Joe Bob's America: Schizo man, ID yourself

NEW YORK, June 17 (UPI) -- Hands-free cell phones -- hate them. It's now impossible to tell which New Yorkers are talking to themselves on the street and which ones are talking to their offices.

I find it a little frightening. Is he a delusional paranoid schizophrenic or just a stockbroker? You have to listen to the conversation and adjust your behavior accordingly. One way to tell is by listening to the number of times a person uses foul language. The more X-rated words you hear, the more likely he's a refugee from Bellevue. (This doesn't apply, however, for people who work in the media or for Donald Trump.)

Or you can do the reverse and listen for the words "synergy," "branding" or "counter-intuitive." The corporate types are just as obnoxious as the loonies -- we just can't legally commit them.

At any rate, I was reminded of this last week when Bristol-Myers Squibb announced a kinder, gentler medication for schizophrenia. It's a new drug called "aripiprazole," which sounds like an acne cream for astronauts, and supposedly it will be available later this year.

Haven't heard of it? Of course not. It's for schizophrenics, most of whom don't vote and don't spend their own money on treatment. The only time they call something a "miracle drug" is when it's a fancy new antidepressant, like Prozac or Zoloft, for people who aren't really mentally ill.

I say this all the time and get busted for it. "How dare you judge a person's needs like that?"

Well, if they're going to their jobs and functioning within their families and not killing themselves or anybody else, they're NOT MENTALLY ILL. Anti-depressants are for rich people in western countries who brood a lot. Ever heard of a Masai tribesman on Zoloft? I think not.

People who are really crazy -- schizophrenics and manic depressives -- are NOT THAT HARD TO SPOT, whether it's on the street or on visiting day at the asylum. The other thing people say about mental illness is, "Well, we're all a little bit crazy. Those people in the hospital are probably not that different from you or me."

Excuse me, but, as Judge Judy would say, WRONG!

Ask anybody who's had a schizophrenic in his family. Theys ay crazy things. They see crazy things. They do crazy things. They can't control themselves without sophisticated cocktails of various dopamine-receptor medication. They have to be constantly watched, so that they'll take the medications, some of which have such awful side effects that it's only a matter of time until they DO start flushing them down the toilet.

Eliminating the medication suddenly can result in violence, weird religious pronouncements, or at the very least the kind of ugliness you normally don't find outside a Quentin Tarantino movie.

Ask any father who's had to call the sheriff to come get his daughter and forcibly take her to the mental hospital, where, because of modern privacy laws, he might not be able to find out her condition because the doctors aren't allowed to speak to him. I don't think he's likely to say, "Well, she's just like you and me."

There IS a condition called crazy. The reason we don't see it much -- unless you live in New York, where the schizophrenics cruise the subways all night -- is that we've mostly hidden these people away, or shuffled them around until they blend in with the homeless. Back in the 1950s we would put them in a mental hospital and they would rarely get out. But that was actually KINDER than what we do today.

Unless they're having violent episodes, we normally cart the schizos back and forth between "community treatment centers" (take a number), charity hospitals that hold them for two days and then release them, various family members who eventually kick them out ("Any family members left who haven't been burned by you yet?" is a not uncommon question), and just "general out-patient release." Hence the guys on the streets.

For example, I came across a guy raving about Jesus in the 77th Street subway station one night, and there happened to be a cop hanging around the turnstiles. I told the cop that the man needed to be committed.

"We can't do that without a complaint," he said.

"Well, can I make a complaint?"

"What did he do?"

"He thinks he's Jesus."

He laughed. "No, he has to make a threat or take some kind of aggressive action."

So I dropped it. Up until a certain time -- the early 1970s -- the belief that you were Jesus was AUTOMATIC grounds for commitment. Now it's just considered quirky behavior. In countries that have far FEWER mental-health resources, like Russia, claiming you're Jesus Christ is STILL grounds for commitment, but Americans tend to think, "Oh, he doesn't really mean it."

He really means it! It's a common schizophrenic delusion.

Ever since about 1970 most schizophrenics have been abandoned by the mental health system. The reason Bristol-Myers Squibb can make such a killing on a new schizophrenia drug is that, for most of the 2 million schizos in America, that's the ONLY treatment they're likely to get.

The reason is that, in the early 1970s, commitment to insane asylums was gradually phased out. It was thought of as "warehousing" and causing too much separation from family -- even though the original reason we called it an "asylum" is that doctors noticed the patients improved when they were REMOVED FROM THEIR FAMILIES!

Also many schizophrenics woke up one day to find out that shock treatments -- the only thing that kept their disease under control -- had been outlawed in several states. You had patients, and especially the families of patients, begging physicians to resume the regular series of shock treatments that had allowed the patient to think clearly, go home frequently, and sometimes even hold jobs. I've asked quite a few doctors exactly WHY the shock treatments were cut back, even though by 1970 it had become a fairly routine procedure.

Apparently it's because of the movie "One Flew Over the Cuckoo's Nest." I'm not making this up. Legislatures actually overrode the opinions of medical professionals because shock treatments DAMAGED JACK NICHOLSON'S BRAIN! I didn't believe it myself until Dr. Edward Shorter, a professor at the University of Toronto, documented it in his book "A History of Psychiatry." (Actually I think it's a misreading of the movie. Jack Nicholson is shown receiving shock treatments, but has no lasting effects. In the final scene of the movie, he's obviously received a lobotomy, not a shock treatment.)

At any rate, once there was no permanent commitment and no shock treatment, the solution was supposed to be "community treatment centers." The idea was that the patient would go in once a week and get psychotherapy or medication or both, and the only people in the hospitals would be those who were violent or catatonic.

In fact, most of those schizophrenics ended up in nursing homes -- or, to use the politically correct phrase, "assisted day care facilities." So they ended up in an institution after all, but an institution that DIDN'T HAVE DOCTORS!

Defenders of this new system said it didn't matter anyway because all we had to do was give them the new generation of schizophrenia drugs that removed their symptoms. The problem with those drugs was that, besides making the patient FEEL bad, they had all kinds of side effects, like weight gain, sexual dysfunction and a very high incidence of diabetes. First-time visitors to a mental ward are often amazed at how many FAT PEOPLE are there, and, believe me, it's not because of the cafeteria food.

And now, for better or worse, we have a third-generation schizophrenia drug, which on closer examination turns out to be just another second-generation drug but without the more severe side effects. And that's good, I guess. At least they won't be overweight and going blind from diabetes. But all these drugs deal only with symptoms, not causes. From what I can tell, we've given up on cures entirely. Most schizophrenia research today is directed toward brain genetics, in an effort to find out how the disease is passed down in the first place.

Unfortunately schizophrenics can't form political action committees or pressure Congress or agitate for reform. I mean, they could -- some of them manage to function well enough to do that -- but they're always gonna sound like the raving religious freak standing in the 77th Street subway station. It's easy to just walk on by.

(Joe Bob Briggs writes a number of columns for UPI and may be contacted at [email protected] or through his website at joebobbriggs.com. Snail mail: P.O. Box 2002, Dallas, Texas 75221.)