Schizophrenia is the price we pay for minds poised near the edge of a cliff

I've lost one of my best friends to what I think is schizophrenia. We don't know because she's cut off all contact with friends and family and refuses to see a doctor. It's definitely psychosis. She thinks she's in some kind of Truman show that she calls "the game". Since none of her friends or family are willing to admit to it, then we must be in on it.

We don't know her full family medical history because her dad was adopted. I do know that she was "microdosing" and macro-dosing hallucinogens for years. Mostly acid and shrooms as far as I know. She followed the band Phish around with a group of friends. I can't imagine most of those shows were sober.

We've also seen a few incidents of paranoia when she was under the influence of drugs/alcohol going back decades. So it feels like this was always there in some form, but maybe the estrogen was holding it back before menopause hit. I read an article about women who get schizophrenia after menopause that suggested this could be the case.

Anyway, whenever I see wellness healers and the like extolling the virtues of psilocybin, I want to point out that there could be a downside. We don't know that all of her hallucinogen use over the years contributed to this. But it's certainly a possibility.

Plenty of intelligent people entertain this possibility, as well as many other possibilities, around how our world works.

If they then become obsessed with the idea being a fact and refuse to even consider updating their mental model when presented with evidence contradicting it then they have developed a fixed belief.

When that fixed belief is not common among their culture, it becomes a bizarre fixed belief.

When, as a result of their obsession with those bizarre fixed beliefs, they are unable to function (hygiene, nutrition, finances, care of their dependents, etc.) - then there’s a problem.

Or do you think a mind is a perfect thing that can never be ill?

> When that fixed belief is not common among their culture, it becomes a bizarre fixed belief.

> When, as a result of their obsession with those bizarre fixed beliefs, they are unable to function (hygiene, nutrition, finances, care of their dependents, etc.) - then there’s a problem.

But why does the issue of whether it is “common among their culture” matter? A person unable to function due to a non-bizarre fixed belief has just as big a problem as a person unable to function due to a bizarre fixed belief, if we assume the same degree of functional impairment in each case. The question of whether the belief is “bizarre” seems irrelevant, and possibly even encoding cultural prejudice

“Common among their culture” is a quick way of determining whether lots of other people are able to hold this belief and function fine. It also suggests an origin for the belief that isn’t unique to the person. You can’t go around saying “ah this person’s problem is they believe in angels” if the person’s belief in angels is simply part of their religion or culture. “But they believe in imaginary beings” is not a helpful observation in that context.