Over the years psychologists have changed the way they think about and treat schizophrenia, the mental illness made famous by mathematician John Nash, subject of the film “A Beautiful Mind.” Now, instead of assuming the illness will likely be lifelong and that the patient will inevitably deteriorate over time, doctors know that a percentage of people will likely be able to recover given the right set of circumstances.
So, what is schizophrenia and what does it take to get better?
The mental illness is a “chronic, severe, and disabling brain disorder” according to the National Institute for Mental Health . About 1 percent of Americans are affected, showing the first signs of the disorder between the ages of 16 and 30 years old. Symptoms include hallucinations, delusions, thought disorders, movement disorders, difficulty paying attention and making use of working memory, as well as problems with executive functioning — the ability to understand and use information to make decisions.
About 80 years ago, before the availability of medications for schizophrenic patients, studies showed that about 20 percent of people with the disorder recovered on their own with time. Studies now show that with proper treatment and the right set of conditions, up to 60 percent of patients can recover. Recovery, in this instance, means that the patient has minimal symptoms for a period of at least six months — not that the schizophrenia goes away.
According to Live Science , Dr. Gilda Moreno, a clinical psychologist at Nicklaus Children's Hospital in Miami, said that those who went into remission tended to develop schizophrenia later in life, much like John Nash who didn’t present with symptoms until he reached 30 years old. Nash, and his wife, died recently in a car crash.
Also beneficial for recovery was having a strong social network. Having a job, close ties with friends, the greater community, and having family who can assist when needed were also indicators of a patient having a better outcome.
Dr. Richard Warner, the Director of Colorado Recovery, wrote in his paper about effective rehabilitation efforts, “Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process.”
Warner also writes that optimism about recovery from the disorder can be a contributor to a patient going into remission. In essence, hope — something that didn’t really exist for patients with the illness until more recent years— can help. Warner also believes that reducing the internalized stigma of mental illness could enhance the recovery process.
The site Living with Schizophrenia offers additional factors that could contribute to the recovery process. Patients, they note, who abstain from drugs and alcohol tended to have better outcomes, as well as those who had a more rapid onset rather than a slow development of the disorder.
Aging is also thought to help with symptoms and aid in the recovery process. John Nash, for example, found that his symptoms started to decrease in his 50s. The New York Times reported that Nash wrote to a friend describing the feeling. He confessed, "I emerged from irrational thinking, ultimately, without medicine other than the natural hormonal changes of aging."
Not every person with schizophrenia will recover. However, more research is being done all the time to figure out exactly why some people have better success than others. As science advances, who knows how much better treatment options will become. As of right now, the prognosis is certainly better than it was a few decades ago. As doctors understand the disorder better, treatment options expand for all patients.
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