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“The schizophrenic mind isn’t split, it’s shattered,” said Elyn Saks in an interview broadcast on Your Mental Health Talk Radio¹ (YMHR). “Your self dissolves.” Saks, Associate Dean at USC School of Law, spoke from experience, having lived with symptoms of schizophrenia for decades. She attended Oxford University, while experiencing delusions and paranoia, then graduated and attended Yale University to earn a law degree. Her intelligence remained intact even while her “self felt like it was losing its cohesiveness.”

The sense of losing cohesiveness, which she likens to the dissolving of a sand castle, led her to title her 2007 memoir, The Center Cannot Hold: My Journey Through Madness. Though Saks has the logical mind of a scholar, lawyer, and professor, she admits it took years to accept she had a mental illness. She kept quitting medication, a problem often associated with mental health consumers.

Saks, however, sees little difference between people diagnosed with mental illness and people diagnosed with physical illness. She heard of a study of college professors on medication for high blood pressure whose rate of discontinuing medication was the same as that for individuals diagnosed with schizophrenia. (*See reference to two studies listed below which support Saks’ comment.) “Nobody likes taking medication,” she said.

After accepting her diagnosis and adhering to medication Saks endured a period of tenuous years before she reached a point of stability. In her description of those years she said:

“… I was teetering on the edge all of the time. A slight breeze would push me over into the land of psychosis. Now, I’m mostly well. I’m mostly thinking clearly. I do have episodes, but it’s not like I’m struggling all of the time to stay on the right side of the line.” (TIME Magazine, 2007)²

An important aspect of her ability to maintain her career as a law professor and adjunct professor of psychiatry involves compartmentalizing thoughts. Saks counts herself fortunate that she never lost “social judgments.” In other words, she knew which thoughts would frighten others. In the same way a person knows not to express strong thoughts and emotions of grief while on the job, Saks said she knew to put disturbing thoughts aside while she taught classes at the university where she is a tenured professor.

“Even today,” she said in a TIME Magazine interview, “with all the treatment and all of the medication, I still have transient psychotic thoughts, probably daily. Where a thought like, I’ve killed people, comes to my mind and I just say, oh that’s your illness acting up.”

Saks addresses stigma in her interviews by TIME and by YMHR, noting that the “negative expectations” of recovery or stability from schizophrenia is a significant problem. She also believes that stigma from mental illness becomes life threatening because psychiatric patients often do not receive adequate work-up for other health problems. In her case, doctors attributed her loss of short-term memory to schizophrenia and sent her home when she was actually suffering from bleeding in the brain.

In spite of several health crises along with schizophrenia, Saks considers herself fortunate. She is a specialist in mental health and advanced family law, married, and training to become a psychoanalyst. Her advice for anyone trying to help a person struggling with symptoms of schizophrenia? Saks suggests asking, “I can see you’re struggling. What can I do to help you?”

Elyn Saks has helped by discussing her symptoms and becoming an advocate. You can listen to her interview at the link provided.

References:
¹ Interview with Elyn Saks by Jackie Foreman, Your Mental Health Talk Radio. http://www.blogtalkradio.com/ndbmedia/2011/12/24/ymhr–schizophrenia

² “A Memoir of Schizophrenia” by Andrea Sachs, TIME Magazine, April 27, 2007. http://www.time.com/time/arts/article/0,8599,1656592,00.html

Newer online article and video dated 8/12/12:  http://www.cnn.com/2012/08/12/opinion/saks-mental-illness/index.html

*  “Apparent discontinuation rates in patients prescribed lipid-lowering drugs,” by Simons LA, Levis G, and Simons J, University of New South Wales Lipid Research Department, St Vincent’s Hospital, Sydney, The Medical Journal of Australia[1996, 164(4):208-11]. http://ukpmc.ac.uk/abstract/MED/8604188

*  “The role of patient inexperience in medication discontinuation: A retrospective analysis of medication nonpersistence in seven chronic illnesses” by Mark Vanelli, Alex Pedan, et al, Clinical Therapeutics, Volume 31, Issue 11 , Pages 2628-2652, November 2009.
http://www.clinicaltherapeutics.com/article/S0149-2918(09)00418-4/abstract

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