Hey Everybody! I recently made this new brain/neuron fabric and gift wrap! I made a giant brain pillow for my psychiatrist too, and he seemed to like it which was awesome! :) Here are some pics! Also, the fabric, gift wrap, and wall paper are available on spoonflower here: http://www.spoonflower.com/fabric/3713721
Some of you may remember that I have been getting Haldol Decanoate injections for the past 13 years or so in order to keep my schizophrenia in check. I wrote about it here: https://kristinbell.org/2012/06/14/the-haldol-injections-after-10-years/. Recently Abilify Maintena, the long-acting injectable form of Abilify came onto the market. After discussing it with my doctor, we decided to give it a try. I have been taking the oral form of Abilify along with the Haldol Dec injections for about two or three years with no adverse side effects, and it has really improved my functioning as well. The long term risks of side effects like tardive dyskinesia are much higher with the Haldol than with the Abilify which is one reason why we decided to switch. Abilify also has fewer metabolic side effects (things like less weight gain are associated with Abilify). We are taking a giant leap into the great unknown. I got my first injection of the Abilify tonight. It comes in an injection kit with sterile water that must be mixed with the powder Abilify and then injected. The Haldol is an oil-based mixture that is also injected. I am hoping to also have less sedation side effects from the Abilify. I’m just crossing my fingers that all will go well. I will keep you all updated as time passes. It is also interesting to note that Abilify Maintena has been approved for much longer in many other countries, but it just became available in the US. The US also lags behind many European countries in the administration of injectable forms of antipsychotics. Personally, I think that all people with chronic schizophrenia should give injectable antipsychotics a try. The injections don’t hurt and it is much easier to manage than oral medications. I’m including some pics of what my injection kit looks like too. It looks complicated, but it really only took about 4-5 minutes to administer including reading the directions! I’m saying Hello to Abilify Maintena and goodbye to my old friend Haldol Decanoate!
I have some great news! I was able to ask Dr. Steven G. Potkin, Professor of Psychiatry in the Department of Psychiatry and Human Behavior at the University of California, Irvine (UCI) Medical Center, some questions regarding the negative symptoms of schizophrenia. He is also the Robert R. Sprague Endowed Chair in Brain Imaging. It was a brief, by email interview, but I’m happy to share what I’ve learned with you all! The following is the Q&A:
Kristin: What are negative symptoms?
Dr. Potkin: “Negative” does not refer to a person’s attitude, but instead to a lack of characteristics that should be present. Symptoms include reduced amount and content of speech, even when encouraged to interact (alogia), lack of emotional and facial expression (affective flattening), diminished ability to begin and sustain activities (avolition), decreased ability to find pleasure in everyday life (anhedonia) and social withdrawal (asociality).  
Negative symptoms can appear a few years before other symptoms appear in young adulthood in the so-called “prodromal” stage of the illness. Unfortunately these symptoms often go undetected because they manifest themselves as issues common among teenagers: social withdrawal, problems with school work, irritability, depression and sleeping problems.
Kristin: Do all people with schizophrenia have negative symptoms?
Dr. Potkin: No, but at any point in time, negative symptoms can affect approximately 50 percent or more of people with schizophrenia. 
Kristin: How do negative symptoms affect a person with schizophrenia? How do they affect their family and friends?
Dr. Potkin: Research suggests that for people living with schizophrenia, negative symptoms are key factors in poor quality of life as well as problems with personal hygiene, school and work performance, maintaining relationships, interacting within the community, and participating in social activities.    
For caregivers of people with schizophrenia, negative symptoms may cause more burden than do other types of symptoms as they see their loved ones life isolated and lacking in meaning or joy. 
Kristin: How are negative symptoms currently treated?
Dr. Potkin: Current treatments for schizophrenia focus on reducing characteristic symptoms and can include both medication and psychosocial interventions. No effective medication treatment has yet been approved for specific treatment of negative symptoms. Despite progress in the medication side of treatment, there are still unmet needs in terms of symptom control. A large study found that despite treatment, approximately 57 percent of people receiving treatment for a schizophrenia spectrum disorder still had at least one negative symptom.
Kristin: What is the research that Genentech is doing regarding negative symptoms?
Dr. Potkin: Researchers at Genentech are pursuing new treatment strategies for schizophrenia, including increasing N-methyl-D-aspartate (NMDA) receptor activity in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.   
Specifically, through a clinical trial program, Genentech is looking at an investigational medication for people with schizophrenia, including people who experience mostly negative symptoms of schizophrenia, despite taking medication. For more information, please visit www.SearchLyteschizophrenia.com
Kristin: How can family and friends of someone with schizophrenia help someone with negative symptoms?
Dr. Potkin: Caregivers can talk to doctors about interventions including medication, psychosocial rehabilitation (work, school, relationships), medical care and wellness, and therapy (e.g. cognitive behavioral therapy and peer support groups), as well as ongoing clinical trials. They can work with physicians to find the medications and non-medicine therapies that are right for their loved one. Different medicines may have different side effects. Caregivers can also consider programs from the National Alliance on Mental Illness (NAMI) including:
• NAMI Hearts and Minds
– Online, interactive wellness initiative
• NAMI Peer-to-Peer
– Free, 9-week educational course on recovery
• NAMI Connection
– Recovery support group for adults
Kristin: Do scientists know the biological mechanisms involved in negative symptoms? If so, what are the areas of the brain and/or mechanisms involved in negative symptoms?
Dr. Potkin: In the 1970s, the “dopamine hypothesis” of schizophrenia emerged, suggesting the biological basis of schizophrenia was an excess of signaling by dopamine, a chemical messenger in the brain. This theory, however, could not explain negative or cognitive symptoms. In the late 1980’s a newer theory suggested positive, negative and cognitive symptoms could all be due to reduced function of NMDA receptors in the brain. This theory is now known as the “NMDA receptor hypofunction hypothesis.”   
Researchers are pursuing new treatment strategies for schizophrenia, including increasing NMDA receptor function in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.    It is thought that NMDA receptor activity is an important pathway in psychiatric disorders, especially schizophrenia.
End of article.
*Note: I would like to thank Dr. Potkin for helping me put together this interview. This research is very exciting and I hope that negative symptoms can be tackled in this decade! I know how debilitating they can be!
4. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
6. Bobes J, Arango C, Garcia-Garcia M, Rejas J. Prevalence of negative symptoms in outpatients with schizophrenia spectrum disorders treated with antipsychotics in routine clinical practice: findings from the CLAMORS study. J Clin Psychiatry. Mar 2010;71(3):280-286.
10. Milev P, Ho BC, Arndt S, Andreasen NC. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. Mar 2005;162(3):495-506.
12. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
13. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
Hi! As you might know if you have scanned my blog, I make it a point to talk about mental health/illness, because I have schizophrenia and I believe in stomping out the stigma of mental illness. Well, I have this cute story to share! I was waiting outside of the classroom for my biology lab class to start this fall and started talking to a supernice girl who was in my class. We got to talking and to try to explain why I had been in school so long I decided to tell her that I have schizophrenia. Lo and behold she says “oh yah, my mom has bipolar and my brother has schizophrenia too!” What a small world!!! It turns out her whole family is active in the mental health field in advocating for the erasure of stigma related to mental illness and they have a website called http://bringchange2mind.org/ . I am always surprised when I talk to people about my own illness and then they also know someone or are someone with mental illness too! It is such a big thing in peoples’ lives and when we talk about it, it is surprising/amazing/wonderful that we aren’t alone in our struggles. So, I just wanted to share this little story and a link to the Bring Change 2 Mind website. It was a wonderful feeling to meet someone else at school who knows first hand about mental illness and to be able to talk openly about it! :) Three cheers for no more stigma!!! :)
Hey Everybody! I wanted to share with you this cool genetics testing that is available to people. I just got it done, because my nurse practitioner ordered it and Medicare pays for it. (Medicare pays for this testing, because it saves a LOT of money and can save lives!) It is really cool, because it tells you how medications will interact with your specific genetic makeup! It is extremely important if you are taking really any kind of medication. For example, had I known about my results before I took Wellbutrin years ago, it would have saved me from basically having a manic reaction to the medication. It turns out that I metabolize differently than normal on some of the metabolic pathways. This means that I will metabolize the meds on those pathways different than people without this issue. If you have Medicare, I strongly urge you to get this testing done. It could save your life from a bad genetic-medication mistake. I think many other insurance carriers might also pay for it. It also explains why I can take a lower dose of many medications and still get the desired effect from the medication. I would say that anyone who is trying to figure out their psych meds should really get this testing done too. It doesn’t just tell about psych meds though, it tells about stuff involving all other sorts of meds. Seriously, this is pretty awesome! Again, here is the link: http://www.genemedrx.com/
I was just posting about this on Facebook, so I thought I’d drop a note about it here too. According to Scientific American Mind, May/June 2012, one of the changes that is coming to the DSM-5 (aside from dropping the roman numerals) is that they will be getting rid of the category of Asperger’s. Instead, people with this disorder will be labeled on a spectrum disorder with levels of severity noted. I’m including the short article here, so you can read more about it. It was kind of surprising to me to hear about this. I know that there are a lot of people with Asperger’s who have parts of their identity wrapped up in the diagnostic criteria. It would be like them getting rid of schizophrenia I guess. Suddenly some part of your identity is renamed. It is kinda strange. I don’t know if it is good or bad. That is part of the tricky thing about mental disorders and labels…most people with a mental disorder usually wind up having some part of their identity tied to a label. For good or bad or whatever…it just seems to happen.
I was just informed of this great project called Schizowhat? that is a website aimed at raising awareness about schizophrenia. For those of you who don’t know, I have schizophrenia. I was first diagnosed when I was about 15/16 years old. I hope others of you who are interested or in some way impacted by schizophrenia will check out the website and contribute! Let’s fight the stigma! Yay!
A study performed by Hui-jie Li et. al. based in Beijing, China and published in Schizophrenia Research vol. 134 (2012) tested 12 patients with schizophrenia for facial emotion processing. In the study, 12 of the non-ill siblings of the patients were also tested along with a control group of 12 people who were matched for demographic variables like IQ, age, gender, and education levels.
The researchers were especially interested in evaluating whether or not the patients with schizophrenia had deficits in facial emotional processing like other studies from Western populations have indicated. In essence, this was a replication study paired with a cultural component to test if facial emotional processing deficits are universal or not.
The data obtained from 8-minute fMRI scanning sessions where participants were shown 20 happy faces, 20 fearful faces and 20 neutral faces (at different times with different time intervals) were analyzed and it was found that the patients with schizophrenia showed abnormal activation of the “social brain neural circuit.” In addition, the sibling participants showed slight abnormalities that fell between what the patients with schizophrenia displayed and what the control group displayed. This result led researchers to hypothesize that there might be a deficit even in the non-ill siblings that the patients’ brains are trying to compensate for.
During the study the control group showed greater activation in various brain regions that processed the happy faces, but the patients with schizophrenia showed greater activation than the controls in the left middle frontal gyrus when processing the fearful faces. The sibling participants also showed greater activation than the controls (but less than their siblings with schizophrenia) when processing fearful faces, but had similar activation responses to controls with the happy faces.
The results of the study are similar to previous studies done to test for facial emotional processing in people with schizophrenia indicating that there are universal deficits in facial emotional processing that patients with schizophrenia must compensate for.