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Show your Support for the Reclassification of Schizophrenia

Join me and sign letters to both the Centers for Disease Control and Prevention (CDC) and the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) to promote the reclassification of Schizophrenia from a mental illness to a neurological/brain disease. Reclassification of Schizophrenia would greatly improve the care of those with the illness, as well as make treatment options more accessible. Reclassification would also end incarceration of those with the illness and reduce homelessness in people with Schizophrenia.

Show your support for reclassification here!

More about the Schizophrenia and Related Disorders Alliance of America(SARDAA) here.

#reclassifyschizophrenia

statistics courtesy of SARDAA

Considering Immune Response as a Factor in the Development of Schizophrenia and Bone Marrow Transplantation as Treatment

In 1927 a man named Julius Wagner-Jauregg did something fascinating, he began treating patients with severe psychiatric illness by inoculating them with malaria virus. He went on to win the Nobel Prize in 1927. And while Jauregg mainly treated patients with illnesses like syphilis and dementia, he was the first to identify how immune response and fever affected psychiatric illnesses like psychosis and catatonia. The patients who survived long enough for the treatment to work eventually recovered or had significantly improved quality of life.

It would be a leap to say that he cured them. He didn’t. What he did do, however, is set the stage for later research into the immune response is a factor in the development of Schizophrenia. Further, it may no longer be an unwarranted leap to suggest that bone marrow transplantation and low dose antibiotic treatment may help or even eliminate Schizophrenia and its symptoms.

If you’ve ever known anyone with Schizophrenia or, like me, have it yourself, you understand how difficult the condition can be and what it can take away from you. Most frequently developed in a person’s early twenties, the condition is one of the most disabling diseases documented and for some may even be degenerative.  Ranging from effective to severe and manifesting in several subtypes including catatonic, paranoid, disorganized, early onset (childhood), and Schizoaffective Disorder, it affects everyone equally with no racial or sexual preference. Schizophrenia can have genetic components, with the chances of development increasing in the children of parent(s) who have it but can also affect a person with no family history of psychiatric illness.

Until recently, the typical treatment for Schizophrenia consisted of antipsychotic medication, sedatives, mood stabilizers, and antidepressants. These medications, while integral to the process of recovery, often come not without severe and/or damaging side effects. Antipsychotics can have lasting damage to the body if taken over a long period of time. Antipsychotics can also cause significant weight gain which can lead to cardiovascular disease risk and diabetes. However, scientists now have a new treatment to consider: bone marrow transplants.

Incredibly, in 2017, a man who had been diagnosed with Paranoid Schizophrenia at twenty-three, developed cancer at twenty-four, and in an effort to treat his cancer, a bone marrow transplant ended up curing both his cancer AND his schizophrenia. Similarly, a man without schizophrenia developed the illness after receiving a bone marrow transplant from his schizophrenic brother. If a bone marrow transplant can cure or induce psychosis, naturally, the immune system must play a role in the development and symptomology of schizophrenia and other psychotic disorders, as bone marrow transplants essentially reboot a person’s immune system.

Historically there is a great deal of evidence that points to the immune system playing a huge role in schizophrenia.  In their case report, which reviews the evidence that supports a bone marrow transplant causing a remission of schizophrenia, Miyaoka wrote, “Although schizophrenia is regarded as a syndrome with different biological backgrounds, involvement of immune system disturbances could be one of the common mechanisms. The association between maternal infection and neurodevelopmental disorders is long-standing but not without controversy. After the 1964 rubella pandemic, the incidence of schizophrenia rose from less than 1% in the unexposed population to about 20% in the exposed population. Subsequent studies charting historic outbreaks of flu, measles, mumps, chickenpox, and polio have revealed an association with schizophrenia.” The New York Times has even reported about a recent study in which a woman with schizoaffective disorder was relieved from her psychotic and depressive symptoms after a dangerously high fever. 

But this doesn’t come without risk, as bone marrow transplants are extremely risky and require weeks of chemotherapy and isolation. This idea of treating schizophrenia with something other than heavy medication and long-term hospitalization feels like a step in the right direction. Furthermore, the possibility that we might come to fully understand the mechanism behind the development of schizophrenia would, automatically, help us to understand how to prevent people from developing it all.  Of course, scientists can’t confirm if the immune response is the cause of all types of schizophrenia. Some schizophrenias maybe be driven solely on the dysfunction of serotonin and norepinephrine, while other types may be autoimmune diseases masquerading as schizophrenia or psychosis. In the previous case study highlighted, Miyaoka wrote, and it is important to remember that, “…[a] single case report, we apparently cannot confirm an immune pathogenesis of schizophrenia. However, several reports support the theory that immunological system is one key factor of pathogenesis of schizophrenia.” As time goes on people with or affected by schizophrenia can only hope that these possibilities become more solidified.

Psychosis can be beautiful, but there isn’t a single day I wouldn’t prefer to live without it. Would I try something as risky as a bone marrow transplant to cure me? I’m relatively high functioning. But I’m only high functioning on my medications. Off my meds and I’m sure many people wouldn’t even recognize me. I would very much prefer not to have to take all of these medicines for the rest of my life. And even on my medications, I’m still hearing voices constantly. I’ve been hearing voices for so long now I don’t even really remember what it was it was like to not hear them. I would risk a procedure like this if it meant security and protection from schizophrenia. If I wouldn’t ever have to worry about my medications stopping working. If the world could be quiet again. Then I’d do it.

I can’t imagine living in a world not haunted by mental illness, not stalked by twinges of paranoia, not exhausted by an utter lack of motivation to do anything more than breathe, not living a noisy life even when it’s actually quiet, not living under the thumb of psychosis, or held down by the big, wet blanket of depression, not waiting to be tossed into a manic episode. To avoid never having another hallucination or delusion again I’d do anything.

These are things someone with schizophrenia lives with. We live with the fear that our symptoms bring and fear of stigmatization. Schizophrenia and it’s related disorders impact every part of the person who has it.  And any glimmer of hope, any sign of a cure, is reason enough to pursue the possibility to its end.

 

 

Chen, S., Tvrdik, P., Peden, E., Cho, S., Wu, S., Spangrude, G., & Capecchi, M. R. (2010, May 28). Hematopoietic origin of pathological grooming in Hoxb8 mutant mice. Retrieved April 6, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/20510925

Miyaoka, T., Wake, R., Hashioka, S., Hayashida, M., Oh-Nishi, A., Azis, I. A., . . . Horiguchi, J. (2017, September 21). Remission of Psychosis in Treatment-Resistant Schizophrenia following Bone Marrow Transplantation: A Case Report. Retrieved April 6, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613125/#B26

Sommer, I. E., Bekkum, D. W., Klein, H., Yolken, R., Witte, L. D., & Talamo, G. (2014, October 06). Severe chronic psychosis after allogeneic SCT from a schizophrenic sibling. Retrieved April 6, 2019, from https://www.nature.com/articles/bmt2014221?draft=journal

Velasquez-manoff, M. (2018, September 29). He Got Schizophrenia. He Got Cancer. And Then He Got Cured. Retrieved April 6, 2019, from https://www.nytimes.com/2018/09/29/opinion/sunday/schizophrenia-psychiatric-disorders-immune-system.html

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Mad Men, Monsters, and Geniuses: Depictions of Schizophrenia in Film

Introduction

If one does an internet search for films about Schizophrenia they will be presented with a countable list, meaning, there are few of them. And of those films are any of them accurate depictions of the disease? Among them, is A Beautiful Mind, which is perhaps the most viewed film about Schizophrenia ever. The Oscar-winning film is about John Nash, a Princeton mathematician diagnosed after a psychotic break toward the end of his education. The film was a romanticized explosion. A secret agent pic mixed with Nash’s mathematician genius. Equally as impressive, there is 2014’s Love and Mercy which depicted Brian Wilson’s experience with the illness. While both of these movies have their place, Love and Mercy succeeded where A Beautiful Mind failed. Instead of becoming a box office hit, Love and Mercy was a quiet indie release which showed the reality of Schizophrenia. The film took the depiction of the disease beyond hallucinations, something that most movies about the illness tend to get hung up on. Love and Mercy highlighted Schizophrenia’s cognitive symptoms and showed what life after treatment could look like.

When considering movies about Schizophrenia there tend to be three categories. The first is horror in which the person with Schizophrenia is a villain or a murderer at the whim of their illness. Then original scripts which too often depict the character with Schizophrenia as someone with little to no touch with reality. And finally biopics typically about how Schizophrenia makes the person in the film a genius. These categories can intersect, and often do. They come together to create inaccurate representations of characters with Schizophrenia. There are villains who are geniuses, residents of institutions who have committed heinous acts of violence, artists and academics who have surpassed any other in their respective fields, and people who are so far out of touch with reality they have created entire fantasy worlds to exist within. All these characters have one thing in common: they all have Schizophrenia. These films go as far as to depict Schizophrenia as a defining factor in a character’s extremeness, with the disease being the part of them that drives them to violence or insanity. Yet many people are able to live with the disease undisturbed.   

Horror

Horror movies are quick to depict evil or detestable main characters as mentally ill, and especially as having Schizophrenia. In this way, films can assert the idea that having Schizophrenia makes a person violent. When in fact, research has found that people with mental illness are more likely to be victims of violence than perpetrators of it (North Carolina State University). Most violent crimes are actually committed by people without mental illness. While anyone has the potential to be violent, society tends to place the blame for incomprehensible acts of violence on people with mental illnesses. No doubt Schizophrenia can be a scary and uncomfortable disease, but the only thing it makes a person more likely to do is to pass away prematurely, leaving people with Schizophrenia at risk for developing many other illnesses, but it does not increase their chances of being violent(SARDAA).  

Movies like The Fisher King (1991), Psycho (1960), and Halloween (1978) have an incredibly damaging impact on the way people understand Schizophrenia. All films in which the antagonist, a murderer or serial killer, is either directly or indirectly said to have Schizophrenia. For many people, their only understanding of the disease is from what they see in films like these. And based off this knowledge alone they would have good reason to be scared. Horror films paint a scary picture of mental illness, even if it is inaccurate. Media has such a deep and undying impact on how people understand the world. Bias is easy to plant but difficult to uproot. This means that it could take years to undo the stigmatization that exists because of the ways mental illness and Schizophrenia is depicted in the horror genre.

People with Schizophrenia in original script and movies based on books

In original scripts, and sometimes scripts based on novels, people with Schizophrenia are often completely out of touch with reality. They are frequently residents of a hospital or institution and are often victimized. Abuse and trauma is almost always part of the backstory for the main character. These films can also depict characters with Schizophrenia as living in their own, hallucinatory world. Movies like this include Donnie Darko (2001), K-PAX (2001), Spider (2002), Sucker Punch (2011), and Shutter Island (2010).  These movies tend to completely fictionalize the disease, suggesting that having Schizophrenia leaves a person completely disconnected from reality. These movies depict people with Schizophrenia as people lost in a delusion they perceive as real. While delusional thinking and hallucinations are part of the diagnosis, Schizophrenia is rarely so severe that people with it have almost no connection to reality. People with Schizophrenia, while spending time in psychiatric hospitals or even spending extended amounts of time there, very rarely need to live there anymore. With new medications and treatments coming out the all time, people with Schizophrenia have better outlooks than they ever have before.

 

Biopic

Biopics, ones like A Beautiful Mind (2001) and Love and Mercy (2014), exclusively depict the subject as a genius but suggest that this genius is due to Schizophrenia. They place the subject of the biopic on a pedestal and posit, isn’t this weird, aren’t they weird, we don’t understand them but they’re a genius. This is familiar with recalling the plot of either aforementioned movie. Both subjects are at the crux of their careers, one a mathematician at Princeton and the other a singer/songwriter/composer for The Beach Boys, who develop Schizophrenia and nearly lose themselves to the disease.

Of course, it is their Schizophrenia which makes them a genius, not their intellect alone, or their years of studying and practicing, and dedication. It is their disease, which is insinuated to be misunderstood and surreal, that is isolating them from others. In biopic films, people with Schizophrenia are put on high because the general public cannot understand them and therefore people with Schizophrenia are othered. Like an oracle or profit, being this type of misunderstood makes you mystical. Yet, Schizophrenia is prevalent enough to make it a fairly common disease and certainly, most people with Schizophrenia are not John Nash or Brian Wilson.

So why this idea that if you are not violent then you are mystified? Why not just normal, why not just average? Wahl in their article: Impact of a Television Film on Attitudes Toward Mental Illness, explains, “Social scientists have long been interested in the possible impact of mass media images on the public and have given considerable attention to false stereotypes of women, minorities, and the elderly. Mental health advocates have urged that attention be extended to another stereotypes group-mentally ill persons. Preliminary research has indicated that mental illness is a common theme in mass media. Stereotypes as mentally ill persons as different or dangerous have also been documented, and there is a strong belief that such stereotypes help maintain stigma which accompanies mental illness,”(Wahl 522). These examples of people with mental illness further perpetuate the incorrect public view in which people who are different are extreme examples of violence, insanity, or genius.

Discussion

When an entire group of people is boiled down into stereotypes, the resulting concoction breeds discrimination like bacteria. In films, people with Schizophrenia have always been either madmen, monsters, or magicians of intellect. A Schizophrenic is rarely a person; they are sick, violent, and out of touch. Rarely has a diagnosis carried such stigmatization. As time marches on and society distances itself from an era of cruel institutions and lobotomies as a legitimate treatment, mental illness is becoming less stigmatized. However, while the conversation surrounding depression, anxiety, and Bipolar Disorder increases, the same cannot be said about the conversation surrounding Schizophrenia. Mass media, arguably America’s favorite past time, is not helping the cause. In a survey which highlights how people interpret messages about mental illness on television an in film, Borinstein found that, “Americans are more likely to receive information about mental illness from the mass media than from mental health professionals. For example, 87 percent of respondents said that they had seen something about mental illness on television in the past several years. Other sources were newspapers (76 percent), magazines (74 percent), radio (73 percent), family or friends (51 percent), and books (50 percent). Only about three in ten said that they had received information from a mental health professional such as a psychiatrist or psychologist (31 percent) or a physician (29 percent). Americans may be receiving most of their information about mental illness from the news media, but whether they believe what they hear or see from those sources is another issue,”(Borinstein 189). With so much influence from mass media, and such poor portrayal by the same source of information, the general knowledge about serious mental illness like Schizophrenia is tainted.

Consistent misinformation leads to decades of misunderstanding, especially when the majority of the information sourced is inaccurate. The prevalence of Schizophrenia is about one in one-hundred. This makes the disease fairly common. About 3.5 million people worldwide have Schizophrenia. Which means 3.5 million people suffer stigma that is so severe that they might never seek treatment(SARDDA).

Conclusions

Films about mental illness are designed to entertain. People have always been captivated by madness and violence. For decades we have been combining stereotypes about Schizophrenia and mental illness with blockbuster plots. The damage has been done. In order to halt this type of stigmatization, the grossly inaccurate depiction of people with mental illness must be changed. The influence of mass media can be used to help people make informed opinions or at least can be used to generate compassion through accurate representation. Just as dangerous as racism and sexism, ableism and stigma toward mental illness is taking lives.

One trend that has become visible in the difference between earlier films like A Beautiful Mind and more recent examples like Love and Mercy is the clear shift to a more accurate depiction of mental illness and Schizophrenia. This change brings to mind films like Silver Linings Playbook (2012), about Bipolar Disorder and Borderline Personality Disorder. The film gives accurate but difficult images of both illnesses. However, what cannot be dismissed are movies like Split (2016), an atrocious and hurtful suggestion of what Dissociative Identity Disorder (DID) looks like. The film Split featured an antagonist, a villain with DID living with twenty-three personalities. Compelled to kidnap and torture three teenage girls, each of his personalities terrifies his captors in different ways.

It is clear that American culture and understanding is beginning to move past our outdated understanding of serious mental illness like Schizophrenia, but old habits die hard and changes do not happen overnight. Split was so contested that it started a petition which garnered a good deal of signatures begging the movie not be released. That did not happen, and no matter how many signatures, it is doubtful the film would have ever been pulled. A sequel is set to be released. After decades of misrepresentation, it is to no one’s surprise that movies like Split are still being produced. But things are changing and more people are becoming fed up with the rehashed mentally ill villain.   


Citations:

 

About Schizophrenia. In: Sardaa. https://sardaa.org/resources/about-schizophrenia/. Accessed

9 Dec 2018

 

Borinstein AB (1992) Public Attitudes Toward Persons With Mental Illness. In: The Physician

Payments Sunshine Act. https://www.healthaffairs.org/doi/10.1377/hlthaff.11.3.186. Accessed 9 Dec 2018
VOL. 11 NO. 3

 

Corrigan P, Watson A, Ottati V (2003) From Whence Comes Mental Illness Stigma?

International Journal of Social Psychiatry 49:142–147. doi: 10.1177/0020764003049002007

 

Fleming MZ, Piedmont R, Hiam CM (1990) Images of Madness: Feature Films in Teaching

Psychology.  Teaching of Psychology 17:185–187. doi: 10.1207/s15328023top1703_12}

 

LIVINGSTON KATHY (2004) VIEWING POPULAR FILMS ABOUT MENTAL ILLNESS

THROUGH A SOCIOLOGICAL LENS. Teaching Sociology 32:119–128. doi: https://doi.org/10.1177/0092055X0403200111

 

North Carolina State University. “Mentally ill more likely to be victims, not perpetrators, of

violence, study shows.” ScienceDaily. ScienceDaily, 25 February 2014. <www.sciencedaily.com/releases/2014/02/140225101639.htm>.

 

Penn D, Chamberlin C, Mueser T (2003) The Effects of a Documentary Film About

Schizophrenia on Psychiatric Stigma. Schizophrenia Bulletin 29:383–391.

 

Wahl, Otto, and J Yonatan Lefkowits. “Impact of a Television Film on Attitudes Toward Mental

Illness.” American Journal of Community Psychology, vol. 17, no. 4, 1 Aug. 1989, pp. 521–528. Research Gate, https://www.researchgate.net/publication/20546422.


Films Referenced:

A Beautiful Mind. Directed by Ron Howard.

Performances Russell Crowe,

Universal Pictures, 2001

 

Love and Mercy. Directed by Bill Pohlad.

Performances Paul Dano

River Road Entertainment, 2014

 

The Fisher King. Directed by Terry Gilliam.

Performances Jeff Bridges

TriStar Pictures, 1991

 

Psycho. Directed by Alfred Hitchcock.

Performances Anthony Perkins

Shamley Productions, 1960

 

Halloween. Directed by John Carpenter.

Performances Jamie Lee Curtis

Compass International Pictures, 1978

 

Donnie Darko. Directed by Richard Kelly.

Performances Jake Gyllenhaal

Pandora Cinema, 2001

 

K-PAX. Directed by Iain Softley.

Performances by Kevin Spacey

IMF Internationale Medien und Film GmbH & Co. 2. Produktions KG, 2001

 

Spider. Directed by David Cronenberg.

Performances Ralph Fiennes

Odeon Films, 2002

 

Sucker Punch. Directed by Zack Snyder.

Performances Vanessa Hudgens

Warner Bros., 2011

 

Shutter Island. Directed by Martin Scorsese.

Performances Leonardo DiCaprio

Paramount Pictures, 2010

 

Silver Linings Playbook. Directed by David O. Russell.

Performances Bradley Cooper, Jennifer Lawrence

The Weinstein Company, 2012

 

Split. Directed by M. Night Shyamalan.

Performances James McAvoy

Blinding Edge Pictures, 2016

 

Radical Acceptance is cool