Schizophrenia and Loose Associations

I often get hits on my blog from people searching for examples of Loose Associations

First, it may be helpful to know that I am a psychiatrist who works much of the time on an adult inpatient psychiatric ward at an academic medical center. My blog is just a hobby, and for entertainment (my own mostly) purposes only. I thought that the term loose association fit well with the format and content of this blog. I use the term in a general way, but it is apropos because of my line of work. I thought I’d take a moment to describe what a loose association is and talk a bit about schizophrenia.

The term loose association is used clinically when assessing the mental status of a patient. It refers to illogical connections between thoughts and statements. A loose association is a logical misstep. It is when the successive individual thoughts in a train of thought are loosely associated with each other. The train of thought is derailed. Loose associations can be appreciated in a variety of psychiatric disorders, but are very prominent in patients with Schizophrenia. To understand what a loose association is, it may be helpful to understand Schizophrenia.

Schizophrenia is a devastating neurological disorder that usually causes life long suffering and alienation. It is a  characterized by 3 categories of symptoms: positive, negative and cognitive. Positive symptoms are usually in the form of hallucinations (most commonly auditory i.e. hearing voices) and delusional thinking (fixed, false beliefs i.e. paranoia.) Negative symptoms are harder to treat and often cause some of the most devastating effects of schizophrenia. Examples of negative symptoms would be extreme apathy and social isolation. Finally, there are the cognitive symptoms. Patients with schizophrenia have difficulties with thinking. They have difficulty with sorting out and prioritizing their thoughts. This leads to below average functioning in an otherwise intelligent person.

Patients with schizophrenia often get caught in a downward socioeconomic spiral. Their symptoms and behavior often alienate loved ones, and their decreased functioning often leaves them with little ability to care for themselves. Too often these folks succumb to homelessness and drug addiction. There are some effective treatments that improve functioning and quality of life. These include anti-psychotic medications, supportive therapy and aggressive case management. Though a general lack of resources for the mentally ill often makes it difficult, treating folks with these issues can be rewarding.

So there you go. My blog is called Loose Associations because I intended to write on vast array of loosely associated topics. I also meant for it to be a nod to my day job.

Making Changes

For the past few months, I have not been exercising, and not eating all that well.

For the past few weeks, I have made an effort to correct this. A few weeks ago, my wife threatened to cancel my gym membership if I didn’t use it. Now I go at least once a week to lift weights and swim,  and I started a weekly fitness yoga class (which was really hard the first time!).

In addition to this, I’ve also started running. I’m using the Couch to 5K running plan from www.coolrunning.com that was set to music in a pod-cast I downloaded several years ago. I’m on week 2 of 9 with this.

As far as my diet goes, I am trying to break some bad habits. My routine for a while has been to run through the Tim Horton’s drive-thru on the way to work and pick up coffee and donuts. My Mom never spoke truer words to me than she did when I was a teenager “if you eat donuts for breakfast every day, you are going to get fat.” So now I am bringing some food from home to eat in the car. I am also packing a lunch instead of eating out. This is way cheaper and way healthier.

So far so good with all of this. My wife accuses me at times as doing things in a non-sustainable, all or nothing way. We’ll see…