Hello, friends! I hope you’re all doing great.   In today’s episode, we dive into the following awesome listener questions:   Our first question comes from a concerned parent whose son was diagnosed with schizophrenia eight years ago. At the time, they didn’t agree with the diagnosis due to a variety of circumstantial factors, but now they recognize that their son does indeed have schizophrenia. They are seeking guidance on how to help him understand his condition and learn to manage it without relying on medication. They also ask for recommendations on therapists who specialize in non-medication treatment options. We will navigate this sensitive topic, discussing ways to approach the conversation and exploring non-medication treatment strategies for schizophrenia.   Our second question is from a listener who’s been struggling with assertiveness and self-respect, often prioritizing others’ needs over their own to avoid conflict. This listener also has ADHD which exacerbates the issue, making it challenging for them to communicate effectively during moments of conflict due to executive functioning overload. They seek advice on accepting their shortcomings, cultivating self-love, and prioritizing their own needs without fear of pushing others away. We will discuss the importance of setting boundaries, effective communication strategies, and ways to build self-respect while managing ADHD.   As always, feel free to send your questions to duffthepsych@gmail.com. You can find the show notes for this episode at http://duffthepsych.com/episode356. —–   This episode is brought to you by Mindbloom, the leader in at-home ketamine therapy. Get $100 off your first treatment at http://mindbloom.com/duff with the code duff at checkout.   This episode is also brought to you by Betterhelp. Take control of your mental health with the help of a licensed therapist, completely online at http://betterhelp.com/duff.

Question 1:

Hi, my son was diagnosed about 8 years ago.  At the time I didn’t agree with it. There were so many other things going on. But now I see he does have schizophrenia. I haven’t talked to him about it recently because in the past he would get angry. It’s a long story.

I’m seeking help on what can I do to help him see his condition. To help him understand his condition and that there are ways to manage and learn to live with and function without taking meds.  Meds are absolutely not an option for him.  I’m afraid for his safety. Please help me or give me therapists who specialize in no med treatment or resources I can look for the help.

He’s against taking any prescriptions.  Always has been since he was a kid.  For me to  suggest meds can help him would close his mind up and shut him down to listening to anything else.

8 years ago we had him picked up. He spent a week in Pine Rest.  His dad, my ex, left the decision up to me for him to stay and take lithium.  At that time, I thought there was more going on. I had a strong feeling my son’s pot was laced with something that put him into a psychotic episode. He never had an episode before.  It’s a long story  and it’s that story that will explain why I thought it wasn’t schizophrenia

I’ve read and heard about Chris Howard and Eleanor Longden.  They don’t use medication. I want to know how they came to know they have schizophrenia and have a functioning life not taking meds. How can I get my son to be open to the people he thinks are out to get him etc is real only to him and to use these delusions/hallucinations to learn what they are telling him about himself

I don’t know how else to ask and have someone understand what I want to know. I fear the worse for my son.

Answer 1:

First of all, I want to commend you for reaching out and seeking help for your son. It’s evident that you genuinely care about him and want to explore all possible options to support him. Dealing with schizophrenia can be challenging, so let’s break down some key points to consider.

Schizophrenia is a complex disorder characterized by symptoms such as delusions, hallucinations, disorganized speech, catatonic behavior, and negative symptoms like diminished emotional expression or lack of volition. It’s important to understand that individuals with schizophrenia often struggle with a lack of insight into their condition, meaning they may have difficulty recognizing their own experiences as symptoms of the disorder. Delusions and hallucinations become their reality, even if it doesn’t align with the outside world.

Navigating conversations with someone who has schizophrenia can be tricky due to their lack of insight. They may resist discussions about their mental health or become agitated when confronted with the topic. This poses a challenge because it’s difficult for someone to actively work on their recovery when they don’t believe they have a problem. Building awareness and understanding of their condition is crucial but can be a gradual process.

Regarding medication, it is important to note that psychiatric medication is typically the primary intervention for schizophrenia. While medication is not the sole solution, it is often a fundamental component of treatment. A comprehensive approach that combines medication, therapy, family involvement, and other interventions like nutrition and vocational training is generally the golden standard.

However, every individual’s situation is unique. Some people with milder symptoms of psychosis may lead successful lives with minimal medication, but it’s important to consider the specific factors contributing to their ability to manage the disorder effectively. On the other hand, individuals with more severe symptoms may require medication as a cornerstone of their treatment to improve their quality of life.

You mentioned that your son is against taking any prescriptions, which can pose challenges. It may be helpful to explore alternative approaches while still considering the potential benefits of medication. Cognitive Behavioral Therapy (CBT), family therapy, community treatment programs, and even clinical trials involving brain stimulation devices are among the non-medication options available. Additionally, therapeutic skills such as managing strong emotions, practicing meditation, and developing social skills can also play a vital role in coping with schizophrenia.

It’s worth noting that nutritional changes and supplements have shown some promise, but the research in this area is still limited and not yet robust. Consultation with a healthcare professional is advised before incorporating any supplements into the treatment plan.

While a supportive family and access to resources are important, it may be necessary to reevaluate the “no medication” stance. Sometimes hospitalization is required to stabilize individuals through the use of antipsychotics, which can alleviate the burden of psychosis and potentially foster insight into their condition.

Taking a different perspective, you can address your son’s distress caused by delusions rather than solely focusing on the psychosis itself. For example, working on managing anxiety, which often accompanies paranoid thoughts, can be an entry point for initiating mental health treatment.

If your son has not undergone a proper evaluation, prioritizing this step is crucial. A psychologist or psychiatrist who specializes in assessment can help determine the accurate diagnosis and provide tailored recommendations for his specific needs.

I wish you the best of luck in supporting your son on his journey towards understanding and managing his condition. It’s important to remember that progress may take time, and it’s essential to approach the situation with patience, empathy, and professional guidance.

Question 2:

I have a communication/self respect problem. I opt towards making people around me happy and deal with any discomfort I have on my own. It’s made me perpetually exhausted and I don’t know/respect myself. When there is some kind of conflict (work, romantic relationships, roommate relationships, family, etc) I instinctively diffuse rather support my own needs so I don’t push the others away.

Something to note is that  I have ADHD, which mainly shows in executive functioning overload. Because of this, when I do try to speak up, I lose track of my thoughts and go blank with stress. I end up feeling stupid and evil for causing a conflict I can’t even back up my feelings on in a way others can understand.

I want to accept my shortcomings, really love myself, and stop shutting my own needs down so people don’t leave me. If you have any advice I would greatly appreciate it

Answer 2:

Thank you for reaching out, and I’m glad to see that you are actively seeking ways to prioritize your own well-being. The struggle you described is not uncommon, and it’s commendable that you recognize the need to address this issue.

Many individuals respond to conflict in different ways. Some become heated, while others avoid it altogether. It seems that your approach is more focused on appeasing others and diffusing conflicts, even if it means neglecting your own needs. This pattern has left you perpetually exhausted and struggling with self-respect.

Considering your ADHD diagnosis and the executive functioning overload you experience, it becomes even more challenging to express yourself and stand up for your needs. This can lead to feelings of inadequacy and self-blame, as you find it difficult to articulate your feelings in a way that others can understand.

Therapy would be an excellent option for you. It appears that you already possess a level of self-awareness and a desire to grow. Therapy can help you delve into the origins of your self-concept issues and provide you with tools to develop self-respect and accept your shortcomings.

In addition to therapy, there are several areas you can work on independently. Start by setting small boundaries for yourself and challenging yourself to hold firm to them. Take incremental steps towards becoming the person you aspire to be. For example, if your roommate asks you to take care of something that should be a shared responsibility, politely decline by explaining that you don’t have time at the moment, but you’ll address it within your agreed timeframe.

Openly communicate your intentions and growth journey with those around you. People may have certain expectations based on their past experiences with you, which could lead to pushback or strong emotions. However, it’s essential to stay true to yourself and be honest about your efforts to improve. Find the right words to express that you are actively working on becoming more assertive and comfortable voicing your needs.

Remember that you can revisit conversations or situations where you didn’t speak up initially. Let others know that you weren’t able to fully express yourself at the time, but you’ve gained clarity and would like to address the matter now.

It’s important to recognize that the pressure and overwhelm caused by ADHD don’t invalidate your thoughts or feelings. Although it may feel like time is against you when you’re stressed or overwhelmed, take a moment to collect your thoughts, take a deep breath, and calmly communicate that you need to express yourself despite feeling jumbled up.

Another crucial aspect is understanding that you are not responsible for managing other people’s emotions. Feeling guilty or assuming fault when others are upset is not necessary. People are allowed to experience anger or other emotions, and it doesn’t automatically mean you did something wrong. Challenging these assumptions and identifying thinking traps, such as personalization, catastrophizing, and emotional reasoning, can be beneficial. Cognitive Behavioral Therapy (CBT) can help you work through these thoughts and develop a healthier perspective.

Expanding your self-concept and building confidence can be achieved through self-exploration. Engaging in therapy, journaling, and pursuing new hobbies or social opportunities can help you discover more about yourself and your capabilities, independent of others’ perceptions.

As you embark on this journey, it’s essential to remember that missteps and fumbles are part of the process. Embrace them as opportunities for growth and self-discovery. You deserve to prioritize your own needs and develop a genuine sense of self-respect. I’m excited for you and wish you the best of luck!