N,N-dimethyltryptamine), or psilocybin. In fact, modern psychiatry doesn’t distinguish much between the schizophrenic state, and whether it is caused by exogenous or endogenous factors.
Among the greatest concerns for schizophrenic people is the issue of violence and suicide. These concerns are echoed and amplified by the media and modern folklore, in which unexplainable criminal violence is often linked to a kind of madness that is equated with the symptoms of schizophrenia. Research indicates however that schizophrenics are unlikely to be violent, and in most cases, prefer to be left alone. Where violence does occur among schizophrenics it is often the result of acute states of psychosis, typically brought about by substance abuse, and is directed towards those in close proximity to the schizophrenic. Suicide however is a more common feature in schizophrenics, especially in young adult males, but is not radically higher when compared to the societal average.
Substance abuse or self-medication is very common in the schizophrenic person. Among the most commonly abused substance is nicotine, with the prevalence of abuse among schizophrenic three times higher than the national average. The reason for smoking among schizophrenic is unclear, although it is well known that nicotine interferes and inhibits the effect of many anti-psychotic drugs. Alcohol is occasionally abused but because it worsens the psychotic symptoms it is not common. Similarly, stimulants such as amphetamines and caffeine are also abused, and make the symptoms worse. Cannabis is another commonly used substance among schizophrenics, although the effects will often ameliorate the psychotic episodes, and can be considered a form of self-treatment.
There are several biological theories to explain the cause of schizophrenia. Neurological testing has revealed that a schizophrenic twin may have distinct and notable differences in brain shape from that of the non-schizophrenic twin. Findings such as these have lent support to the view that schizophrenia is caused by biological processes, or at the very least, that changes in the brain can parallel schizophrenic symptoms. There is also some evidence to suggest that schizophrenia runs in families, with a child of a schizophrenic parent running about a 10% chance of developing the condition themselves. Genetic research however, while providing some interesting possibilities on a genetic cause for schizophrenia, has so far failed to provide any conclusive data.
The most popular theories for the cause of schizophrenia are built upon the concept of physical abnormalities of the brain or neurochemical defects. The argument that it is a physical abnormality of the brain that causes schizophrenia is fairly weak in that all schizophrenics do not display what are considered to by physical abnormalities, and by the same token, not all people with physical abnormalities of the brain experience schizophrenia. There simply hasn’t been enough research into what a “normal” brain should look like, let alone what is unique about the brain of schizophrenics.
The idea that a neurochemical imbalance causes schizophrenia is certainly the most prevalent of the medical theories, and it is upon these ideas that psychiatric treatment is based. A relative dopamine excess has been proffered as a possible cause, primarily based upon the success of using dopamine-antagonists like clozapine to inhibit schizophrenic symptoms by down-regulating dopamine secretion in the limbic and cortical areas of the brain.
Another theory is that NMDA (N-methyl-D-aspartate) receptors in the brain, normally involved in memory and cognition, are stimulated to excess by excitatory amino acid neurotransmitters like glutamate, resulting in schizophrenic hallucinations. Based on this idea, some treatments are orientated around the usage of NMDA receptor agonists like D-cycloserine and glycine, which have neurophysiological effects similar to the inhibitory GABA.
The single-carbon hypothesis is another theory developed by researchers, based on the observation that disturbances of the single-carbon folate pathway can lead to schizophrenic symptoms. This metabolic pathway provides carbon groups for a variety of chemical reactions in the brain, including the synthesis of the amino acid methionine. Several studies have shown that methionine metabolism is impaired in most schizophrenic patients, apparently caused by enzyme deficits in the folate pathway. The relationship that these feature have to neuronal transmission however are unclear.
The membrane hypothesis is based upon the theory that a relative deficiency of unsaturated fatty acids such as eicosapentanoic acid (EPA) in the brain upsets neurotransmission. Nerve cells are largely composed of fatty-acid containing phospholipids, and thus proper phospholipid metabolism is absolutely critical to proper brain function. Many studies have shown that supplementation with cold water fish oils have significantly reduced schizophrenic symptoms.
Despite the fact that psychiatrists only have a few working models for the cause of schizophrenia, the usage of anti-psychotic drugs is by far the most common approach to the condition. The rationale for their usage is to allow the schizophrenic to function “normally,” that is, without experiencing the multi-sensorial hallucinations that often cause aberrant or non-social behaviours. Unfortunately, many of the drugs used to achieve these results have unwanted side-effects such as drowsiness, restlessness, muscle spasms, tremor, involuntary movements (tardive dyskinesia), dry mouth, or blurring of vision. More severe and worrisome effects for drugs like clozapine include agranulocytosis, which is a loss of the infection-fighting white blood cells. Despite the apparent success that many of these drugs have in limiting the symptoms of schizophrenia there is often poor compliance among schizophrenics themselves, many of whom feel that the effects of these drugs somehow make them feel less “human.”
Of course there are other, non-drug treatments used by psychiatrists, such as electroshock therapy, which is still used today in some institutions. There is little evidence that electroshock therapy does anything however, other than to shock the patient into submission, and in the process kill portions of the brain. By any standard electroshock therapy is barbaric and inhumane practice, rationalized by those psychiatrists who clearly have little understanding of the ethics of healing.
There is mounting evidence that trauma can play a large role in the later development of schizophrenia, as well as other conditions such as depression and bipolar disorder. Traumatized people have been shown to have difficulty evaluating sensory stimuli, accessing appropriate levels of physiologic arousal, and neutralizing stimuli in their environment in order to attend to day-to-day tasks. Sounds, images, or thoughts that are either consciously or unconsciously related to traumatic incidents result in classic fight or flight responses. Such responses promote states of high excitation, perhaps resulting in the psychosis described in schizophrenic patients. The long-term effect of trauma plays havoc with immune function because of continual cortisol secretion, and to this extent many schizophrenics suffer from chronic immunodeficiency.
Despite the fact that the cluster of symptoms that characterize schizophrenia have been labeled as a disease, many other cultures perceive these symptoms as representing something quite different, usually some kind of spiritual sickness or transformational state. In this context the term psychosis seems to be a convenient label to describe anything which Western society deems abnormal. When it comes to working with schizophrenics, very little if any attention is given to the actual details of a schizophrenic’s experience by the psychiatrist. If schizophrenics share their experiences while in therapy they are all too quickly dismissed as delusional, as the psychiatrist takes out his or her ruler for normal behaviour and compares it to the diverse and complicated world of the schizophrenic. Interestingly, many of the psychotic episodes experienced by schizophrenics are deeply similar to the experiences described in detail by the various prophets, mystics and sages throughout history. In India, people who express bizarre behaviour similar to that of the schizophrenic are called the “adhudtvas,” or “crazy saints,” and always given respect and the benefit of the doubt. In the West, many of our most brilliant painters, poets, and musicians were certainly considered eccentric if not quite mad in their day (e.g. Vincent Van Gogh, William Blake, etc.). Today the timeless and inspired beauty of their artistic vision speaks volumes to many of the so-called “normal” people, and helps relieve the banality and drudgery of this “everyday” world.
Some cultures are obviously more tolerant of aberrant social behaviours than our culture, and it is no wonder our society appears to be so spiritually bereft when we lock our mystics and prophets in institutions and call them schizophrenic. Schizophrenics that have been allowed to value their “hallucinations,” and not view them as a symptom of a pathology but as feature of self-knowledge and realization, fare much better than those who have other, apparently normal people tell them how messed up they are. Those schizophrenics that value their experiences are more likely to experience a sense of unity and holiness, along with all the other, sometimes disturbing phenomena.
Among the indigenous people of South America, schizophrenic symptoms are called the “shaman’s sickness.” It is a state of ego-dissolution, where the individuality, the knowledge of “I-ness” is significantly diminished, and sometimes absent altogether. According this shamanic perspective, the schizophrenic has entered into the Land of the Dead, and is forced to wander the barren lands of non-identity, experiencing the intensity of the whole of existence. This is why schizophrenics seek meaning in random events, because the whole universe is speaking to them, or feel with enormous empathy the pain of other people.
Holistic treatment of schizophrenia
The holistic treatment of schizophrenia is at best supportive: proper nutrition and spiritual guidance are the best tools that a health care practitioner can offer a schizophrenic. In the final analysis it must be recognized that schizophrenia represents a transformational state of the soul, and that the only one that can cure the schizophrenic is him or herself.
Among the more useful techniques for a schizophrenic is how to quiet the mind naturally. Repetitive tasks such as mindfulness of breath, drumming, grinding herbs, long walks, weeding, washing the dishes, and dancing to trance-like and hypnotic music are useful techniques to get out of the head and into the body. Because schizophrenics have poor ego-identification they must become aware of their physical bodies to a greater degree, to ground and harmonize their energies in the rhythm of the Earth. The natural environment is very important healing tool in schizophrenia, as is working with soil and plants, or other animals.
Many schizophrenics experience other beings and entities in their visions. It is important that the patient not be told to discard these as delusion: for the patient these communications and encounters are real, and should be given due respect. Sometimes these entities are malignant or simply mischievous. It is important to be able to track the impact of these beings on the spiritual body. To that end a schizophrenic can be taught to do a body scan, to see if there has been any impact on the energetic body. Various techniques can be used to negate the impact of these actions, such as sending a powerful healing light that emanates from the heart, clears obstructions and repairs damage, and fortifies the energetic body against invasions.
All schizophrenics in one way or another need to express their visions, but they need to be selective with whom they share. An important adage for a shaman-in-training is “to know, to dare, to keep silent.” But expressing themselves artistically is very therapeutic. Drawing or painting the characters or locales of the vision is very beneficial, as is writing poetry of the same things. All of these activities will strengthen that schizophrenic’s ideation of self, of recreating places, people or things that can visited again and again with a sense of purpose and identity.
Sleep and adequate rest is very important for schizophrenics, as deprivation will almost certainly bring on psychosis. Please refer to the treatment options described under insomnia.
Substance abuse is common among schizophrenics and every effort should be made to avoid them, especially coffee, cigarettes, alcohol, and psychostimulants like amphetamines. Cannabis may help to relieve psychosis when used occasionally but it can make symptoms much worse. Psychotropic drugs like LSD, magic mushrooms or ayahuasca have been used successfully by schizophrenics while in psychosis to help gain a better sense of self, but such measures should always supervised by an experienced non-user.
Nutrient deficiencies are very common in schizophrenia. The vitamin B complex is needed for proper neuronal functioning and should be supplement along with omega 3 fatty acids (i.e. EPA/DHA), and choline and lecithin. Schizophrenics may benefit from taking increased doses of niacin, which has been used for years by LSD-trippers to inhibit hallucinogenic visions. Schizophrenics will often fail to achieve the characteristic niacin “flush” when taking this supplement, indicating a deficiency. An iron deficiency has also been observed in schizophrenics.
The following herbal and nutritional recommendations can play a very important role is limiting psychotic episodes, enhancing health and immunity, and bring a greater sense of self-awareness:
- To help ground and calm the body/mind: Ashwagandha (Withania somnifera), Milky Oats (Avena sativa), Ling Zhi (Ganoderma spp.), American Ginseng (Panax quinquefolium), Brahmi (Bacopa monniera)
- For active psychosis: Mistletoe (Viscum album), Sarpagandha (Rauwolfia serpentina), Skullcap (Scutellaria lateriflora), St John’s Wort (Hypericum perforatum), Vervain (Verbena hastata), Sweet Flag (Acorus), Jatamamsi (Nardostachys jatamansi)
- vitamin B complex, 200-300 mg daily
- folate, 1 g daily
- vitamin C, to bowel tolerance
- vitamin E, 400 IU daily
- calcium/magnesium, 1:1, 500 mg each thrice daily
- manganese, 15-30 mg daily
- zinc, 50 mg daily
- chromium, 200 mcg thrice daily
- iron, 20 mg daily
- EPA/DHA, 2-3 g daily
- implement an elimination challenge diet
- ensure high protein/fat (vata-reducing diet), low gluten, lots of leafy greens
- eliminate refined foods, carbohydrates and sugar
- avoid stimulating foods and beverages such as coffee, tea, aspartame, MSG, and chocolate
- for vata: lavender, rose, vetivert, sweet marjoram, bergamont, lemon, clary sage, myrrh, frankincense, sandalwood, cinnamon
- for pitta: chamomile, lavender, rose, gardenia, honeysuckle, ylang, vetivert, jasmine and sandalwood
- for kapha: cedar, pine, rosemary, basil, frakincense, myrrh, eucalyptus, cajeput, camphor, ginger and clove
- cold water showers in manic states; paste of Sandalwood powder mixed with cool milk applied to forehead (pitta); Chandanadi taila
- warm oil massage in asthenic conditions (vata); Balashwagandhalakshadi taila (laksha is the resinous secretion of certain insects)
- cranial sacral therapy
- ensure proper bowel elimination
- rule out candidiasis
- rule of reactive hypoglycemia
- emphasize grounding body movement: contact improvisation, hatha yoga, tai chi
- classes and lectures on spirituality, shamanism, reiki, energy medicine etc.