Schizophrenia, Rachel, Gabe Howard discussed on The Psych Central Show
To inside schizophrenia. I'm Rachel Star withers here with my wonderful co host. Gabe Howard this episode. We are exploring schizophrenia. In women next episode going to focus on the men but this whole episode is for the ladies often. We don't really consider gender dynamics in treatment or medication and this is a chronic across. All health. Not just schizophrenia. A lot of medications etc are only tested on men because of risk they don't want to impact a potential pregnancy etc and on one hand. This sounds good. We're projecting pregnancy but on the other hand. This means there's whole drugs that have made it to market. That may not have ever been tested with women so I think that it's exciting to consider how schizophrenia impacts the genders differently. Obviously we want to state unequivocally that if you meet two people with schizophrenia. You've met two people with schizophrenia. Tends TO BE THIS IDEA. That all people with schizophrenia are exactly alike and and we hope that this show has done a lot to dispel that misinformation. If I meet two guys named Gabe. They're probably both different. Probably probably repeatedly you hear the difference between men and women with schizophrenia. The biggest thing is the age of onset. Women are said to develop it later than men on average they say four to six years later than a man would be diagnose. Let's go be diagnosed with schizophrenia. And that's one of the things. They've noticed repeatedly in research across the years. Is that women get schizophrenia. In life later sometimes you know late twenties. They'll even say it's interesting because as you said it's diagnosed with we know from research. That people are born with schizophrenia. So the question becomes and we don't know the answer to this because research is ongoing. Do Men and women become symptomatic at the same time but men get the diagnosis faster or do women not develop the symptoms of schizophrenia. Until later and it's difficult to discover that and some of it is social engineering if a woman is behaving erratically. Well of course she's a woman and this is the kind of thinking that we have to prevent and get over to make sure that everybody gets the best care but it's on one hand it's interesting to think about when we're diagnosing people and how we're diagnosing people but on the other hand it's kind of sad if men and women are showing symptoms at the exact same age but it takes women an extra four to six years to be diagnosed. That's also scary. Yes they do say however that it's less detectable in women which I could totally see because I grew up having hallucinations but I didn't even realize myself that that was weird until my late teens than I that I stopped talking about it so I didn't get a diagnosis either until my twenties so I could easily see. You know yeah. Women tend to be more social. They tend to be more active than men. Who Have Schizophrenia? So yeah probably fly under the radar much longer. It's interesting how you put that Rachel. You said that as soon as you notice that you were having these hallucinations and issues you hit them but you remained social. You remained engaged in talking to the people around you whereas men when they notice them. They tend to retreat. It's that retreating that I think makes people realize that. Perhaps something is wrong you know. Why is this person? Stay in their room. Why does this person not have a job? Why is this person talking to themselves whereas because you remained social people? Don't say well. Hey we like it when Rachel comes over Rachel is Funny Rachel is Nice. She must be hearing voices in her head and experiencing psychosis and elucidations. And and all of the other symptoms of schizophrenia. I I can see how it could mask. It is especially to our friends and family who are not trained psychologists or psychiatrists and the flip side of. That coin. Is FAMILIES THAT SCHIZOPHRENIA? Tends to run in. There actually is no difference in the onset of age between men and women so brothers sisters. And that's because yeah grandma had it if mom has it you know so cousin. Has you tend to be looking for those symptoms and recognize them earlier. Whether it's a boy or girl growing up you send notice that. They have acknowledged that if the family and friends are aware that there could be a potential problem on the horizon. They are noticing it and much much sooner. There's also a study out of India that is found no difference in the average age of onset between men and women and I think that really does speak to the social dynamics between cultures because if people in India are all having the onset of schizophrenia at the same time it would really be unusual to think that there's some sort of genetic difference between Americans and Indians. It's it's sort of speaks to this being a social construct and again research is ongoing. We're not one hundred percent. Sure of any of these things. In a lot of countries having a mental disorder is looked down upon even more so than I would say the Western world. They don't have statistics on those kinds of things because unfortunately it will go. No one is diagnosed until much later in life where they can't function at all so it is interesting when you look like how people grow up. What's expected of men and women? I do think women could fly under the radar longer. Sometimes just because you're not like well a guy eighteen. He needs to get out. He needs to get a job he needs to at. Yeah I feel like my family. They're going to be little softer on the girl in the family and the boy so I can easily see like that flying under the radar to your point Rachel when we talk about the social differences between men and women Which there's a lot I really think of. People who have battled schizophrenia for a long time and when I work with those people they say hey look. I haven't had a job in five years and all of the men very much want to know what to do about their resume. They've got a five year gap of five year gap five year gap and many of the women are like well a five year gap. No problem I was raising kids. I was a caretaker for family. It just nobody is questioning their five year gap whereas people are questioning a male's five year gap and and all of. This is just a tie in that. In some cases the differences between the treatments and the symptoms of schizophrenia have considerably more to do with our society than it does with the actual disease. Now all that said there are disease processes and symptoms processes that work differently in women versus as as we get into the symptoms. The fine saying this you know like well Rachel. I'm a woman and I don't experience it that way or I'm a man I totally have. No no no just like across the board which symptoms tend to flare up in different genders women actually like we said are more sociable so different things like the flat affect pretty much where you don't experience emotion. You have a very dull. Expression is not seen as often in women. Women tend to even have more emotions and I know that's like Oh of course we've been emotional but with schizophrenia. A lot of times people have blunted emotional response so they don't really react the same way quote unquote normal people do but women we come off a still acting more emotional to those around us inside. We might not but we're able to kind of fake it much better. Our speech isn't reduced and I found this interesting. Gabe women with schizophrenia are actually more physically active than men across the board and also under that it can be more hostile. You know past episodes where he's talked about violence and schizophrenia. If you were to picture a violent schizophrenic I don't think anyone pictures of woman not only do I not think that anybody pictures a woman. I think that the way that society response to a male who is being aggressive and a female. Who is being aggressive is very different. And there's a plethora of reasons for this. Listen I weigh two hundred and seventy five pounds. I'm six foot three if I am being extremely aggressive and loud. That's going to look a lot scarier than if Rachel who is considerably smaller than Gabe is yelling. Also people tend to be more willing to de escalate a female than a male and again a lot of these things fall under social constructs and our whole society is set up this way right. It's not just in schizophrenia. Where this is important. We see this in policing we see this in jobs. We see this in you know I could never scream at a server in public. But you know there's a whole Internet trend of calling women who scream at servers Karen and everybody thinks that that's funny but sincerely the humor comes from somebody yelling at somebody in public and because that person's a woman it's considered funny you could never change the Karen memes to John Well Jaundice stands up and starts screaming at a server. People that's not funny. No that's like yet so everyone turns around and it's like robots call the police thinking he's GonNa start swinging. The perception is very very different. And because schizophrenia is an illness that is based on self reporting based on observation based on behavioral patterns so obviously society's perception of what they're observing is going to determine the diagnosis that you receive and to that end because of the different ways that we perceive the genders. Women are often misdiagnosed with schizophrenia. More often than men are when it comes to self reporting. I feel that men and would probably also report different symptoms more often. I don't think I ever went and was reporting. You know I just don't want to go out with my friends. Oh I just want to like stay inside. I talked about depression and that was the initial diagnosis. I got repeatedly was just that I had depression and I was too scared to even bring up hallucinations and delusions. I kind of you get used to just okay. You're just overreacting. Oh you're overthinking so. That never occurred to me certain things. I was having was a delusion it was just Oh yeah. I just soon. I'm over thinking things so I think across the board. It's easy to see. The women would be diagnosed with different things. I do wonder if doctors are quicker to Label Min- schizophrenic that women it's important to point out how difficult it is to research and study this when we exist in a culture that is an actively discussing it and as we've been talking about this whole show culture and society impacts our outlook so when a male is looking at a female patients some of those biases are bound to creep in. I do think that we have made great strides now that more women are in psychiatry because while they have biases to they at least have interjected more understanding of women and I think that's very very good now one of the things that's interesting to me is when we plotted out this. Show Rachel. I was shocked at how much was just society. How did you feel about that? What were you thinking when you were researching the show it made me look back on my own life and kind of think You know how I like self reported you know certain things and then like the way they were responded to and I think back the more physically active in hostile thing. I was very very hostile towards my father specifically when I was in high school and I don't mean I was like trying to hurt him or anything but I would have these breakdowns and he would try and restrain me which just made it worse. You know not necessarily going. What's the best way to deal with someone having a psychotic breakdown and he was still much bigger than me in able to kind of like grab me and control me but I think now had it been my brother who was bigger than my father? There wouldn't have been any controlling. It definitely would have escalated to police or we can't deal with this on our own situation much quicker than it did with me and it just makes you think though. Wow all heck. Yeah if if I've been guy or even just more physically different. My life could have played out. I don't WanNa say worse but it would have had a different impact. Rachel Wallace is an awkward question. Do you think that a female menstrual cycle has anything to do with schizophrenia? And why or why not? Oh I think it absolutely does. I've long thought that menstrual cycles and the woman type stuff definitely affects my schizophrenia. It frustrates me to no end that at least once a month I know for three days my schizophrenia is going to get a lot worse. I'm going to lose touch with reality. I'm going to kind of get more spacey. I have to really be very careful. I get more delusional. I know my hallucinations get worse. I pretty much have to anticipate. These days are coming enduring these days. I need to live in my room as much as possible to avoid potential issues. And it's right before my period and this has happened over and over and I brought it up to multiple doctors and it's not like you can just okay. Well you know up your medication for three days. It doesn't work that way you know. They'll just be like well. You know make sure you track it and do your best..