Stuff You Should Know - SYSK Selects: How Schizophrenia Works

Episode Date: January 12, 2019

Up to 24 million people worldwide have schizophrenia. Despite the vast amounts of research, the disorder remains mysterious. In this episode, Josh and Chuck delve into the nature of schizophrenia, from the history of the disorder to the latest research. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Apple Podcast, or wherever you get your podcasts. Hi, everyone. It's Josh here, and for this week's SYSK Selects, I've chosen our episode on schizophrenia. First of all, please excuse the rampant use of the word schizophrenic. We know better now. And delight in a clip of Wesley Willis's rock and roll McDonald's. If you've never heard of Wesley Willis, go check him out, as I clearly want you to do throughout this episode.

And also note that there is a rare corrections rather than listener mail, a correction segment that apparently just didn't take off, probably because we would have just ended up doing nothing but corrections for episodes. At any rate, I hope you enjoy this one. It's a good one. Hey, and welcome to the podcast. I'm Josh Clark with me. As always, it's Charles W. Chuckers, Chuck Tran, Chuckaluck, right? How you doing? I'm great. I'm going to see Bob Dylan tonight.

People are going to be like, how many times is Bob Dylan playing on land? Have you ever seen David Bowie? It's good. I have not. Yes, you are, Chuck. I know you're very excited. I am. I've seen him a few times, but it's always good. You really? Yeah. Too short, though. He buzzes through like 15 songs. He's out of there.

Is he short? Oh, well, he's also short, but yeah. Is he really his? How is this kidding? No, he's short. I guess those bell-bottom long pants that he wore in the 60s on his album, he never wore bell-bottoms. Made him look kind of tall.

All right, so enough about Bob Dylan for the second time. I'm not a big Dylan fan myself. Let's talk about schizophrenia instead. I was looking for an intro for this, and I mean, there's plenty of stuff, but it's all pretty research-heavy. AstraZeneca was marketing Cerakwil off label and just settled. Let's see. What else? Jared Loffner is being medicated against as well.

The guy who shot Gabriel Giffords. Oh, okay. Really? Yes. He's been diagnosed as schizophrenic. Interesting. Finally. And then there was a homeless man in Los Angeles who was beaten to death by the police yesterday or today. Awful.

And all of this is kind of, I realized there wasn't any one thing that I was like, well, here's the intro. But I realized all of it together gives a pretty good overview of schizophrenia as it stands right now, which is it's misunderstood. It's heavily prescribed. Underfunded. Research, that is. Yeah. And there's a lot of people out there who aren't necessarily getting help who need it.

Yeah. In fact, I got a stat if you want to go ahead and go there. You got a bunch of stats you set for this, right? I do. If you want to talk about people getting help and, or needing help and not getting it, 6% of schizophrenics are homeless. Yeah. 6% are in jail or prison, 10% in nursing homes, 25% with a family member, 28% are independently living, 20% supervised housing.

And it makes sense, Chuck, too, that these make sense because first of all, you have all of this crazy stuff going on to you that's your reality. So you're having trouble dealing with reality as it stands. Secondly, a lot of times schizophrenia comes on during times when you learn how to hold down a job or take care of yourself or do whatever. So you might never learn how to do this because you're dealing with your schizophrenia. Here's the shocking one. Oh, okay.

At any given moment, there are more people with untreated, severe psychiatric illnesses living on the streets than there are receiving care. Wow. They outweigh the people that are actually getting help. That's, that is shocking, but not surprising somehow. Agreed. Wow. So you said, what was that last one? Severe psychiatric illnesses. So that's an umbrella term, obviously.

Right. But in schizophrenia falls under that, for sure. But prior to the beginning of the 20th century, it was pretty much thought of as a generalized illness. Like mental illness was mental illness and maybe there is a symptom, your symptoms were different, but really you were mentally ill, which was a huge step up from the spirit possession that had previously been ascribed to or probably millions of years. Yeah. So it was, it's a fairly recently classified mental illness.

So it wasn't until 1893 that a German psychiatrist named Emile Craplin classified schizophrenia as a mental illness and he misclassified it as a form of dementia, early, an early type of dementia. And then in 1911, a Swiss psychiatrist named Eugen Blüter came up with the name schizophrenia. That's right, Josh. And he got that word from the Greek words for split in mind, which contributes somewhat to the misconception that it is a split personality disorder. But what he meant was there's a disconnect with reality. Right. The mind splits from reality, which today we still,

that's how you still perceive schizophrenia, but rather than split, we use the word break. There's a psychotic break. Yeah. And we should go ahead and just, since that is a common misconception, it is entirely different than split personality disorder, which they call disassociative identity disorder now. And if you know the move, the show United States of Terra, have you seen that? No, I know what you're talking about though. With Tony Colette.

She is, has split personality disorder on that show. And that's the one that you always see in the movies where you have multiple personalities and they don't know about each other and one dominates the other. And then what all about Eve was about? I had never saw that. Sybil. Sybil, yeah. For sure.

But it's not schizophrenia. They have nothing to do with each other other than they're both types of mental illness. Right. And Hollywood is fascinated by them. That's right. Right. So yeah, that's a pretty good example of medicines is starting to get a hold of what schizophrenia is, what mental illness is in general. And then the public at large still just being completely undereducated about it. So let's educate people about it.

Yeah. I want to say too that this is like a lot of conditions and disorders that develop later in life. To me, that's one of the scariest things that can happen. Yeah. Like you're cruising along at 27, 28 years old and you think like, you know, I'm all good. And you can develop schizophrenia like a boom in a matter of weeks sometimes. Yeah. It can either come on gradually or very suddenly in an acute manner. And you said later in life with men, schizophrenia usually develops in the late teens or early 20s

is when it starts or in women, it's the mid 20s or the early 30s. So yeah, by the time I was 30, I certainly didn't think I was going to become mentally ill. No, you thought, I know my demons, I can write them down in a list. I can quit them anytime I want. Yeah. And that's what they are. They're self-imposed demons. Right. This is, it wasn't something that was beyond my control that happened to my mind. Right.

And yeah, that's how schizophrenia hits you. It hits you later in life and it can happen all at once or gradually. And this is not to scare the crap out of you if you're in your teens or 20s because there's only about a 1% chance that you'll get schizophrenia. It depends. If you're part of the general population, there's a 1% chance, but as we'll see. Yeah. Yeah. Good point. There are risk factors that increase your chances of having schizophrenia.

And no, we're not trying to scare you, but I guess kind of the newest forms of treatment or newest thoughts about treating schizophrenia is to make people aware of it so that they will be able to recognize it early on and apparently early treatment leads to a better success rate. I think that's across the board. But Chuck, there's two kinds of symptoms of schizophrenia and they're positive and negative. And it's not like positive symptom means you hallucinate bunnies where negative symptom means you hallucinate like a hell demon.

Instead, positive symptom is like an exaggeration of normal behavior. So like, I see you, I hear things, but I don't see you with horns and I don't hear Kermit here talking to me. Right. Right? So a positive symptom is an exaggerated behavior. Negative symptom is the absence of normal behavior. Like you lack affect or the ability to experience any emotion or you basically are just generally

apathetic. Right? Yeah. And so that's positive symptoms and negative symptoms. Yes. And certain negative symptoms are cognitive that deal a lot with attention span and memory, lack of memory, inability to like plan anything or organize anything. Right.

And then another form of negative I should say is called abolition. It's basically, I think Crepler, the guy who first classified schizophrenia, call it the annihilation of the will where you're just so withdrawn you can't, you no longer engage in goal directed behavior from brushing your teeth to paying your bills to doing anything. You're just totally withdrawn. Wow. So that's not the form of schizophrenia you usually hear about, but apparently it's fairly common.

Really? Yeah. So to get diagnosed, Josh, you have to exhibit a certain number of these symptoms over at least six months without stopping, right? Yeah. If you have, is it schizophrenia form? Is like a shorter, it's schizophrenia, but it lasts less than six months. Yeah, that's schizophrenia form.

Right. Good point. But if you, according to the DSM, and we should say like this is, you know, it's based on clinical observations or whatever, but this is the DSM saying six months, it may be, you may have schizophrenia and you just haven't reached the six months, you know, period yet, but you're still schizophrenic, but to be diagnosed by a psychiatrist or a psychologist who's a member of the APA, you have to have X number of symptoms for six months or more. Yeah, and they have to do that because it's like the same as the cops when they say you

can't file a missing person's report unless they've been gone for 24 hours. It's not like that, but it's sort of like that. Now there's like a law, I think in Michigan called Cayley's Law or something that they're introducing where if you're a parent and you don't report your kid missing after 24 hours, it's a felony. Oh, really? Yeah. What kind of parent wouldn't do that?

The parent that- Casey Anthony? Yeah, made the kid go away. Allegedly. Allegedly. No, not in general. Schizophrenia apparently is how it's pronounced, can take a few forms. The one you've probably heard about most is paranoid schizophrenia, which is when you have the full-on delusions and hallucinations, and then there's disorganized,

that is disorganized thinking. Your behavior is probably incoherent. It's also called hepophrenic. Really? Yeah. And you probably don't exhibit a lot of emotion. Yeah. Well, usually like there's a negative symptom coupled with disorganized behavior. Okay. So it's almost like two separate things. I think you can be hepophrenic without being negative.

Gotcha. There's catatonic. That means you move around and talk excessively. Yeah, that was a surprise to me. I always thought, you know, catatonic state where you're just like- Yeah, that's what I would think too. But it also says they may become still an uncommunicative state. Right. So it can be one or the other. Yeah.

But I guess it has to do with motion or movement or lack of. Right. It's catatonic. Undifferentiated means that it's just sort of the umbrella term for when you have a mix of symptoms and they don't want to classify you as one specific kind. And then residual is if you have a history of schizophrenia, but you have a long extended period of time with no negative, I'm sorry, with negative, but no positive symptoms, they'll classify you as residual. Right.

Which, you know, I guess that's better than paranoid schizophrenia in a way. I don't think any form of schizophrenia is bad. Right. It would, that would be, it'd be horrible. This is a horrible disease. It is. That's like the curbier enthusiasm when Larry asked us, someone had good Hodgkins from the party of five episodes is what he was referencing when Charlie got sick. He had quote unquote good Hodgkins and they were like, they were so offended there. There is no good Hodgkins.

He's like, yeah, but one's better than the other, right? And they were just like, you're such a jerk. The never seen end like that. Yeah, pretty much. And then we mentioned schizophrenia form, which is an abbreviated version of schizophrenia. And then this one has to be just horrible. Schizoaffective disorder. It's any kind of schizophrenia coupled with the mood disorder, like depression.

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It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. So we should probably say there's delusions and there's hallucinations mixed in together often with schizophrenic symptoms,

and they're often confused. But a delusion is a false belief, and hallucination is a false sensation. Like, hey, I'm Jesus Christ. That would be a delusion. Right. Or hey, there's Jesus Christ on top of that subway car. That would be a hallucination. Yeah.

And you can extend that to anything. It didn't have to be Jesus. Or a subway car. You're right. But just studying hallucinations and delusions are really, really interesting in my opinion. Agreed. The most common hallucination is auditory among schizophrenics,

and the most common auditory hallucination are voices. Yeah, they hear voices that can come from anywhere. From this Kermit the Frog could start talking to me, or it could come from thin air, or it could come from the electrical outlet in the wall. Right. And the voices say, usually it's like one word, a couple of words, there's an implication of a word, sometimes it's indistinct mumbling.

On occasion, very rare occasions, will the voice like ramble on coherently, where the patient understands like long sentences. But that also may be commenting on what the person's doing is very common. Yeah, usually it's not a voice that they recognize, although that can happen as well. Yeah. Right.

And then sometimes there's more than one voice, and even more disconcertingly, the voices will argue about the patient. Yeah. Which, that's, wow. Well, those, I mean, there's a guy on Marta that I see that, and a lot of people that you see that are walking down the street screaming out loud, they, there's probably a pretty good chance that they might be paranoid schizophrenics.

Yeah. And they are yelling at the voice in their head. That reminds me of the stand-up bit I saw when I was a kid in the 80s. This guy was like, this comedian said he was walking down the street, and he walked past this guy, he was talking to himself, and he was just mumbling, sounded so angry, and the comedian goes, and I thought, man, that guy is really crazy. He's talking to himself.

And then I thought, wait, who am I talking to? Yeah, that's a good point. Yeah. I talked to myself all day long. I have arguments in my head. Yeah. But of course, it's not the same thing. No.

No, you don't have two voices arguing over what you're doing at that moment, and what's best for you, or whether you should hurt somebody or hurt yourself. Not making light of that. And the reason that a percentage, a frightening percentage of schizophrenics kill themselves is a lot of times because the voice in their head may command them to do so. Right, there's such a thing as commanding hallucinations, which is sometimes they could be suggestive, like maybe we should go outside for a while, or they could be like go outside, you know?

And it's not always scary. Like they point out sometimes it's, hey, you need to shave again. Right. And you'll go shave again. Yeah, it can be innocuous, but it can lead to violence, or it can urge violence. Apparently, the vast majority of people who suffer dangerous command hallucinations are able to suppress them, but it's a struggle, and this is going on in this person's head. Yeah, and rarely, and I wondered about this too before I got to that point in the article

that you sent me, rarely do you hear really great things. Like you're doing great today, and you should go pick that flower and smell it. It's interesting that it usually takes a dark turn. Yes, it is. And they don't know why. No, they don't. There's also hallucinations of touch, haptic hallucinations, which sound pretty awful. Things are crawling on you, things are inside of you trying to get out.

Your bowels are shriveling, you're being jolted by electricity is a very common one. And then delusions, obviously, of any false belief, there's some that, like you are Jesus Christ, that's a delusion, right? But there was one subcategory that caught my attention that I wasn't aware of, it's called delusion of reference. Yeah, tell me about that. Well, it's basically like every single thing that goes on in life is full of meaning, right? So like in this Brown University sheet I sent you, there's a waiter leaving a crumb on the table that's purposeful, it's an insult to the patient, like the busboy or the waiter did that on purpose

as an insult. Or the street lights coming on all of a sudden is a signal for everybody to swarm on you and finally take you away or kill you or whatever. Like everything in life has meaning and it's making you, it's fueling this paranoia. Your mind is turning against you, it's pretty awful. Have we said it's awful? Yeah, okay. Yes, it is quite awful, but people live with this. Yeah, I mean we painted a dark picture because it is a dark disorder, but the majority of people,

in fact stat time, after 10 years, if you want to know, after 10 years of diagnosis with schizophrenia, 25% completely recover, 25% are much improved and relatively independent and 25% are improved but require a pretty extensive support network. So that's 75% of people after diagnosis after a decade are dealing with it fairly well. Yeah, that's very hopeful. That's not bad, 15% are unimproved and 10% unfortunately are dead probably by suicide. Yeah, well 10% at least of schizophrenics commit suicide, which is incredibly high because in the general population of the United States, 0.01% of people commit suicide.

So 10% to 0.01%. Yeah, and that's people who are successful. They think it could be, attempts could be as high as 55% people that try to kill themselves. Just to, I mean, imagine sometimes the voices say to do it and sometimes it's just a fine piece. Yeah, I was wondering what the breakdown between those two is as well. And then violence is often attendant with schizophrenics, at least in the public mind, right? Yeah, but it's not quite true. You're dangerous.

Yeah. Apparently studies have shown, I don't remember reading about this when we talked about latent inhibition, that if you are typically violent when the symptoms set in your early 20s or whatever, you're going to possibly be a violent schizophrenic. If you're not a very violent person, it's just not part of your personality before the symptoms set in, then you're not going to be a violent schizophrenic. Unless you abuse drugs or alcohol, which apparently vastly increases the chances that you may be a violent schizophrenic.

Yeah, and even then, I think the violence is generally either self-inflicted or it takes place inside the home, like against your family, which is not good, but point is, if you're walking down the street and sadly you see the homeless man screaming out loud, you don't necessarily need to be afraid that he's about to, you know, attack you in a violent manner. Right. That's probably not going to happen. No. Chuck, let's say you do want to talk to that schizophrenic homeless man over there,

but you don't want to make things worse for him, right? But you don't want to ignore him. He's another human being. The National Institutes of Mental Health have suggestions, I guess, for talking to schizophrenics and specifically with their families who have to deal with delusions and hallucinations all the time, specifically delusions. Apparently, you don't contest what they're saying. Yeah, you don't want to say, you're not Jesus Christ.

Like, what are you talking about? Yeah, you definitely don't want to say that. No, you say, I respect your right to believe different things, and I hope you'll respect my right to believe different things, but I, you know, politely disagree. Yeah, and what you also don't want to do is agree and say, I know, honey, you are Jesus Christ. Right. You're okay, you're Jesus, and it's fine. Yes, and a lot of people probably take that tack in the family, you know?

Well, yeah. First, I mean, at the very least, because it's just easier after a while, it's like, yes, yes, or you get so frustrated, you're like, no, you're not, and you want to shake the person. Right. But yeah, apparently, and I wonder how hard it is to say, well, I respectfully disagree with you. Yeah, I bet it's hard. You know, and if it does go over as well as it seems like it suggested it should, you know? All right, Josh, I think this was really interesting, the recovery in the third world part.

Yeah. Apparently, the World Health Organization did a study in the 1960s and found that the recovery rate for schizophrenia in developing nations is higher by a full third than it is in the industrialized world, and then they did a follow-up study even to correct possible selection biases, and they confirmed the original finding. And I thought that was really interesting, and there's a lot of hypotheses, but one of them is that, A, there might not be a stigma like in the industrialized world, and they're just more readily accepted, and the other is that they might be able to have a job that they can do

successfully, and farming or digging the trench for the farm or whatever. Right, and here in the West, we're very competitive. Yeah, it's hard to get a job that a schizophrenic can maybe successfully complete. Right, and I mean, the rest of us are paranoid enough as it is about losing our jobs. If you are clinically paranoid schizophrenic, then it's probably going to be very difficult to keep your job or do it in a way that will help you keep your job. That's very true. But Josh, there have been some successful stories of people that are reflected with schizophrenia.

Well, some were successful, and some, Sid Barrett was successful, but I don't know if you call him a success story, he ended up in a mental institution for the rest of his life. Yeah, Sid Barrett, founding member of Pink Floyd Schizophrenic, and they believe that massive amounts of drugs that he used made it worse. Way worse. John Nash. He is the crazy diamond. Yeah, shine on you crazy diamond.

Yeah. I love that song. That's a good one. All four parts of it, right? And they're like part, I think up to part four. Is it? Yeah, yeah, John Nash. Yeah, from the movie A Beautiful Mind, the Ron Howard film with Russell Crowe as John Nash,

the Nobel winner. The one who helped figure out that cable companies would do better if they cooperated with one another. That's right. And that movie did a lot for putting this on the map in a compassionate way, you know. And Jack Kerouac, did you know that one? That one's debatable. Okay. He was in the Navy and they discharged him honorably after, I think like a little less in a year.

And the report, they said he had schizoid tendencies. But other people have said that he faked that stuff to get out of the Navy and just wanted to not take orders and drink himself to death, which is what he did. And Pop Benny's. Do you know how he died? No. No, he woke up and with just like coughing blood and bleeding from his mouth and basically was like, I got to go to the hospital, took him to the hospital and his liver was so shot

that his blood wouldn't clot and they just were giving him transfusion one after the other. And he just basically bled to death. Holy cow. From drinking. Holy cow. And he was drinking at the time. He was drinking whiskey and like whiskey and malt liquor. When he started, blood started coming out of his mouth.

I wonder how it tastes. Would you shake or stir that? And I don't think he mixed them. I think it was like whiskey with a beer bag. And a garnish with a drop of blood. So kids, there's a lesson for you. There is one more person who is indisputably schizophrenic or was, his name is Wesley Willis. Who's that?

He is a musician who had such songs as well, really the only title I can say is rock and roll McDonald's. I don't, I've never heard of him. You, you have had to have heard of Wesley Willis. Really? Okay. Let me play you a little Wesley Willis right here. All right.

McDonald's is a place to rock. It is a restaurant where they buy food to eat. It is a good place to listen to the music. People flock here to get down to the rock music. So Chuck, that's Wesley Willis. Oh, okay. Okay. And he was very much schizophrenic.

He wrote about it a lot. He talked about it in a lot of his songs. And he said he'd just be going along, having a nice time riding the bus. Yeah. I believe he lived in Chicago. And then all of a sudden his, his hell demons would take him on one of his torture hell rides, which meant he was going on a little bit of an exacerbation of his schizophrenia symptoms. Wow.

But he's a great, great guy, great music, very prolific. And if you liked that, you should go watch Daddy Rock and Roll. Is it documentary about it? Yeah, it's really good. I'll check that out. Yeah. Lionel Aldridge is the last name on our list. And he was a Green Bay Packer.

And he was homeless, unfortunately, after he was diagnosed for a while. And then later was able to climb out from that wreckage and go around and talk about mental illness. And he was, he was playing in the 60s, the 70s. I think it was late 60s or 70s. So think about it, man. That's a big deal to go around and talk publicly about mental illness at that time. I am, for sure. And it still is now.

But I mean, like back then that's, that's off to him. Yeah. He was the guy that I included in the presentation that you did by yourself. Oh, okay. That you're like, he was this guy. Yeah. All right. I understand now.

Yeah. It's all coming together. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it.

And now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal? No, it was hair.

Do you remember AOL instant messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in, as we take you back to the 90s. Listen to Hey Dude, the 90s, called on the iHeart radio app, Apple Podcasts,

or wherever you get your podcasts. I'm Mangesh Atikular, and to be honest, I don't believe in astrology. But from the moment I was born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're going to get secondhand astrology. And lately, I've been wondering if the universe

has been trying to tell me to stop running and pay attention, because maybe there is magic in the stars, if you're willing to look for it. So I rounded up some friends and we dove in, and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop? But just when I thought I had to handle on this sweet

and curious show about astrology, my whole world came crashing down. The situation doesn't look good. There is risk to father. And my whole view on astrology? It changed. Whether you're a skeptic or a believer, I think your ideas are going to change too.

Listen to Skyline Drive and the iHeart radio app, Apple Podcast, or wherever you get your podcasts. So Chuck, what causes this? Well, it seems like there are environmental factors and there are genetic factors. They have isolated what they believe are some genes, the D-I-S-C-1, the Disbinden, the Neurogulin, and the G7-2 genes.

Okay. And they think there might be up to a dozen more genes that could impact this. Okay, so the basis of that is that they can't just look at your genes and say you're going to be schizophrenic. Right. It's possible that it's because we just haven't isolated all the genes and don't know the right combination yet.

Right. Or it's possible that it's from other causes, one of which, one of the theories that's out there right now is that it's the result of an in-utero exposure to either a flu or the dread toxoplasmosis. Remember toxoplasmosis? I do. That hijacks rat's brains that's found in cat urine?

That's why if you have a cat and you're pregnant, you don't be cleaning up that litter box. Right, and they think that one of the reasons, I guess one of the pieces of evidence that supports this is called the birth month effect. And the birth month effect is if you were born in winter months or early spring months, you are at a higher risk for becoming schizophrenic later in life.

And they think that those are flu months. And another aspect of it is apparently the brains of schizophrenics show inflamed white blood cells, which is a sign of an infection. And they think that possibly all of us are carrying around a retrovirus encoded in our genes that lies dormant, like MS, that under the right circumstances, like early exposure to an infection can trigger its release

or trigger its activation. And it takes 18 to 20 to 30 years to come on. Now you see why people that are pregnant are worried a lot. It's amazing that we've gotten anywhere. I know. Yeah. So what else? Well, they did do have some new findings.

I got this today from the internet. They have a New South Wales study from Thomas Weichert. He has identified the brain mechanism that derails decision making in people. So basically the part of the brain is called the ventral stratium. I'm sorry, striatum. And it lights up, you know, they put people in the MRI, lights up in response to rewards and healthy people.

And it's linked to your decision making, but completely unresponsive among schizophrenics. So they don't know the difference between expected and unexpected rewards. And so they don't have the opportunity to make a good decision to begin with. And that, you know, it's a nice finding. It doesn't get us any closer. Well, maybe it does.

You never know. They say with proper funding that they predicted 2013, they could have a cure for this. Well, yeah. But they don't get proper funding. No, but they're looking into stem cells, right? They're looking into figuring out if it is an infection. And if so, like combating that.

And we've also long had antipsychotics. One of the things, strangely enough, that helped develop antipsychotics or better antipsychotics is PCP. Yeah. Apparently researchers figured out that phenylsiclidine or fensiclidine, PCP, the drug, angel dust, produced such similar symptoms to schizophrenia that they started investigating it and found that it had to do with the neurotransmitter glutamate, right?

Right. And dopamine, right? Yes. Well, it has to do with both, but the emphasis before on antipsychotics was strictly dopamine. Okay. And all it all it did was keep dopamine in the synapses longer by blocking its reuptake by receptors.

That's what antipsychotics do. Yeah. And then in the 80s, after the PCP stuff, they figured out that there was glutamate was involved. And they came up with atypical antipsychotics. And these focus somewhat on dopamine, but more on things like glutamate and its reuptake. And these things have produced better results

with fewer side effects. So they're figuring out how to treat it. Right. The problem is, is there's all sorts of side effects, even with atypical antipsychotics, like weight gain, drowsiness, sluggishness, nervousness. Muscle spasms. Yeah, bulging eyes apparently is one.

Oh, really? And I guess most of the stuff can be treated by lowering the dosage, but they're bothersome enough that a lot of people just go off their meds. Right. And that doesn't help. ECT, electroconvulsive therapies, another thing that they still do. It's not something a relic from the 50s.

Yes. It's changed a lot and how they do it. And they're not sure still how it exactly works. They stopped using car batteries. But about 100,000 Americans each year still receive ECT. So that is an option. And obviously the group therapy and family therapy help just the dealing with it aspect of the family.

Yes. So we encourage you to seek help as soon as possible. Yeah, and apparently families can help in very little ways. They're encouraged to set small goals. Apparently, especially if you have lost your drive or your will as a result of your schizophrenia or you're disorganized, it can just be compounded by all the... Like when your life is disorganized, it seems just completely unwieldy.

Yeah, like where do I start? Right, now if that's a symptom of your schizophrenia, it's just that much worse. So if you can help a schizophrenic get back on track by setting small goals and building up their confidence again, apparently that has a measurable effect in their recovery. I'm sure. And then one of the leading edges of schizophrenia treatment right now

is based on this thing called the prodrome, which is the period between the onset of symptoms where you think, maybe I am Jesus Christ and the time when that seems like your reality. So it's this point where you're starting to have the ideas, but they still seem bizarre or weird or why am I having these ideas. So if you apparently seek out treatment for schizophrenia when you start to have these ideas,

in the prodrome the success rate of treatment is through the roof. Really? Yes, this British doctor in the late 80s set up shop in these two towns outside of London and he set to work finding every potential early case of schizophrenia he could and he started treating people with therapy and low doses of antipsychotics. And in four years, those two towns had a tenth of the prevalence

of schizophrenia than the rest of the country. Wow. Yeah. So apparently this prodrome research, there's clinics that are opening up and entire departments and universities are dedicated to this prodrome period where you can be like, come back, this is reality.

Right, wow. Yeah, and they're successful or they have been so far. Well, Josh, I got one more stat. If you live in a city of 3 million people, then over 21,000 people in your city are suffering from schizophrenia. So keep that in mind. Yes.

Don't make fun of people. Don't obviously get scared or violent in a reactive way. I don't know that I'm going to say like you should go over and talk to them like you might want to just be compassionate and hopefully they're getting help. You know what I'm saying? Yes. Go to schizophrinia.com.

You can find all kinds of good information. And if you hadn't already checked out Wesley Willis, check him out. He was a great guy. Check out The Daddy of Rock and Roll. And also, I would say in addition to how schizophrenia works, required reading for this one is an article called Which Way Madness Lies by Rachel Aviv.

It was in the December 2010 issue of Harper's. And I have a link. I'll tweet it. I'll tweet the link with that. That sounds great. If you want more about schizophrenia, there's plenty of it. There's an article and then some on the site. Just type Schizophrinia, which again means split mind.

That's right. Into the search bar at howstuffworks.com. And that brings up what? Check listener mail. Yes, Josh. Specifically, Corrections. Oh, wow. I forgot about those.

Yeah. Well, we'll correct ourselves on Facebook and stuff, but they mount it up. So I think we might as well go for it. Okay. Okay. How wildfires work. Oh, man.

I don't have this guy's name. A couple of people sent this in. The flashpoint of paper is not Fahrenheit 451. I said books. The flashpoint of books is not Fahrenheit 451. It is Fahrenheit 851, Celsius 450, and Ray Bradbury apparently changed the title because Fahrenheit 451 sounds a lot better

than Celsius 450 apparently. What was 481? No, Celsius 450 is the flashpoint, or Fahrenheit 851. Oh, 851. That sounds as good as 451, I think. Yeah. Okay.

But I assume that as well. Man, I wish I had his name. You know who you are. And it was a very nice correction. Those are the ones we like to read. Then we got a correction on who was the first murderer. Apparently, David says, and he even sent in a copy of 1491 by Charles Mann.

What? Where? Where? What? He sent an email. No, not a, he sent a scanned copy of the page. Okay. In 1491, he says, Charles Mann says,

although Billington was in fact hanged, at least two other Europeans were executed before him. One was convicted for the much more interesting offense of killing his pregnant wife and eating her. So how about that? He said that was on page 55 of 1491. Yeah, there it is. That is crazy.

Okay. But still, Billington is a very noteworthy figure, obviously, sees a whole chapter on him. Sure. And then we got some, oh, first of all, some people wrote in about wildfires in Georgia when I said, oh, Georgia didn't have wildfires. South Georgia does.

And there's actually one going on right now in the Okefenokee. So I misspoke for sure because I was just talking about the North Georgia Mountains, which are very lush and green. But South Georgia can get quite dry. And there are wildfires in Georgia. I did not know that.

That is true. And then finally, we got an email from an actual Hindu named Kush, K-U-S-H. And Kush says, you guys missed a few things. Hinduism typically, I'm sorry, technically, only has one God, not a pantheon. It's complicated to explain, especially in the non-Hindus, but the general idea is there is one universal soul or God

that encompasses everything called the Brahman. Okay, I've heard of that. Not the Broham. And every living thing has a part of that in us called the Atman. The different gods are just different forms of the one Brahman. Also, you didn't properly explain the laws of karma. The law of karma has three parts in Hinduism. One, the performer of an action will get the result.

Two, the result of the action will come right at the right time. And three, good actions bring good results. Bad actions bring bad results. And fourth, the gods are technically subject to karma if you also expand the definition of karma to include the law of karma. But he says it was a good podcast overall. You guys really hit it on the head, except for these few points. You did not hit it on the head for that.

No, I'll just for that one part. Wow. And finally, he pointed out, and a few other people pointed out, that I was wrong in correcting you with Jainism, and that it's Jainism. Thank you. But I'm going to play you something right now. Okay. Jainism.

Okay. That was from a dictionary.com. Well, that voice is obviously wrong. Maybe so. This is from Merriam Webster. If it's the same voice, it doesn't count twice. Jainism. Wow.

Did you hear that? That's a different voice. Did that one come through, Matt? Okay. And then finally, this is Google definitions, and this is my favorite of all, actually. I don't like where this is going. Jainism.

Wow. So I don't know, because I had like three other people said, no, man. Three other robots? No, three other real people said, no, it's Jainism. And then I went on YouTube and people said Jainism. So I don't know. Well, I like that it's both. We're both right.

Yes. Or we're both wrong. Yeah. Yeah. It was Jainism. Well, we love corrections so much that I managed to forget that we, or are corrected a lot, or we used to read them. I never forget that we're corrected.

Right. But let's do this again soon. Agreed. Go through all 350 episodes. Find everything you can. That's wrong with them. And then let us know. Okay?

Okay. Or you can just correct the most recent ones, whatever we got wrong in this one, which I'm sure is substantial. You can go on Facebook if you want. You can tweet to us, S-Y-S-K podcast. Or you can send us a plain old fashioned email at stuffpodcast at howstuffworks.com.

For more on this and thousands of other topics, visit howstuffworks.com. Want more HowStuffWorks? Check out our blogs on the HowStuffWorks.com homepage. I'm Munga Chauticular, and it turns out astrology is way more widespread than any of us want to believe. You can find it in Major League Baseball,

international banks, K-pop groups, even the White House. But just when I thought I had a handle on this subject, something completely unbelievable happened to me, and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes, because I think your ideas are about to change too.

Listen to Skyline Drive on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey guys, I'm Kaylee Short. On my podcast too much to say, I share my thoughts on everything from music to martinis, social media to social anxiety, regrets to risky texts, and so much more. I have been known to read my literal diary entries on my show,

and sometimes I do interviews with my crazy group of friends. So if you guys want to tune in, you can hear new episodes of Too Much to Say every Wednesday on the National Podcast Network, available on the iHeart radio app, Apple Podcasts, or wherever you listen to them.