Schizophrenia, like many other disorders, is an invisible illness that affects about 1/100 people within society. The illness itself is cognitive and emotional dysfunctions, including delusions, and hallucinations, disorganized speech and behavior, and inappropriate emotions (Barlow, D. H., Durand, V. M., Lalumiere, M. L., & Hofmann, S. G., 2018).) Many individuals have mistaken schizophrenia as a ‘split personality’ which is also referred to as ‘multiple personality disorder’ in the DSM-5. While some symptoms of both illnesses may seem similar, such as hearing voices that attribute to different people, these illnesses fall in different categories of one another. John Nash, a math prodigy in the movie ‘A Beautiful Mind’, has been diagnosed with schizophrenia. The movie is an accurate representation of schizophrenia and how it affects an individual throughout daily life using John Nash as a perfect example, who exhibits many of the key symptoms of the disease such as hallucinations, delusions, and troubles focusing. The time period the film is set in is a key aspect of the of the development of treatment for schizophrenia. Using John Nash as a case study, this paper will address schizophrenia and the need for diagnostic criteria to fully understand and diagnosis the illness as well as certain treatments used to treat individuals with schizophrenia.
Diagnosis
Schizophrenia is labelled as a psychotic disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). For an individual to be correctly labelled as a schizophrenic an individual has to portray two or more signs of delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms that are present for a significant amount of time within a one-month time period (DSM-5). While delusions are described as false beliefs that are not based in reality, hallucinations are described as hearing or seeing things that do not exist (Barlow, D. H., Durand, V. M., Lalumiere, M. L., & Hofmann, S. G., 2018).) Schizophrenia can be easily described as an individual's feeling out of touch with reality and is usually experienced in adolescence or early adulthood and usually goes through a psychotic break (Kavak, F., & Yilmaz, E., 2018).
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Nash followed the typical path for a schizophrenic as he had his first psychotic break in early adulthood. As an audience we quickly grasp that there is something different about Nash, he states that he likes numbers over people quickly displaying his introverted personality and withdrawal for personal relationships. Nash portrays almost all symptoms outlined in the DSM-5 as he has both auditory and visual hallucinations, paranoid ideations, delusional thinking, as well as a distorted sense of reality. Nash’s hallucinations start at grad school, they start when Nash meets his roommate, Charles, but it very apparent to the audience that the room is made for one person. Charles follows Nash throughout the film helping him find his original thesis. The film moves on and Nash is sought out by a secret agent who explains Nash’s roles in fighting communism. At this point in the film the audience is able to see that all of these people are figments of Nash’s imagination. Nash has a hallucination of a gunfight with Russians causing him to have paranoia that the Russians are trying to kill him. Nash experiences both auditory and visual hallucinations, these episodes create Nash to become out of touch with reality and both paranoia and strange behavior begins. Nash is able to see and speak to his hallucinations, as well and believe and respond to his delusions. The DSM also states that hallucinations are brought on by stress so taking that into account to see if Nash’s symptoms fit within the criteria, we can see the progression and development of schizophrenia within a certain time period.
Environment and History
It is not known what causes schizophrenia but researchers believe that a combination of genetics, brain chemistry and environment contribute to development of the disorder (Craig, M., 2007). Some studies believe that a possible cause of the illness can be the loss of both parents before the age of 16, but they are unaware if its due to the stress or the separation (Engstrom, E. J., 2017) While there are theories about why schizophrenia occurs, it is proven that their brain does show differences in the brain structure and central nervous system of people with schizophrenia. Due to schizophrenia being so unknown there is so much room for questions therefore a reason as to why there is so many myths about schizophrenia. Before a lot of research was done, schizophrenia used to be called ‘dementia praecox’ which meant dementia of early life. It was believed that the illness only occurred in young people and led to mental deterioration. Through the studying of the mental illness, researchers were able to prove that theory wrong and help reduce the stigma that now surrounds the illness. Since the movie does not show Nash’s childhood as well as there is no specific reason as to why one develops schizophrenia, we are not able to compare certain traits to certain theories.
Treatment
Schizophrenia is considered a lifelong condition that is rarely considered cured. While there are multiple treatment pathways to help an individual with schizophrenia such as cognitive behavior therapy, cognitive enhancement theory, and individual psychotherapy as well as antipsychotics, it has taken a long time to discover how to treat individuals that were perceived to be mad. Before there was much knowledge on what schizophrenia was the best treatment that was believed to work was the insulin coma therapy as well as electroshock therapy, which was electrically induced seizures or comas. While researchers plan on how to treat schizophrenia has improved, we still see faults within the treatment as a lot of individuals do take themselves off of their antipsychotics as well as it takes a long time for an individual to find the right drug that works for them. It is found that prosocial approaches paired with antipsychotics does increase the effectiveness of treatment and decreases the chances to relapse (Kavak, F., Yilmaz, E., 2018). When Nash’s hallucinations got to a point where they took over his life, he lost sight of what was real and what was a hallucination. Nash got admitted into a treatment center against his will and was diagnosed with paranoid schizophrenia. Nash undergoes both electroshock therapy as well as insulin coma therapy paired with antipsychotic drugs for 10 weeks 4 times a week. The film effectively portrays the trials and errors of treating schizophrenia and the attempts an individual goes through to regain control of their life. Studies have shown that antipsychotic medications which suppress dopamine activity have been found effective in reducing or eliminating symptoms in many cases of schizophrenia (Bemak & Epp, 2002). In ‘A Beautiful Mind’, Nash struggles with compliance in taking his medication and suffers many symptoms such as drooling, sexual dysfunctions, loss of creativity, and emotional flatness from his antipsychotic drugs. Due to the side effects Nash discontinued his use and succumbed to his hallucinations and delusions once again. Nash eventually was able to gain mind and even though he could still see and hear his hallucination he chose to ignore them which led to his reintegration into society.
Conclusion
Schizophrenia is an illness that takes over an individual's life. Nash was not just a math genius that displayed odd behaviors, such as inward far-fetched thinking, social isolation, as well was emotionally detached, but instead he was showing early symptoms of a mental illness. The film ‘A Beautiful Mind’ effectively used John Nash as a prime example of what individuals go through in the struggles of early symptoms of schizophrenia, understanding the differences between what's real and what's not as well as the struggles individuals faces in finding the right treatment.
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