You just do your best and leave them alone otherwise.

This seems to be mainly about the so called negative symptoms, not positive symptoms (like hallucinations or delusions). While it is often hard to argue with people about their positive symptoms in schizophrenia or in mania, pretty much nobody who has negative symptoms wants to have them. The fact that antipsychotics do little about the negative symptoms is probably the biggest pain of schizophrenia sufferers - and they are aware of that.

Also, and this depends on the jurisdiction, but people can be forced to take psychiatric medication against their will. Or even forced to go through a treatment like ECT, for example when presenting with strong and dangerous mania. BTW, ECT has an extremely unfair popular opinion, it's one of the best treatments in all of psychiatry. It could even be that it is impossible to get a response from the patient, for example if they are catatonic and don't budge within a reasonable time - you just inject them with benzodiazepines, as this is a serious condition if left to last a long time.

Inmiced above. Thanks!

To this point, some cultures see schizophrenia as friendly, not scary.

https://news.stanford.edu/stories/2014/07/voices-culture-luh...

> In the United States, the voices are harsher, and in Africa and India, more benign, said Tanya Luhrmann, a Stanford professor of anthropology and first author of the article in the British Journal of Psychiatry.

I liked how this blog[0] describes it. Schizophrenia itself isn't a spectrum, but rather you have varying levels of schizophrenia risk genes. They have positive fitness functions (creativity, cognitive flexibility, linguistic skill) until you cross the threshold to schizophrenia.

[0] https://www.psychiatrymargins.com/p/schizophrenia-is-the-pri...

You might be interested in this book: https://en.wikipedia.org/wiki/Doctoring_the_Mind

I have some primary care providers in the family and I've asked them since I often have differing opinions. I've asked if some people with bipolar and schizophrenia refuse specific medical treatment and just go on with their life. I've gotten the answer that many of them have learned to recognize what is happening and ride it out well enough that they can live with it. I'm sure it's highly dependent on the severity and the person.

I've noticed something similar with people on say heavy doses if hallucinogens. Some people just ride it out knowing it's the mind playing tricks on them, others hopelessly panic or make irreversible decisions.

> is schizophrenia a spectrum disorder like autism?

I'm a non expert but I believe some people are starting to see it that way. See: https://www.google.com/search?q=schizophrenia+spectrum+disor...

Also there's huge overlap in symptoms between bipolar I with psychosis, schizoaffective disorder, and schizophrenia. People sometimes move around between these diagnoses throughout treatment, different doctors have different opinions, patient behavior changes, etc.

I personally think these symptoms come about through many different causes and the labels are somewhat inadequate. They capture a symptom profile rather than a full understanding.

Well, there's gotta be a line you can draw somewhere between "treating people who actually need it" and "treating people because that's what policy says and we don't care about the individual".

Sometimes, that line is whether or not the state is somehow involved through social services or the criminal justice system.

No but it is a behaviourally defined disorder like autism. Which means it can and has many different causal patterns behind it.

That is there are many different things that can cause the behaviour.

Anyway on your main point, the definition of all psychiatric disorders has requirements of subjective suffering. So if you don't have subjective suffering you don't have the disorder.

Disproportionately many geeks have very strong opinions about psychiatry, probably because we have a lot of people who consider themselves neurodivergent, as well as plenty of folks who experiment with drugs.

Identifying a biomarker for a psychological condition, particularly one like schizophrenia which is hugely disruptive for individuals affected and has a seemingly random onset around early adulthood, is significant in its own right even if it doesn’t lead to a pharmaceutical intervention. It could help identify new risk factors, potential non-pharmaceutical interventions like life style changes, and maybe even identify people who are at risk of developing schizophrenia and preparing them for its onset before their first hallucination and avoiding a downward spiral.

Given how debilitating schizophrenia can be, and how compromised the current treatments are - hey, you don't mind making uncontrollable strange expressions on your face forever, do you? - things like this give hope, even if it's just a little bit.