SECOND OPINION | PSYCHOSIS | BCBS | Full Episode


>>ANNOUNCER: “SECOND OPINION” IS BROUGHT
TO YOU BY BLUECROSS BLUESHIELD. ACCEPTED IN ALL 50 STATES. BLUECROSS BLUESHIELD. LIVE FEARLESS.>>ANNOUNCER: “SECOND OPINION” IS PRODUCED
IN CONJUNCTION WITH U.R. MEDICINE, PART OF UNIVERSITY OF ROCHESTER
MEDICAL CENTER, ROCHESTER, NEW YORK.>>DR. PETER SALGO: THIS IS “SECOND OPINION,” AND
I’M YOUR HOST, DR. PETER SALGO. THIS WEEK, “MYTH OR MEDICINE”?>>ROBERT WEISMAN: IS VIOLENCE MORE COMMON
IN PEOPLE WITH SEVERE MENTAL ILLNESS? FIND OUT ON THE NEXT SEGMENT OF “MYTH OR MEDICINE.”>>DR. PETER SALGO: AND SPECIAL GUEST LYNNE FISHER. SHE HAD A LIFE-CHANGING EXPERIENCE IN HER
MID 20S.>>LYNNE FISHER: I WAS PETRIFIED THAT THEY
WERE GOING TO KILL ME IN THE HOSPITAL, AND I THOUGHT THEY WERE GOING TO DO THAT IN VARIOUS
WAYS. I THOUGHT THEY WERE GOING TO POISON ME WITH
THE MEDS. I THOUGHT THEY WERE GOING TO GAS ME UNDER
THE DOOR AT ONE POINT.>>DR. PETER SALGO: SHE’S HERE TODAY TO SHARE HER
STORY WITH “SECOND OPINION.”>>DR. PETER SALGO: THANKS SO MUCH FOR BEING HERE,
LYNNE. I KNOW YOU’VE GOT A LOT TO TELL US, AND I
KNOW WE’RE GOING TO GET TO YOUR SECOND OPINION, TOO, SO WHY DON’T WE GET RIGHT TO WORK? I WANT TO INTRODUCE YOU TO YOUR “SECOND OPINION”
DOCTORS. THEY’RE GOING TO BE HEARING THIS STORY FOR
THE FIRST TIME. DR. DONALD GOFF FROM THE NATHAN KLINE INSTITUTE
FOR PSYCHIATRIC RESEARCH IN NEW YORK. “SECOND OPINION” PRIMARY CARE PHYSICIAN DR. LOU PAPA FROM THE UNIVERSITY OF ROCHESTER
MEDICAL CENTER, AND DR. DANIEL SMUCKLER FROM THE BRONX PSYCHIATRIC
CENTER. TELL ME A LITTLE BIT ABOUT YOUR STORY, WHEN
THIS ALL BEGAN. YOU WERE IN YOUR 20S, RIGHT?>>LYNNE FISHER: YES, I WAS ABOUT 23 WHEN
I GOT MARRIED, AND IT WAS AN UNHAPPY MARRIAGE. I WAS WORKING ALSO AS A HIGH SCHOOL SPANISH
TEACHER, AND I WAS UNHAPPY AT HOME AND UNHAPPY AT WORK. THE JOB WAS VERY STRESSFUL, AND WHAT HAPPENED
WAS, I GOT VERY DEPRESSED. I DIDN’T KNOW THAT’S WHAT I WAS –>>DR. PETER SALGO: WHAT EXACTLY HAPPENED? I KNOW THAT’S SORT OF THE MEATBALL TERM, BUT
I’M INTERESTED IN MORE OF THE FINE STRUCTURE. WHAT HAPPENED — A DAY?>>LYNNE FISHER: YES. THE LAST DAY I TAUGHT WAS IN A MIDDLE SCHOOL,
AND I WASN’T SPEAKING SPANISH AND I WASN’T SPEAKING ENGLISH CLEARLY, AND THE PRINCIPAL
PULLED ME OUT OF CLASS AND SAID TO ME, “WE THINK YOU NEED TO TALK TO THE SCHOOL GUIDANCE
COUNSELOR,” AND SO SHE PULLED ME OUT, AND THE GUIDANCE COUNSELOR WAS ABLE TO TELL THAT
SOMETHING WASN’T RIGHT, AND THEY CALLED AN AMBULANCE.>>DR. PETER SALGO: AND THEY TOOK YOU TO THE HOSPITAL.>>LYNNE FISHER: THEY DID.>>DR. PETER SALGO: ALL RIGHT, I WANT TO STOP THERE
FOR JUST A MINUTE. IS IT FAIR TO SAY, BASED ON WHAT THE PRINCIPAL
TOLD YOU, YOU REALLY WEREN’T MAKING SENSE? YOU WERE BABBLING?>>LYNNE FISHER: YES.>>DR. PETER SALGO: ALL RIGHT, WHAT’S GOING ON HERE? LOU, YOU’RE A PRIMARY-CARE DOCTOR.>>DR. LOU PAPA: SO SOME OF THE STUFF THAT YOU WORRY
ABOUT AS A PHYSICIAN WHEN SOMEBODY’S BABBLING IS IF THEY’RE HAVING AN ISCHEMIC EVENT, A
STROKE. THEY CAN BECOME APHASIC WHERE THEY’RE MISUSING
WORDS, AND IT’S NOT MAKING SENSE. 23 IS PRETTY YOUNG, AND THAT WOULD BE UNUSUAL
UNLESS YOU’RE TALKING ABOUT A BLEED OR ONE OF THE RARE INSTANCES THAT YOU’LL SEE THAT. SO THAT WOULD BE MY EMERGENT CONCERN IN SOMEBODY
LIKE THAT.>>DR. PETER SALGO: SO, GOING TO THE HOSPITAL, YOUR
FIRST CONCERN IS TO RULE OUT LIFE-THREATENING THINGS — STROKES, BLEEDS, ALL THE BIG PHYSICAL
STUFF THAT A CT SCAN OR AN MRI COULD FIND. I’M ASSUMING YOU’D ALSO LOOK FOR ELECTROLYTE
IMBALANCES…>>DR. LOU PAPA: ABSOLUTELY.>>DR. PETER SALGO: …INTOXICATION, THINGS LIKE
THAT. ALL THAT BEING RULED OUT, GENTLEMEN, WHERE
DO YOU GO NEXT?>>DR. DONALD GOFF: YOU SAID THAT YOU WERE NOT MAKING
SENSE.>>LYNNE FISHER: RIGHT.>>DR. DONALD GOFF: WAS IT BECAUSE YOUR SPEECH WAS
GARBLED OR WERE YOU SAYING THINGS THAT WEREN’T CORRECT?>>LYNNE FISHER: I WAS SAYING THINGS THAT
DIDN’T MAKE SENSE. I DO REMEMBER THAT I WAS UNABLE TO COHERENTLY
PUT A SENTENCE TOGETHER. I WAS TALKING ABOUT THINGS THAT WEREN’T HAPPENING. THEY CALLED IT CLINICAL DEPRESSION AT THE
TIME WITH PSYCHOSIS.>>DR. PETER SALGO: CAN I STOP YOU RIGHT THERE?>>LYNNE FISHER: SURE.>>DR. PETER SALGO: DEPRESSION SOUNDS DIFFERENT THAN
— YOU WERE TOLD YOU HAD DEPRESSION.>>LYNNE FISHER: YES.>>DR. PETER SALGO: BUT THAT DOESN’T SOUND LIKE DEPRESSION
TO ME. DOES IT SOUND LIKE DEPRESSION TO YOU?>>DR. DANIEL SMUCKLER: NO, NOT ON THE FACE OF IT. OF COURSE I HAVE MANY MORE QUESTIONS. I’M WONDERING FOR HOW LONG THIS WAS GOING
ON.>>LYNNE FISHER: OVER THE SPAN OF THREE YEARS. SO IT WAS A GRADUAL DECLINE.>>DR. DANIEL SMUCKLER: A GRADUAL DECLINE UNTIL THIS
MOMENT OF CRISIS.>>LYNNE FISHER: EXACTLY.>>DR. PETER SALGO: AND IT CULMINATED WITH THIS MOMENT.>>LYNNE FISHER: YES.>>DR. PETER SALGO: IS THAT IT?>>LYNNE FISHER: AND NO ONE KNEW IN MY FAMILY. I DIDN’T TELL ANYONE HOW SERIOUSLY — YOU
KNOW, I DIDN’T REALIZE IT MYSELF HOW ILL I WAS.>>DR. PETER SALGO: NOW — I’M SORRY. THEY TOLD YOU YOU WERE DEPRESSED? IS THAT WHAT I HEARD?>>LYNNE FISHER: YES.>>DR. PETER SALGO: AND THEN WHAT DID THEY DO FOR
YOU IN THE HOSPITAL?>>LYNNE FISHER: THEY GAVE ME E.C.T.>>DR. PETER SALGO: ELECTROCONVULSIVE THERAPY. AND IN LAY TERMS, SHOCK THERAPY.>>LYNNE FISHER: EXACTLY.>>DR. PETER SALGO: NOW, THAT SOUNDS A LITTLE SCARY. I MEAN, EVERYONE HAS THIS VISION OF “ONE FLEW
OVER THE CUCKOO’S NEST.”>>DR. DANIEL SMUCKLER: WELL, I WONDER. DID THEY START WITH THE E.C.T. OR DID THEY TRY SOMETHING ELSE FIRST?>>LYNNE FISHER: TO THE BEST OF MY MEMORY,
THEY DECIDED PRETTY QUICKLY TO USE E.C.T., THE REASON BEING IT’S QUICKER THAN ACTUAL
MEDICINE. MEDICINE TAKES A WHILE TO KICK IN, SO THEY
SAID, “SHE NEEDS IT QUICKLY.”>>DR. DANIEL SMUCKLER: WELL, IT’S TRUE.>>DR. PETER SALGO: BEFORE WE EVEN GO DOWN THIS ROAD,
LET’S GET SOME DEFINITIONS. WHAT IS E.C.T.?>>DR. DANIEL SMUCKLER: WELL, ELECTROCONVULSIVE THERAPY
IS DELIVERING ELECTRICAL CURRENT TO THE CENTRAL NERVOUS SYSTEM.>>DR. PETER SALGO: TO THE BRAIN.>>DR. DANIEL SMUCKLER: THE BRAIN.>>DR. PETER SALGO: AND IT CAUSES YOU TO HAVE A SEIZURE.>>DR. DANIEL SMUCKLER: IT CAUSES A SEIZURE. IT IS ALSO A HIGHLY EFFECTIVE MEANS OF CORRECTING
MOOD DYSREGULATION.>>DR. PETER SALGO: AGAIN, NOW, THE REASON I’M GOING
THROUGH ALL OF THIS — IN OTHER WORDS, LET’S BE VERY CLEAR. THEY PUT ELECTRODES ON YOUR HEAD.>>DR. DANIEL SMUCKLER: YES.>>DR. PETER SALGO: THEY GIVE YOU AN ANESTHETIC. THEY PUT ELECTRICITY IN YOUR BRAIN, AND YOU
SEIZE. AND HOW THIS WORKS IS NOT ENTIRELY CLEAR. IS THAT FAIR TO SAY? BUT IT RESETS SOMETHING.>>DR. DANIEL SMUCKLER: YES.>>DR. PETER SALGO: AND YOU FEEL BETTER IF YOU’RE
DEPRESSED.>>DR. DANIEL SMUCKLER: YES.>>DR. PETER SALGO: BUT DOES IT MAKE YOU FEEL BETTER
IF YOU’RE NOT DEPRESSED AND THAT’S THE WRONG DIAGNOSIS?>>DR. DANIEL SMUCKLER: NOT NECESSARILY. I’D LIKE TO POINT OUT, THOUGH, THE DIFFERENTIAL,
NOT KNOWING MUCH ELSE, CAN INCLUDE A MAJOR DEPRESSION WITH A PSYCHOTIC ELEMENT, FOR EXAMPLE,
AND SO, PERHAPS, THIS IS WHAT THE CLINICIANS WERE THINKING.>>DR. PETER SALGO: WELL, LET’S MOVE ALONG. BECAUSE WHAT HAPPENED? DID IT WORK?>>LYNNE FISHER: IT DID WORK. I HAD THREE TREATMENTS A WEEK FOR THREE WEEKS. I IMPROVED DRAMATICALLY, AND I WAS OUT OF
THE HOSPITAL WITHIN A MONTH.>>DR. DONALD GOFF: AND AS YOU SAID, FOR PSYCHOTIC
DEPRESSION — MEANING SOMEONE WITH DEPRESSION AND PSYCHOTIC FEATURES. IN YOUR CASE, YOU WERE DISORGANIZED AND YOU
BELIEVED THINGS THAT WERE NOT TRUE, WHICH WE CALL DELUSIONS. E.C.T. IS ACTUALLY THE MOST EFFECTIVE RAPID
TREATMENT. THERE ARE OTHER DRUG TREATMENTS, BUT IT MAY
BE A REASONABLE APPROACH. OFTEN PEOPLE TRY DRUGS BEFORE THEY GO TO THAT,
BUT IT IS DEFENSIBLE TO START WITH E.C.T.>>DR. PETER SALGO: WERE YOU PUT ON MEDICATION TO
FOLLOW?>>LYNNE FISHER: I WAS.>>DR. PETER SALGO: AND WHAT HAPPENED AFTER THE THREE
WEEKS — YOU WERE RELEASED?>>LYNNE FISHER: I WAS RELEASED. I WENT ON WITH LIFE. I GOT A NEW JOB. I DID HAVE SOME RELAPSES OVER THE NEXT SIX
YEARS. I HAD A FEW HOSPITALIZATIONS, SOME ROUGH TIMES. ALWAYS WENT BACK TO WORK, AND THEN I HAD THE
BIG CRISIS IN 1999.>>DR. PETER SALGO: BUT BEFORE WE GET TO THAT, YOU’RE
GOING BACK TO WORK. YOU’VE BEEN HOSPITALIZED FOR A PSYCHIATRIC
DISORDER, WHICH, LIKE IT OR NOT, CARRIES A STIGMA IN OUR SOCIETY. DID YOU TELL YOUR COWORKERS WHAT YOUR DIAGNOSIS
WAS?>>LYNNE FISHER: THEY KNEW. YOU KNOW, I HAD FRIENDS THAT I’D SHARED WITH
THAT I HAD PREVIOUS ILLNESS, AND THEY BASICALLY KNEW. IT WAS A LITTLE AWKWARD GOING BACK IN THE
FIRST DAY. I KIND OF SMILED AND LAUGHED IT OFF, BUT IT
WAS TOUGH.>>DR. DONALD GOFF: DID YOU FEEL AS IF YOU HAD RETURNED
TO YOUR EARLIER STATE OF BEING WHEN YOU WERE DISCHARGED?>>LYNNE FISHER: YES. I THOUGHT IT WAS A ONETIME THING AND THAT
IT WOULD BE OVER AND DONE WITH.>>DR. DONALD GOFF: BECAUSE USUALLY THAT’S VERY IMPORTANT
IN TERMS OF OUR TRYING TO DECIDE ON A DIAGNOSIS. THERE ARE PSYCHIATRIC ILLNESSES WHICH ARE
EPISODIC. YOU HAVE AN EPISODE AND YOU RETURN TO YOUR
PREVIOUS LEVEL OF FUNCTIONING, AND THAT’S MORE CONSISTENT WITH A PSYCHOTIC DEPRESSION
THAN A CHRONIC ILLNESS LIKE, SAY, SCHIZOPHRENIA.>>DR. PETER SALGO: NOW, YOU WENT BACK IN, YOU SAID…>>LYNNE FISHER: 1999.>>DR. PETER SALGO: WELL, BEFORE 1999 FOR OCCASIONAL
E.C.T.>>LYNNE FISHER: YES.>>DR. PETER SALGO: DID YOU TELL YOUR COWORKERS THAT’S
WHAT YOU WERE DOING?>>LYNNE FISHER: NO. I DIDN’T SHARE THE DETAILS OF IT. I SAID I HAD A PSYCHIATRIC ILLNESS, BUT I
DIDN’T SHARE TOO MUCH OF THE DETAILS.>>DR. DANIEL SMUCKLER: I WONDER WHAT WERE THE SYMPTOMS
THAT TOOK YOU BACK TO HOSPITAL FOR THESE REPEATED EPISODES.>>LYNNE FISHER: MOSTLY PARANOIA. THERE WAS A LOT OF PARANOIA. YOU KNOW, YOU START OUT THINKING JUST MINOR
THINGS LIKE PEOPLE ARE TALKING ABOUT ME OR PEOPLE DON’T LIKE ME, AND IT SNOWBALLS.>>DR. PETER SALGO: UNTIL 1999?>>LYNNE FISHER: UNTIL 1999.>>DR. PETER SALGO: I KNOW YOU WANT TO GET TO THAT.>>LYNNE FISHER: OH, YEAH.>>DR. PETER SALGO: SO WHY DON’T WE GET TO THAT? WHAT HAPPENED IN 1999?>>LYNNE FISHER: OKAY. IN 1999, I WENT DOWN TO FLORIDA ON A VACATION
JUST BY MYSELF, AND I WAS VERY STRESSED OUT. I WAS STRESSED OUT AGAIN IN MY JOB, AND I
FLEW DOWN TO MIAMI BEACH, AND I WALKED THE BEACH FOR A WEEK, AND I DIDN’T TELL ANYONE
I WAS GOING. MY FAMILY’S VERY CLOSE. WE HAVE A VERY CLOSE-KNIT FAMILY, AND I CALLED
THEM FROM MIAMI BEACH, AND I SAID, “I’M DOWN HERE,” AND WHEN I GOT BACK TO ROCHESTER, THEY
WERE WAITING FOR ME AT THE AIRPORT AND TOOK ME BACK TO THE HOSPITAL.>>DR. PETER SALGO: AND THEY COMMITTED YOU TO THE
HOSPITAL INVOLUNTARILY.>>LYNNE FISHER: THEY DID.>>DR. DANIEL SMUCKLER: WHY WOULD THEY BE WAITING
FOR YOU? WHAT WAS GOING ON WITH YOU?>>LYNNE FISHER: THEY KNEW THE SYMPTOMS — THE
PARANOIA.>>DR. DANIEL SMUCKLER: SO PARANOIA AGAIN.>>LYNNE FISHER: THE PARANOIA WAS THE MAIN
SYMPTOM, YEAH.>>DR. PETER SALGO: AND HOW — HOW DEEP DID THE RABBIT
HOLE GO? WERE YOU AFRAID OF EVERYTHING? WERE YOU AFRAID OF DOCTORS? AFRAID OF TREATMENT? WHAT?>>LYNNE FISHER: MOSTLY DOCTORS AND TREATMENT. I WAS PETRIFIED THAT THEY WERE GOING TO KILL
ME IN THE HOSPITAL, AND I THOUGHT THEY WERE GOING TO DO THAT IN VARIOUS WAYS. I THOUGHT THEY WERE GOING TO POISON ME WITH
THE MEDS. I THOUGHT THEY WERE GOING TO GAS ME UNDER
THE DOOR AT ONE POINT, AND THEN, ALSO, I WAS DEATHLY AFRAID OF E.C.T. EVEN THOUGH I’D HAD IT SEVERAL TIMES IN THE
PAST, I THOUGHT THEY WERE GOING TO USE IT THIS TIME TO OFF ME BECAUSE I WAS SUCH A BAD
PERSON AND THE WORLD WOULD BE BETTER OFF IF I WASN’T IN IT. AND SO I TOOK MY PARENTS TO
COURT. IN 1999 I WAS A PATIENT, AND I HAD A PRO BONO
LAWYER. A VERY KIND SOCIAL WORKER GOT ME A PRO BONO
LAWYER, AND I TOOK THEM TO COURT AND I LOST, WHICH WAS THE BEST THING THAT EVER HAPPENED
TO ME.>>DR. PETER SALGO: YOU GOT SHOCK THERAPY.>>LYNNE FISHER: I GOT THE E.C.T. COURT-ORDERED.>>DR. DANIEL SMUCKLER: IF I MAY, WERE THERE MOOD
SYMPTOMS AT THIS TIME, OR WAS IT JUST PARANOIA?>>LYNNE FISHER: NO, THERE WAS DEPRESSION. SCHIZOAFFECTIVE WITH DEPRESSION WAS THE DIAGNOSIS.>>DR. PETER SALGO: AND YOU MENTIONED A WORD — AND
BEFORE WE GO TO BREAK, I WANT THAT WORD TO BE REALLY EMPHASIZED.>>LYNNE FISHER: YES.>>DR. PETER SALGO: YOU SAID “SCHIZOAFFECTIVE.”>>LYNNE FISHER: YES.>>DR. PETER SALGO: THAT’S THE FIRST TIME YOU’VE
MENTIONED THAT HERE. WAS THAT FIRST TIME YOU’D EVER HEARD THAT
WORD?>>LYNNE FISHER: IT WAS, AND I HAD TO LOOK
IT UP. I HAD NO IDEA WHAT IT WAS.>>DR. PETER SALGO: I WANT TO TALK ABOUT SCHIZOAFFECTIVE
DISORDER, AND WE’RE GOING TO DO THAT WHEN WE COME BACK. SO, EVERYBODY, STAY RIGHT WHERE YOU ARE. WE’RE GOING TO BE RIGHT BACK TO HEAR YOUR
SECOND OPINION, TOO, BY THE WAY. BUT FIRST, HERE’S THIS WEEK’S “MYTH OR MEDICINE.”>>NARRATOR: VIOLENT CRIMES ARE PREVALENT
IN THE NEWS ON A DAILY BASIS IN THE UNITED STATES, AND WHEN WE HEAR ABOUT AN ATROCIOUS
ACT COMMITTED BY SOMEONE WITH A SERIOUS MENTAL ILLNESS, IT’S HARD NOT TO RELATE THAT ACT
TO THE ILLNESS. IS THIS BECAUSE PEOPLE WITH SERIOUS MENTAL
ILLNESS ARE MORE PRONE TO VIOLENCE? IS THIS MYTH OR MEDICINE?>>ROBERT WEISMAN: PEOPLE WITH SEVERE MENTAL
ILLNESS ARE OFTEN MORE DANGEROUS AND VIOLENT. THAT’S A MYTH, AND I’M GOING TO TELL YOU WAY. MY NAME IS ROBERT WEISMAN, AND I’M ASSOCIATE
PROFESSOR OF PSYCHIATRY AT THE UNIVERSITY OF ROCHESTER MEDICAL CENTER. WHEN A PERSON WITH SERIOUS MENTAL ILLNESS
IN OUR COUNTRY COMMITS A VIOLENT ACT, IT OFTEN OBTAINS NATIONAL ATTENTION. THIS ATTENTION FOCUSES ON THAT PERSON’S SERIOUS
MENTAL ILLNESS AND OFTEN GENERALIZES THAT CONCERN. BUT THE FACT IS THAT PEOPLE WITH SERIOUS MENTAL
ILLNESS ARE USUALLY NOT VIOLENT. THEY’RE ESPECIALLY AT LOW RISK IF THEY ARE
TAKING THEIR TREATMENT PROPERLY AND THEY HAVE THEIR BASIC NECESSITIES MET. WITH APPROPRIATE ASSESSMENT, ATTENTION, AND
CARE, THE RISK OF VIOLENCE BECOMES NO GREATER THAN IN THE GENERAL POPULATION. OUR FOCUS SHOULD BE LESS ON RELATING VIOLENCE
AND MENTAL ILLNESS AND MORE FOCUSED ON ALLOWING THEM TO HAVE NORMAL LIVES IN THE COMMUNITY
AND TO HELP THEM ACCESS THE NEEDED CARE THAT THEY DESERVE. AND THAT’S MEDICINE.>>NARRATOR: NOT SURE IF IT’S MYTH OR MEDICINE? CONNECT WITH US ONLINE. WE’LL GET TO WORK AND GET YOU A SECOND OPINION.>>DR. PETER SALGO: AND WE’RE BACK. WE’RE HERE WITH LYNNE. THANK YOU SO MUCH FOR SHARING YOUR STORY. IT CAN’T BE EASY TO SHARE THIS STORY, BY THE
WAY, AND I’M GLAD YOU’RE HERE.>>LYNNE FISHER: YEAH.>>DR. PETER SALGO: WHEN WE WENT TO BREAK, THE WORD
THAT LOOMED IN FRONT OF US WAS “SCHIZOAFFECTIVE DISORDER.”>>LYNNE FISHER: CORRECT.>>DR. PETER SALGO: NOW, IS THIS THE SAME AS SCHIZOPHRENIA?>>DR. DANIEL SMUCKLER: NO. THE NOTION HERE IS IT’S A SIGNIFICANT MENTAL
ILLNESS, OF COURSE, WHEREIN YOU HAVE BOTH MAJOR MOOD ISSUES, AS WELL AS PSYCHOTIC ELEMENTS,
AND THE TWO ARE NOT NECESSARILY OVERLAPPING. SCHIZOPHRENIA, FOR EXAMPLE, CAN CO-OCCUR WITH
DEPRESSION AND OFTEN DOES, BY THE WAY. BUT SCHIZOAFFECTIVE IS A CIRCUMSTANCE WHERE
OUTSIDE OF THE MOOD SYMPTOMS, THERE ARE PSYCHOTIC SYMPTOMS. AS YOU DESCRIBE, THERE WERE THESE EPISODES
OF PARANOIA.>>LYNNE FISHER: YES.>>DR. DANIEL SMUCKLER: YOU DIDN’T SAY YOU WERE DEPRESSED
OR MANIC AT THE TIME, BUT WE KNOW THAT YOU ALSO HAD MOOD SYMPTOMS WITH PSYCHOSIS, SO
THAT SAYS SCHIZOAFFECTIVE.>>DR. PETER SALGO: IS IT FAIR TO CALL THE PSYCHOSIS
SCHIZOPHRENIA AND THEN THE ADD-ON WITH THE MOOD THE SCHIZOAFFECTIVE COMPONENT? IS THAT WHAT WE’RE TALKING ABOUT OR NOT?>>DR. DONALD GOFF: THAT’S CORRECT. SOME PEOPLE CAN HAVE PSYCHOSIS ONLY WHEN THEY’RE
DEPRESSED, AND THAT’S PSYCHOTIC DEPRESSION. OTHER PEOPLE CAN HAVE MORE CHRONIC PSYCHOSIS,
AND THEN AT TIMES BECOME DEPRESSED. IT SOUNDS LIKE THAT’S WHAT YOU HAD.>>LYNNE FISHER: YES, EXACTLY.>>DR. DANIEL SMUCKLER: THERE’S ALSO CONSIDERATION,
AND PERHAPS LYNNE CAN SPEAK TO THIS. THERE’S DIFFERENT DEGREES OF PRESENTATION. SOME INDIVIDUALS MAY HAVE A TOUCH, FOR EXAMPLE,
OF ILLNESS, AND OTHERS ARE GREATLY, GREATLY BURDENED.>>DR. PETER SALGO: YOU LOST THE CASE, YOU SAID.>>LYNNE FISHER: YES.>>DR. PETER SALGO: SO WHAT DID THAT MEAN FOR YOUR
TREATMENT IN THE HOSPITAL AT THAT TIME?>>LYNNE FISHER: WELL, IT WAS COURT-ORDERED
E.C.T., SO I WAS TAKEN DOWN TO THE E.C.T. ROOM BY SECURITY GUARDS. I WAS A LITTLE BIT REBELLIOUS. I THOUGHT THIS WAS GONNA BE THE END FOR ME. SO I BROKE AWAY FROM THE SECURITY GUARDS AND
GUZZLED WATER BECAUSE YOU’RE NOT ALLOWED –>>DR. PETER SALGO: FOR THE NON-ANESTHESIOLOGIST
IN OUR AUDIENCE, THAT’S THE CARDINAL SIN THAT KEEPS YOU FROM GETTING AN ANESTHETIC. BECAUSE YOU DRANK WATER, YOU HAVE A FULL STOMACH. AND YOU KNEW THAT.>>LYNNE FISHER: I KNEW THAT. YEP. AND I THOUGHT THAT WAS GONNA GET ME OFF
THE HOOK. IT DIDN’T. [ CHUCKLES ] THEY DID IT TWO DAYS
LATER, AND THEY HELD TIGHTER ON ME SO I WOULDN’T BREAK AWAY, BUT THE COURT-ORDERED E.C.T. WORKED, AND I GOT BETTER WITHIN A FEW WEEKS.>>DR. DONALD GOFF: I THINK THE IMPORTANT PART OF
YOUR STORY IS — AND IT’S VERY TYPICAL — IS WHEN PEOPLE ARE PSYCHOTIC, WHEN THEY’RE PARANOID,
IT’S TERRIFYING. IT’S VERY TERRIFYING TO BELIEVE PEOPLE ARE
TRYING TO KILL YOU. BUT PEOPLE DON’T REALIZE THAT IT’S AN ILLNESS,
AND THEY RESIST TREATMENT. THEY DO THEIR BEST, AS YOU DID, TO AVOID TREATMENT,
BUT THEN WHEN TREATMENT IS EFFECTIVE, AS IT WAS WITH YOU, IT BRINGS ENORMOUS RELIEF.>>LYNNE FISHER: OH, IT DOES.>>DR. LOU PAPA: IT’S TERRIFYING FOR THE FAMILY AS
WELL. MY PATIENTS THAT HAVE HAD THAT, IT’S VERY
OFTEN THEY ARE AT A DISTANCE OR THEY’VE “ESCAPED” AWAY FROM EVERYTHING, AND THE FAMILY’S TERRIFIED. THERE’S MULTIPLE PHONE CALLS.>>LYNNE FISHER: ABSOLUTELY.>>DR. LOU PAPA: IT’S VERY DIFFICULT.>>DR. PETER SALGO: I CAN HEAR, THOUGH, PEOPLE IN
OUR AUDIENCE GOING, “WHAT RIGHT DOES SOCIETY HAVE TO TAKE THIS WOMAN WHO HASN’T COMMITTED
ANY CRIME, HAVE A COURT-ORDERED SECURITY PATROL, BRING HER DOWN TO A TABLE AND SHOCK HER BRAIN?” WHERE DOES THAT RIGHT COME FROM? I HEAR THIS.>>DR. DANIEL SMUCKLER: YOU KNOW, OF COURSE, IT’S
A COMPLICATED QUESTION, BUT THERE IS SO MUCH SUFFERING. IT’S SO CLEAR IN LYNNE’S HISTORY. I THINK THIS MOTIVATES US, WHO WANT TO HELP,
TO TAKE THESE EXTRAORDINARY MEASURES.>>DR. PETER SALGO: WAS THERE ANYTHING ELSE THEY
COULD HAVE TRIED OTHER THAN E.C.T.? WOULD YOU HAVE TAKEN PILLS?>>LYNNE FISHER: IT DOESN’T WORK AS WELL OR
AS QUICKLY.>>DR. LOU PAPA: IT SOUNDS LIKE YOU WERE WORRIED
ABOUT BEING POISONED, AS WELL.>>LYNNE FISHER: YES.>>DR. PETER SALGO: BUT THERE ARE DRUGS, RIGHT?>>DR. DONALD GOFF: THERE ARE DRUGS THAT FOR MANY
PEOPLE ARE QUITE EFFECTIVE. IT SOUNDS LIKE THEY WEREN’T FOR YOU, BUT IT’S
A QUESTION OF WHERE WE DRAW THE LINE BECAUSE MANY PEOPLE HAVE THESE ILLNESSES, DON’T GET
TREATMENT, AND ARE NOT REALLY AT RISK ENOUGH FOR THE COURT TO ORDER TREATMENT, AND SO WE
SEE SOME PEOPLE FOR VERY LONG TIME PERIODS BEING PSYCHOTIC, REFUSING TREATMENT, AND THEN
AT SOME POINT, THE LINE IS DRAWN AT WHICH POINT YOUR SAFETY IS AT SUCH RISK, THEN THE
COURT WILL ORDER TREATMENT.>>DR. LOU PAPA: PLUS, I THINK EVERYBODY HAS THE
RIGHT TO REFUSE TREATMENT, BUT THAT REFUSAL HAS TO COME WITH THE ABILITY TO HAVE THE INSIGHT
AND THE JUDGMENT TO DO THAT. HER THOUGHTS WERE DISORGANIZED. SHE WASN’T IN THE RIGHT MIND TO MAKE THE PROPER
DECISION.>>DR. DANIEL SMUCKLER: THE STANDARD IS RISK TO SELF
OR OTHERS, AND PRESUMABLY YOU WERE AT THAT POINT WHERE YOU WERE AT GREAT RISK TO YOURSELF.>>DR. PETER SALGO: DID THE E.C.T. WORK?>>LYNNE FISHER: E.C.T. HAS ALWAYS WORKED FOR ME. IT’S MY GO-TO. I EVEN HAVE AN ADVANCE DIRECTIVE THAT IF I
GET SICK AGAIN, THAT’S THE FIRST LINE OF TREATMENT.>>DR. DANIEL SMUCKLER: WOW.>>LYNNE FISHER: I’VE SIGNED THAT.>>DR. DANIEL SMUCKLER: GENERALLY SPEAKING, IT’S
NOT THE FIRST LINE OF TREATMENT FOR A VARIETY OF REASONS.>>LYNNE FISHER: YEAH.>>DR. DANIEL SMUCKLER: BUT WE KNOW IT’S A HIGHLY
EFFECTIVE TREATMENT.>>DR. PETER SALGO: SO YOU EVENTUALLY HAD THE E.C.T.>>LYNNE FISHER: YES.>>DR. PETER SALGO: AND IT WORKED?>>LYNNE FISHER: IT WORKS PHENOMENALLY WELL
FOR ME. EVERY TIME I’VE HAD IT, IT ONLY TAKES ABOUT
NINE TREATMENTS OR LESS, AND I’M RIGHT BACK TO MY NORMAL SELF.>>DR. PETER SALGO: NOW, E.C.T. DOESN’T WORK FOR SCHIZOPHRENIA. IT WORKS FOR DEPRESSION. AM I RIGHT ABOUT THAT?>>DR. DANIEL SMUCKLER: THAT IS THE WAY WE THINK
ABOUT IT AT THIS POINT.>>DR. PETER SALGO: SO WHY DID IT WORK IF SHE HAD
SCHIZOAFFECTIVE DISORDER?>>DR. DANIEL SMUCKLER: GOOD QUESTION.>>DR. PETER SALGO: THANK YOU.>>ALL: [ LAUGHTER ]>>DR. DANIEL SMUCKLER: CLEARLY, THERE WERE MOOD
SYMPTOMS. THERE IS THE IDEA, AT LEAST AMONG SOME, THAT
IT MAY BE AN ARTIFICIAL SEPARATION SAYING SCHIZOPHRENIA AND MAJOR MOOD DISORDER. WE KNOW OUR UNDERSTANDING OF THE PHYSIOLOGY,
THE PATHOPHYSIOLOGY OF THESE DISORDERS IS UNCLEAR.>>LYNNE FISHER: YES.>>DR. DANIEL SMUCKLER: IF IT WORKED, THAT’S WONDERFUL.>>DR. PETER SALGO: AND YOU’RE ON MEDICATION NOW?>>LYNNE FISHER: YES. I TAKE ZOLOFT AND ABILIFY, AND THEY WORKED
REMARKABLY WELL. AND I AGREE WITH YOU, DAN, THAT IT DOESN’T
MATTER WHAT THAT DIAGNOSIS IS, IF SOMETHING WORKS, YOU GO WITH IT, AND THAT’S WHY THEY’VE
ALWAYS CHOSE E.C.T. FOR ME BECAUSE IT WAS EFFECTIVE.>>DR. DONALD GOFF: AND OFTEN OUR TREATMENTS ARE
MORE SYMPTOM-DIRECTED THAN DIAGNOSIS, AND YOU HAD DEPRESSION AND PSYCHOSIS, AND THAT’S
TYPICALLY WHAT E.C.T. IS SO EFFECTIVE FOR.>>DR. PETER SALGO: YOU’RE NOW IN THERAPY, AS WELL
AS ON DRUGS. IS THAT IMPORTANT?>>LYNNE FISHER: OH, VERY MUCH SO. I ONLY GO ONCE A MONTH. I’VE CUT BACK. IT USED TO BE BIWEEKLY — OR BIMONTHLY, BUT
NOW IT’S ONCE A MONTH, AND IT’S MOSTLY A MED CHECK AND TO SEE HOW I’M DOING.>>DR. PETER SALGO: IS THERE A TYPICAL PROFILE OF
SOMEBODY WHO SHOWS SCHIZOPHRENIA? CAN YOU SPOT SOMEBODY GOING INTO THIS — HEREDITY,
ANYTHING?>>DR. DONALD GOFF: SCHIZOPHRENIA IS A DIAGNOSIS. IT MEANS A PERSON HAS PSYCHOSIS AND USUALLY
DIFFICULTY FUNCTIONING IN MANY AREAS OF THEIR LIFE, AND IT TYPICALLY OCCURS IN THEIR EARLY
20S, AND IN TERMS OF PREDICTING IT, IT’S VERY DIFFICULT. A LOT OF RESEARCH IS LOOKING AT GENETICS AND
OTHER DEVELOPMENTAL PROBLEMS, BUT WE STILL REALLY CANNOT PREDICT WELL WHO’S GOING TO
DEVELOP SCHIZOPHRENIA.>>DR. PETER SALGO: IT DOES RUN IN FAMILIES.>>DR. DONALD GOFF: IT RUNS IN FAMILIES, BUT NOT
TO A DEGREE THAT WOULD ALLOW US TO REALLY PREDICT IT.>>DR. PETER SALGO: I KNOW THERE ARE TWIN STUDIES,
AND THE CONCORDANCE IS THERE, BUT IT’S NOT 100%.>>DR. DONALD GOFF: CONCORDANCE IS 50% WITH IDENTICAL
TWINS.>>DR. PETER SALGO: WOULD SHE FIT THE PROFILE IF
THERE WERE ONE?>>DR. DONALD GOFF: I’M NOT CONVINCED THAT YOU HAVE
SCHIZOPHRENIA TO SAY, AND WITHIN THE DIAGNOSIS, THERE’S A WIDE RANGE OF PEOPLE WHO ONLY HAVE
PSYCHOSIS, AND THAT RESPONDS TO MEDICINE, AND THEY’RE REALLY NOT IMPAIRED BY THEIR ILLNESS. OTHERS CAN BE VERY IMPAIRED AND ALSO HAVE
PROBLEMS WITH COGNITION AND WITH MOTIVATION, AND THEY OFTEN ARE QUITE DISABLED.>>DR. PETER SALGO: AND WHAT MEDICINES ARE THERE
OTHER THAN E.C.T., BUT ACTUAL MEDICATIONS YOU CAN TAKE?>>DR. DANIEL SMUCKLER: THERE’S RIGHT NOW, ACTUALLY,
A RATHER WIDE VARIETY OF MEDICATIONS GENERALLY OF THE ANTIPSYCHOTIC CLASS. IN A CASE OF SOMEBODY WITH YOUR HISTORY PROBABLY
WOULD BE NOT ONLY AN ANTIPSYCHOTIC, BUT ANTIDEPRESSANT MEDICATIONS.>>LYNNE FISHER: RIGHT.>>DR. DANIEL SMUCKLER: AND YOU DESCRIBED BEING ON
ZOLOFT, AN ANTIDEPRESSANT, AND ABILIFY, AN ANTIPSYCHOTIC.>>DR. PETER SALGO: SOME OF THESE MEDICINES HAVE
SIDE-EFFECT PROFILES.>>DR. LOU PAPA: THAT’S WHAT I WAS GOING TO SAY. IT’S REALLY IMPORTANT TO STAY IN CONTACT WITH
YOUR PRIMARY CARE DOCTOR BECAUSE THEY DO INCREASE RISK FOR METABOLIC DISORDERS. SO YOUR CHOLESTEROL BECOMES ABNORMAL. YOU GET GLUCOSE — YOU CAN EVEN DEVELOP DIABETES.>>LYNNE FISHER: YES.>>DR. LOU PAPA: SO MODIFYING YOUR LIFESTYLE AND
MONITORING FOR THAT AND THE RISKS ASSOCIATED WITH THAT, EVEN HEART DISEASE IS VERY IMPORTANT.>>DR. PETER SALGO: AND BEFORE I GIVE YOU YOUR SHOT,
I WANT TO ASK ONE LAST QUESTION. I’VE HEARD THIS IN MY PRACTICE OVER THE YEARS. “I FELT REALLY GOOD. I FIGURED I WAS OKAY SO I DIDN’T NEED THE
MEDS, AND I STOPPED THEM,” AND THE NEXT THING WE SEE IS THEY’RE BACK IN THE HOSPITAL. HOW COMMON IS THAT?>>DR. DONALD GOFF: THAT’S VERY COMMON, AND THAT’S,
I THINK, WHY THE MEDICATION’S IMPORTANT, BUT EVEN MORE IMPORTANT IS ESTABLISHING A RELATIONSHIP
WITH THE PERSON WITH THE ILLNESS AND TRYING TO HELP THEM THROUGH THAT TEMPTATION.>>DR. LOU PAPA: AND I THINK THAT’S A STIGMATIZATION,
TOO, BECAUSE THAT HAPPENS IN 50% OF PATIENTS. 50% OF PATIENTS STOP THEIR MEDICATIONS FOR
ALL DIAGNOSES. YOU STOP YOUR ANTIHYPERTENSIVE MEDICATIONS,
NO ONE’S GOING TO SEE THAT.>>DR. PETER SALGO: NOW IT’S YOUR CHANCE. WHAT WOULD YOU LIKE TO ASK?>>LYNNE FISHER: WELL, I DON’T KNOW IF IT’S
A QUESTION OR MORE OF A COMMENTARY. FOR ME, IT WAS VERY DIFFICULT TO ADMIT I HAD
SCHIZOAFFECTIVE. I THINK IN SOCIETY, DEPRESSION IS AN OKAY
ILLNESS. IT’S MORE ACCEPTABLE. I’VE EVEN BEEN CALLED BIPOLAR. I MENTIONED THAT I HAVE HAD SEVERAL DIAGNOSES,
AND THAT WAS MORE SERIOUS, BUT THE WORD SCHIZOPHRENIA OR SCHIZOAFFECTIVE PROVOKES TERROR IN PEOPLE,
AND I JUST WANT TO SAY THAT WE’RE LESS LIKELY TO BE VIOLENT AND MORE LIKELY TO BE VICTIMS
OF VIOLENCE. AND SO THERE’S A LOT OF STEREOTYPES THAT,
YOU KNOW, COMING ON HERE I HOPE TO DO AWAY WITH, OR AT LEAST DIMINISH. SO THAT’S WHY I DO MY TALKS FOR NAMI ROCHESTER.>>DR. DANIEL SMUCKLER: I’M GLAD YOU SPOKE UP, BECAUSE
I COULDN’T AGREE WITH YOU MORE. IT’S TRUE. WE KNOW THAT THERE’S STIGMA. WE KNOW THAT IT’S, AT TIMES, VERY CHALLENGING
TO LIVE WITH THE SYMPTOMS THAT YOU HAVE LIVED WITH.>>LYNNE FISHER: YES.>>DR. DANIEL SMUCKLER: IT’S SO GOOD TO SEE YOU HERE
WITH US.>>LYNNE FISHER: THANK YOU. THANK YOU VERY MUCH.>>DR. DONALD GOFF: AND I THINK PEOPLE WHO HAVE A
LOVED ONE WITH THE ILLNESS UNDERSTAND THAT IT’S NOT FRIGHTENING, IT’S AN ILLNESS LIKE
MANY OTHERS, AND SO FOR YOU TO SORT OF PUT A FACE TO THE ILLNESS, IT’S SO IMPORTANT FOR
PEOPLE TO SEE THE HUMAN SIDE.>>LYNNE FISHER: THANK YOU.>>DR. PETER SALGO: AND I WOULD JUST LIKE TO SAY
THAT THE STIGMA EXISTS. YOU ALLUDED TO IT, AND YET YOU HAD THE COURAGE
TO JOIN US AND TO SHARE WITH US WHAT YOUR LIFE IS LIKE.>>LYNNE FISHER: YEAH.>>DR. PETER SALGO: I JUST WANT TO THANK YOU SO MUCH
FOR SHARING THAT WITH US.>>LYNNE FISHER: OH, YOU’RE WELCOME.>>DR. PETER SALGO: IT’S WONDERFUL. AND WITH THAT, I WANT TO THANK YOU, OUR WONDERFUL
PANEL, FOR BEING HERE, TOO. WHY DON’T YOU LET US KNOW WHAT YOU THINK ABOUT
TODAY’S DISCUSSION AND LYNNE’S SECOND OPINION BY TWEETING US OR BY COMMENTING ON OUR FACEBOOK
PAGE? AND NOW HERE’S THIS WEEK’S “SECOND OPINION
5.”>>DR. ERIC CAINE: HELLO. I’M DR. ERIC CAINE, AND I WANT TO TELL YOU FIVE REASONS
TO CONSULT A MENTAL HEALTH PROFESSIONAL. THE FIRST IS WHEN YOU HAVE THOUGHTS, EMOTIONS,
OR BEHAVIORS THAT ARE OUT OF CONTROL, ESPECIALLY WHEN THEY’RE AFFECTING YOUR RELATIONSHIPS,
YOUR WORK, OR YOUR SENSE OF WELL-BEING. NEVER FEEL EMBARRASSED TO ASK FOR HELP AT
TIMES WHEN YOU ARE UPSET OR DEPRESSED. THE NEXT IS WHEN YOU’RE STRUGGLING TO DEAL
WITH LIFE’S PAINFUL CHALLENGES. THESE MAY BE YOUR OWN, BUT COULD INCLUDE THOSE
OF OTHERS WHOM YOU CARE ABOUT, SUCH AS A MAJOR ILLNESS, THE LOSS OF A LOVED ONE, DIVORCE,
OR JOB PROBLEMS. THE THIRD IS WHEN THE USE OF ALCOHOL OR DRUGS
INTERFERES WITH YOUR HEALTH, YOUR EMOTIONS, YOUR RELATIONSHIPS, YOUR JOB, OR YOUR ABILITY
TO FULFILL YOUR DAILY RESPONSIBILITIES. ANOTHER IS WHEN YOU’RE CONFUSED, FRAUGHT WITH
EMOTIONS, AND NEED THE PERSPECTIVES OF A CARING, YET UNBIASED PERSON TO HELP SORT AMONG DIFFICULT
CHOICES. AND LASTLY, WHEN YOU FEEL THAT LIFE IS NO
LONGER WORTH LIVING, THAT YOU ARE HOPELESS AND HAVE REACHED THE END OF THE LINE AND WOULD
RATHER DIE THAN FEEL THE PAIN OF THE PRESENT, IN THE MIDST OF SUCH DISTRESS, YOU’RE NOT
PREPARED TO MAKE LIFE-OR-DEATH DECISIONS. ASK FOR HELP. A GOOD PLACE TO BEGIN YOUR SEARCH FOR AN EXCELLENT
MENTAL-HEALTH PROFESSIONAL IS TO SEEK THE ADVICE OF YOUR PRIMARY CARE PHYSICIAN, WHO
LIKELY KNOWS MANY LOCAL MENTAL-HEALTH COLLEAGUES. AND THAT’S YOUR “SECOND OPINION 5.”>>DR. PETER SALGO: THANK YOU SO MUCH FOR WATCHING,
AND REMEMBER. YOU CAN GET MORE “SECOND OPINIONS” AND PATIENT
STORIES ON OUR WEBSITE, AT SECONDOPINION-TV.ORG. YOU CAN ALSO SEND US YOUR SHOW IDEAS AND SHARE
YOUR OWN HEALTH STORY. MAYBE WE’LL EVEN INVITE YOU TO BE ON THE SHOW. YOU CAN CONTINUE THE CONVERSATION ON FACEBOOK
AND TWITTER WHERE WE ARE LIVE EVERY DAY WITH BREAKING HEALTH NEWS. I’M DR. PETER SALGO, AND I’LL SEE YOU NEXT TIME FOR
ANOTHER “SECOND OPINION.”>>ANNOUNCER: “SECOND OPINION” IS BROUGHT
TO YOU BY BLUECROSS BLUESHIELD. ACCEPTED IN ALL 50 STATES. BLUECROSS BLUESHIELD. LIVE FEARLESS.>>ANNOUNCER: “SECOND OPINION” IS PRODUCED
IN CONJUNCTION WITH U.R. MEDICINE, PART OF UNIVERSITY OF ROCHESTER
MEDICAL CENTER, ROCHESTER, NEW YORK.

2 comments

  1. I had what she had on one occasion in fifteen years. The telepaths who are now murdering the living shit out of me were able to reroute words and their meanings in my mind.

    So "i'm hungry, i'm going to have a banana" could be rerouted into some crazy sounding shit. You can replace words and their meanings in people's minds.

    From the perspective of the person it makes complete sense as it would to someone who had been given a conscious form of computer virus.

    I have the other kind of schizoaffective though, the kind where the aliens and shadow people come, some other beings as well who have been seen througout the ages by the shamanic peoples of the world.

    She was right, ect is very bad for people and so are the drugs. They are both poisonous things and kill people. They jolt your brain to the point that you aren't even living anymore, just a shell of your former self. Other avenues need to be looked into i'd say but who really cares when the world is coming to a close am i right?

    I shouldn't even be saying this right now, i have no brain left, i'm fairly certain it's them saying this.

    None of what this person described sounds like psychosis or schizoaffective disorder.

Leave a Reply

Your email address will not be published. Required fields are marked *