[ceallen]

It's interesting that both the author's story and one other in this thread so far both mention their significant marijuana usage.

While the "marijuana causes schizophrenia" hype is statistically exaggerated (and the opposite causality may actually be the case), it's still a good reminder to perhaps avoid or severely restrict usage if you have a family history of the condition.

[Thevet]

Agreed - this is the biggest issue of cannabis legalization from a public health perspective, in my opinion. (I'm still for it, but with major safeguards in place). My brother developed acute schizophrenia after spending his late teens dabbling in psychedelics and smoking weed often, and I can't help but wonder if the absence of those triggers might have changed the course of the disease. Despite dabbling myself, if I ever have kids I'm going to try to make it clear to them what the stakes are for people with family histories like mine.

[lafar6502]

I think I had a taste of psychosis after smoking too much weed one time: I totally lost the sense of time, my brain was overflowing with all kinds of thoughts and fears, had some auditory hallucinations and totally misinterpreted people's behavior (everyone suddenly seemed hostile). Then a panic attack followed and I felt stuck in some crazy time loop that would never end. That's why i don't experiment with marijuana or other psychoactive substances, the effects are too similar to a mental illness in my case.

[jMyles]

Good for you (and dfischer) for recognizing this reaction and removing this item from your diet as a result.

I love weed (smoking some right now) and feel that I strongly benefit from having it in my diet, but I have a lot of respect for people who remove it to their own improvement.

[mdellabitta]

https://en.wikipedia.org/wiki/Derealization?

[dfischer]

This is what happened when I smoke weed and because of it I avoid it.

[peterwwillis]

It happened to me at DEFCON. I was drinking a lot, and I ate an entire bag of marijuana popcorn, and probably some other stuff. I blacked out, but the stuff people told me I was doing was pretty weird. The stuff I remember about the crazy ward I woke up in involves sobbing, screaming, and being absolutely certain that the doctors were getting ready to remove my organs and sell them on the black market. I tried to escape but I couldn't figure out where the exit was. In the morning when I was finally sane again, I had huge cuts and bruises all over and bloody knuckles. I was told later I tried to punch a very pretty medic in the casino my friends were fireman-carrying me through, so I can't imagine what I might have done to whomever brought me to the hospital.

To this day i've never felt anything as extremely horrifying, and I also now know what it feels like to resign yourself to death. Incidentally, for months afterward, heavy drinking resulted in word salad. Once I drank too much at a club and tried to walk out of south beach, because aliens had taken over the island. There might have been other substances involved but I don't remember.

I've never done a study of my own experiments with pot, but generally speaking if I took it by itself, I was fine, with the usually documented side-effects. Other times i've tried marijuana (typically with alcohol) i've ended up like others have mentioned: misinterpreting behavior or intentions of others in potentially bad ways. Luckily by that point I was aware that my mind would simply make shit up when I was on drugs, so I would just hide myself until the effects wore off.

Don't do drugs, kids.

[washadjeffmad]

Sufferers of schizophrenia have also been shown to have a very strong preference for smoking tobacco, so the question still remains unanswered whether people with schizophrenic tendency merely have that similar preference for marijuana, and whether that use might also trigger or exacerbate the pre-existing mechanisms for schizophrenia in their brains.

Someone else mentioned bipolar disorder, and it's interesting to note that schizophrenia, schizoaffective disorders, and bipolar disorders share a similar relationship to dopamine, and so the primary method of action of many anti-psychotic medications is to block dopamine reuptake.

Also interesting is that things like alcohol withdrawal, amphetamines, and marijuana deplete dopamine while tobacco, heroin, and cocaine stimulate its production.

[xkcd-sucks]

do you have a ref for the differential regulation of dopamine synthesis by amphetamine and cocaine?

[washadjeffmad]

I don't, and I see that I implied synthesis when I should have said that they only inhibit its reuptake, except for amphetamine, which also stimulates dopamine release.

Here's a general article on it: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC368179/

Good catch.

[riemannzeta]

I too found this interesting. I wonder also whether this particular individual was misdiagnosed as schizophrenic. Sounds pretty similar to a bipolar episode of mania, and marijuana is a documented trigger for bipolar mania.

[meowface]

I agree, I get the impression that this was a temporary psychotic episode possibly triggered through sleep deprivation, heavy use of cannabis, and maybe some underlying mental condition. Schizophrenia is typically a very chronic condition and doesn't manifest as only one psychotic episode per year.

I'm no doctor, psychiatrist, or psychologist, but I think his diagnosis is probably closer to "psychosis not otherwise specified".

However, he did mention that he is still taking the anti-psychotic medication, which can indeed inhibit the effects of schizophrenia for a long period of time. If he stops taking the medication and encounters psychotic symptoms again, then it probably is schizophrenia or similar.

[codezero]

I'm not a doctor, but I have a friend who is schizophrenic, the feeling of hearing cacophony, as well as believing people are hiding in cameras, and things are always about to fall are pretty good indicators. So many mental health issues are on a spectrum where one or two bits overlap with other diagnoses, so it's often hard to pin just one.

[michaelochurch]

It doesn't sound like a typical manic episode at all. Perhaps a mixed episode (mania and depression at same time, or dysphoric mania) with psychotic features.

"Schizophrenia" is a weird term and diagnosis, because it's probably many different diseases. I'd guess that most of these mental illnesses are symptom profiles related to dozens of different physical maladies. The symptoms were clearly psychotic (not all mania is psychotic, and hypomania rarely is, unless you include the benign religiosity) but I don't know (having experienced neither psychosis nor schizophrenia) if it's of the same character as what people with chronic schizophrenia experience.

[fifthesteight]

Correlation is not causation.

[thenmar]

It's a very good reason to investigate causation. This comment gets tossed around all too often by armchair scientists with a political agenda.

[tomcam]

Absolutely true! But it seems like playing with fire to use a powerfully psychoactive drug like hash when one has such symptoms. He doesn't seem to mention that he stopped smoking up. Common sense tells us that would probably be a good idea.

[fifthesteight]

You sound like a completely sane person.

The use (abuse) of substances is widespread among large swaths of the majority of mental illnesses. Associating the use of marijuana specifically with schizophrenia is absurd-- schizophrenics also abuse alcohol, does that mean wine causes schizophrenia?

I speak not only as a person with a mental health disorder (bipolar) but a member of a family with several actual schizophrenics.

Correlation is not causation. Downvote as you will.

[DanBC]

I strongly support the legalisation of all drugs.

> Associating the use of marijuana specifically with schizophrenia is absurd

It's not absurd. There's strong correlation between people who have a psychotic illness and previous cannabis use.

There are several different things people say about psychotic illness and cannabis.

i) smoking cannabis causes psychotic illnesses even in people with no underlying illness

ii) cannabis causes psychotic illness in people who already have a previously unseen underlying illness

iii) cannabis triggers episodes of illness in people who we know to have a psychotic illness

iv) cannabis has no effect either way

v) cannabis has high correlation because people are self medicating

vi) cannabis is protective

If you have a family history of psychotic illness it's probably a good idea to be cautious with drugs. That's not a controversial statement and it's intensely frustrating when people ignore any possibility of harm from cannabis. (The illegality of cannabis, and the ethics of research involving people with such a severe mental illness, mean that the research is not very good.)

(Also, if you're on certain meds you should stop smoking because the hydrocarbons in smoke interact with the meds).

http://www.nice.org.uk/guidance/cg178

> Offer people with psychosis or schizophrenia who smoke help to stop smoking, even if previous attempts have been unsuccessful. Be aware of the potential significant impact of reducing cigarette smoking on the metabolism of other drugs, particularly clozapine and olanzapine.

[chc]

I don't ignore any possibility of harm from cannabis, but I do tend to frown on FUD like this about pretty much any substance. If this comment thread were about vaccines rather than something more traditionally controversial like marijuana, I think more people would feel the same way.

(Just for the record, I'm not a marijuana user.)

[DanBC]

But we have so much evidence to show that vaccines are very safe. We do not have that evidence for cannabis. We do have strong correlations between people with severe mental illness and cannabis use and that has not been explained yet.

Letting people know that there is that strong correlation and suggesting that they be cautious, especially if they have a family history of mental illness, is totally different from vaccine-FUD which is nonsense.

[lg]

alternatively a desire to abuse cannabis might be a warning sign that you're developing a psychotic illness.

[woah]

How does one abuse cannabis?

[Kenji]

Proof by anecdote, n=2. I'm not saying you're wrong, I'm just saying that two stories have little statistical significance, if any at all. Taking life decisions based on such information is, in my eyes, unjustified.

[vinceguidry]

Reliance on anecdotes is driven by paucity of statistically meaningful data. Reminding people that the former is not as good as the latter is unhelpful. Anecdata is still data.

[Kenji]

It's like saying "Everyone I know who got suicidal depression consumed alcohol - better stay away from alcohol" You'd be surprised how common it is for people to take THC in one form or another. It is literally meaningless to pull two stories together and derive a causation.

[mikeash]

It's not at all proof by anecdote. He's saying that there's some evidence the two are linked, and that these anecdotes should remind us of this evidence and to use caution accordingly.