Other Neurodiversity Conditions, Part 1

Last time, I discussed the main conditions that fall under neurodiversity. They include dyslexia, ADHD, autism spectrum disorders, dyspraxia/DCD, dyscalculia, and Tourette Syndrome. But there are more people with other neurological conditions or diseases woild want to be included in the neurodiversity movement. They believe that the disorders they have are not actually disorders, but variation in the human brain. These include the following:

Schizophrenia[1]
Schizoaffective Disorder[1]
Parkinson’s Disease[1]
Cicardian Rhythm Disorder[1]
Developmental Speech Disorder[1]
Dysnomia[1]
Bipolar Disorder[1]
Depression[2]
Obsessive Compulsive Disorder[1]

Actually, neurodiversity was coined out of the Autism rights movement. Then, it was extended to dyslexia, ADHD, dyspraxia, dyscalculia, and Tourette syndrome. Then, the other neurodiversity conditions enumerated above are also to be considered. Some believe that the disorders are caused by variantions and faults in brain developmentand not necessarily personality or mental related like psychopathy. Here, each of the disorders above are discusses below:

SCHIZOPHRENIA

image
Image courtesy of wikipedia.org

Self portrait of a person with schizophrenia

Schizophrenia is a mental disorder often characterized by abnormal social behavior and failure to recognize what is real. Common symptoms include false beliefs, unclear or confused thinking, auditory hallucinations, reduced social engagement and emotional expression, and inactivity.[3] Contrary to popular belief, schizophrenia isn’t a split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking[4], though it came from the Greek words skhizein (“to split”) and phrēn (“mind”).[3]

Schizophrenia is lifelong with the onset in the late teens and persists into adulthood. Usually symptoms appear between ages 16-30.[5] Changes in behavior can be apparent in teens like social isolation and unusual thoughts and suspicions.[5] A schizophrenic usually has delusions where he or she has false beliefs about the world they are living with like believing that they are controlled by other people or they are constantly persecuted.[5]

Schizophrenia’s cause is still unknown, though it is contributed by genetics, brain chemical imbalances involving neurotransmitters dopamine and glutamate[6], larger brain ventricles[6], and small changes in distribution of brain cells.[6]

Treatment of schizophrenia includes a combination of medication, psychological counseling, and self-help resources.[7] Medications include antipsychotics (risperidone, olanzapine), antidepressants, and anxiolytics to help control symptoms.

If proper intervention and support is given plus lots of compliance from the schizophrenic, he or she can lead productive lives. Examples of schizophrenics are listed below[8]:

Lionel Aldridge – professional football player
Parveen Babi – Indian actress
Syd Barrett – British musician, founding member of Pink Floyd
Buddy Bolden – pioneering jazz musician
Clara Bow – Hollywood flapper actress and “It Girl” of the 1920s
Camille Claudel – French sculptor of the 19th century
Philip K. Dick – American sci-fi author. Diagnosis is contested.
Eduard Einstein – son of Albert Einstein
Will Elliott – Australian writer
Roky Erickson – rock musician, founder of The 13th Floor Elevators
Zelda Fitzgerald – wife of writer F. Scott Fitzgerald; writer, dancer and artist
Vincent van Gogh – visual artist/painter (with schizophrenia and/or bipolar)
Andy Goram – Scottish football/soccer player
Jim Gordon – drummer, member of Derek and the Dominos
Peter Green – guitarist, founder of Fleetwood Mac
Darrell Hammond – comedian, actor on Saturday Night Live
Tom Harrell – successful Jazz Musician
John Hinckley, Jr., American failed assassin
Adèle Hugo – Daughter of French writer Victor Hugo; her story is told in the film The Story of Adele H.
Daniel Johnston – musician
Veronica Lake – Hollywood actress of the 1940s
Ash Lieb – Artist, comedian and writer
Mary Todd Lincoln – Wife of Abraham Lincoln and First Lady of the United States
Rufus May – clinical psychologist
Joe Meek – pioneering English record producer and songwriter
William Chester Minor – contributed to Oxford English dictionary
Bob Mosley – rock musician, member of Moby Grape
John Nash – economist/mathematician/Nobel Memorial Prize winner in Economic Sciences in year 1994 (along with John Harsanyi and Reinhard Selten)
Vaslav Nijinsky – ballet dancer, choreographer
John Ogdon – English pianist and composer
Jeremy Oxley – Musician and member of Australian band the Sunnyboys
Khieu Ponnary – Wife of Pol Pot
Katherine Routledge – British archaeologist
Elyn Saks – law professor/schizophrenia writer/researcher
Alexander “Skip” Spence – rock musician, cofounder of Moby Grape
Gene Tierney – American actress
Louis Wain – artist
Wesley Willis – Musician and artist
Brian Wilson – Musician and member of The Beach Boys

How can schizophrenia be part of neurdiversity?

A study done by researchers at Tel Aviv University’s Sackler Faculty of Medicine and the Sheba Medical Center showed that schizophrenia and autism have similar roots, and are linked to other mental conditions, such as bipolar disorder.[7] Researchers the Cross Disorders Group of the Psychiatric Genomic Consortium reported that schizophrenia, major depressive disorder, bipolar disorder, autism spectrum disorders, and ADHD (attention-deficit hyperactivity disorder) share the same common inherited genetic faults.[7]

Some may theorize also that during prehistoric times, schizophrenics are also the first spiritual leaders and helped create religion amd mythology as we know it today.

This means schizophrenia may be more of a neurological condition than mental, and therefore should be included in the neurodiversity continuum.

What is my stand? I do not really know. It can be considered, but schizophrenia is different from other neurodevelopmental disabilities because it has a later onset and does not develop neurological deficit like the way dyspraxia has.

SCHIZOAFFECTIVE DISORDER

image
Image courtesy of wikipedia.org

Francisco Goya’s painting, Yard With Lunatics, depicts symptoms of schizoaffective disorder.

Schizoaffective disorder (SZA or SAD) is characterized by abnormal thought processes and deregulated emotions.[9][10][11] The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone.[9][10][11]

SZA is thought to be a bridge between schizophrenia and depression. The exact cause is unknown. Genetics and environment may play a role. Drugs may or may not exacerbate the symptoms. Extensive evidence exists for abnormalities in the metabolism of tetrahydrobiopterin (BH4), dopamine, and glutamate in people with schizophrenia, psychotic mood disorders, and schizoaffective disorder.[9]

Symptoms include delusions and hallucinations, along with depressive and/or euphoric moods. For bipolar type, hallucinations or delusions must be be present for at least 2 weeks without an episode of depression or mania.[12] Episodes of depression or mania are present for the majority of the time of the illness.[12] Also, social isolation and self-neglect are apparent. Suicide ideation is also present.

Management of SZA includes medication, with improved outcomes using combined long-term psychological and social supports.[9][13] Medications inculde atypical antipsychotics (quetiapine, ziprasidone) to control symptoms and mood stabilzers (valproic acid, carbamazepine) to avoid mood swinging and cycling.[9] Anxiolytics (lorazepam, diazepam) are also prescribed for anxiety symptoms. If SZA is severe, electroconvulsive therapy may be considered.

Supportive psychotherapy and cognitive behavioral therapy are both helpful.[9][14] Intensive case management (ICM) has been shown to reduce hospitalizations, improve adherence to treatment, and improve social functioning.[9][15] With ICM, clients are assigned a case manager responsible for coordination of care and assisting clients to access supports to address needs in multiple areas related to well-being, including housing.[9]

Like schizophrenia, schizoaffective disorder needs compliance and especially support from family and friends in order to live a functional life. Untreared, this can lead to substance abuse, chronic unemployment, and homelessness.

How can SZA be part of neurodiversity continuum?

It may have some genetic sharing with other neurodiverse conditions. I dunno if I’m correct. But some can release their stress in art, like what Francisco Goya did in his painting above. I guess SZA folks can be great artists.

Phew. I think these are enough for now. Next time, Parkinson’s disease, cicardian rhythm disorder, developmental speech sisorder, and dysnomia will be discussed.

References:
1. en.wikipedia.org/wiki/Neurodiversity
2. http://www.thenewatlantis.com/publications/mental-disorder-or-neurodiversity
3. http://en.m.wikipedia.org/wiki/Schizophrenia
4. http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/definition/con-20021077
5. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
6. http://psychcentral.com/lib/what-causes-schizophrenia
7. http://www.medicalnewstoday.com/articles/36942.php
8. http://en.m.wikipedia.org/wiki/List_of_people_with_schizophrenia
9. http://en.m.wikipedia.org/wiki/Schizoaffective_disorder
10. “F25 Schizoaffective disorders”. ICD-10 Version:2010. World Health Organization.
11. Malaspina D, Owen MJ, Heckers S, Tandon R, Bustillo J, Schultz S, Barch DM, Gaebel W, Gur RE, Tsuang M, Van Os J, Carpenter W (May 2013). “Schizoaffective disorder in the DSM-5”. Schizophrenia Research 150 (1): 21–5. doi:10.1016/j.schres.2013.04.026. PMID 23707642.
12. http://www.nami.org/Learn-More/Mental-Health-Conditions/Schizoaffective-Disorder#sthash.1zXWC31a.dpuf
13. van Os J, Kapur S (August 2009). “Schizophrenia”. Lancet 374 (9690): 635–45. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006.
14. BMJ Group, “Schizoaffective disorders: Treatment”, 2012
15. Dieterich M, Irving CB Park B et al (2010). Dieterich, Marina, ed. “Intensive Case Management for Severe Mental Illness”. Cochrane Database of Systematic Reviews 10 (CD007906). doi:10.1002/14651858.CD007906.pub2.

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