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I don’t want to sound like a Pollyanna about schizophrenia; mental illness imposes real limitations, and it’s important not to romanticize it. We can’t all be Nobel laureates like John Nash of the movie “A Beautiful Mind.” But the seeds of creative thinking may sometimes be found in mental illness, and people underestimate the power of the human brain to adapt and to create. –E. Saks

The above quote by Elyn Saks¹ who has symptoms called schizophrenia reflects two realities about the condition: people underestimate the possibility of living and working successfully, and the degree of success ranges from slight to staggering.  In her essay, “Successful and Schizophrenic,” published in the The New York Times, Saks points out that the grave prognosis given decades ago to newly diagnosed individuals—don’t expect much of a life—has been proven incorrect.

Because she became successful in the fields of law and psychiatry, Saks has been told she did not really have schizophrenia (because you cannot do much of anything if you do), or, that she could not possibly have made any accomplishments if she did have the illness.  The truth is that whatever you want to call the clump of symptoms she had, which did add up to the description called schizophrenia in the diagnosis manual, it did not add up to the life of an invalid.

Saks and three colleagues studied the lives of 20 individuals diagnosed with the illness, who had jobs and in most cases a college degree, “including a doctor, lawyer, psychologist, and chief executive of a nonprofit group.” How could they possible function at such levels with symptoms such as delusions and hallucinations?

“We learned,” she said, “that in addition to medication and therapy, all the participants had developed techniques to keep their schizophrenia at bay.”  The techniques included:

  • vigilance about symptoms and what triggers them
  • controlling sensory inputs such as sound levels and visual clutter
  • engaging in work
  • a healthy lifestyle  — diet, exercise, avoidance of alcohol, sufficient sleep
  • a belief in God and prayer

Saks noted that working yielded a strong benefit for the participants, yet psychiatrists have often not considered jobs as a therapeutic goal.  Having a job “… is my best defense,” she said.  “It keeps me focused, it keeps the demons at bay. My mind, I have come to say, is both my worst enemy and my best friend.”  When hallucinatory, an enemy.  When engaged in intricacies of law and medicine, a best friend.

Saks urges an expanded therapeutic model for physicians to consider, one that gives room for the intelligence and creativity usually dismissed in patients with severe symptoms.  Fortunately, for our sakes, Saks has boldly revealed the hardship of living with schizophrenia while attaining high professional achievements.  She adapted and created. Considering the recent media coverage of events related to mental illness, Evelyn Saks’ honesty and advocacy is a breath of fresh air.

An approach that looks for individual strengths, in addition to considering symptoms, could help dispel the pessimism surrounding mental illness. Finding “the wellness within the illness,” as one person with schizophrenia said, should be a therapeutic goal.

Reference: ¹ “Successful and Schizophrenic” by Elyn Saks, The New York Times, January 27, 2013.  View online at: http://www.nytimes.com/2013/01/27/opinion/sunday/schizophrenic-not-stupid.html?_r=0

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