Schizophrenia is a chronic and disabling brain disorder

Schizophrenia is a chronic and disabling brain disorder that affects approximately two million Americans today (Schizophrenia Fact Sheet). Schizophrenia can affect anyone at any age, but most cases typically emerge in between adolescence and age 30 (Facts on Schizophrenia). Schizophrenia is characterized by hallucinations, delusions, confused speech or behavior and it alters a variety of aspects of a person’s ability to think, behavior and emotions (Schizophrenia Statistics). Although there’s currently no cure for schizophrenia, the treatment success rate using antipsychotic medications, psycho-social therapies, and community treatments is very high.     The movie “A Beautiful Mind” is based on the life of the genius mathematician John Forbes Nash who suffers from paranoid schizophrenia. The movie portrays a timeline of Nash’s life that begins with him entering graduate school at Princeton for mathematics where the early symptoms of schizophrenia begin to appear and gradually increases as the movie continues into the later parts of his life such as when he wins the Nobel Prize while still dealing with delusions and hallucinations caused by paranoid schizophrenia.  Symptoms     Patients with schizophrenia have positive, negative, and cognitive symptoms and portray psychomotor abnormalities. The positive symptoms are characterized by the presence of problematic behaviors such as hallucinations, delusions, and disorganized thoughts and speech. Patients with negative symptoms are usually absent from healthy behavior. For example, they lack expression, pleasure, or interest in life or socially withdraw themselves from their community. Cognitive symptoms are associated with attention and memory problems such as the inability to sustain attention and difficulty in using recent information. Patients with psychomotor abnormalities portray strange gestures, peculiar movements or postures, or extremes in activity levels such as slowed down movement or loss of movement.     In the movie, Nash experiences extreme delusions and hallucinations, which were then diagnosed as symptoms of paranoid schizophrenia. The movie helps a lot to portray an accurate representation of schizophrenia. Nash’s schizophrenia sets in when he starts graduate school at Princeton in his early 20’s (the typical age for when the symptoms of schizophrenia begin to show up in people), however, the symptoms did not cause distress and impairment for Nash until he was in his early 30’s. He is obviously not like other people and even Nash describes himself as a man who does not “like people much”. He is obsessed with creating a mathematical theorem that is unique and unheard of which causes him not to attend class regularly during graduate school. The delusions and the hallucination are proven when half way through the movie, we find out that a few people we met and the places and situations we saw throughout the movie are only illusions that Nash develops in his mind. One of the first imaginary personalities that Nash makes up in his mind is his roommate Charles Herman, who is an English Literature student. Later on, we also find out that Charles’ niece Marcee and William Parcher, who Nash thinks he works for in order to solve codes and classified documents for the government are also imaginary characters Nash created in his mind. Nash also thinks that he is being followed by the Russian agents who are trying to kill him. Assessment/Diagnosis   The type of schizophrenia Nash has is called paranoid schizophrenia which is the most common type of schizophrenia. Paranoid schizophrenia is characterized by the presence of auditory hallucinations or paranoid delusions that involve persecution alongside a relatively unaffected mood and cognitive functions (What Is Paranoid Schizophrenia?). When Nash thinks he is being chased by the Russian agents who are supposedly trying to kill him because he is the only person who can solve the codes prove that he is under the influence of his hallucinations and delusions.     Diagnosis of schizophrenia is not easy. People who are using drugs such as methamphetamines or LSD can cause schizophrenia-like symptoms(Schizophrenia and Street Drugs). It is also very hard to diagnose schizophrenia because most patients are not aware of their illness which makes the treatment and diagnosis very complicated. It is important to evaluate the symptoms and the course of a person’s illness over six months for a correct diagnosis. Delusions or hallucinations alone can often be enough to diagnose schizophrenia, however, when being evaluated, factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder should be ruled out (Facts On Schizophrenia). According to DSM-5 to be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:DelusionsHallucinationsDisorganized speechDisorganized or catatonic behaviorNegative symptomsEarly diagnosis also has a high impact on a person’s chances of managing the illness and reducing psychotic episodes on their way to recovery.     I feel Nash most clearly meets the DSM-5 criteria for schizophrenia based on A) having delusions, hallucinations, disorganized or catatonic behavior, and negative symptoms each presenting a significant amount of time during a 1 month period (unless successfully treated) B) continuous signs of disturbance for at least 6 months, with at least one month of meeting criterion A and C) his disturbance is not attributable to the effects of a substance or another medical condition.     It becomes very difficult for Nash to cope with his illness especially after he was admitted to the hospital to see a psychiatrist where he was diagnosed and where he finds out about his complications and still believes he is being held by the government. He even cuts his wrist to look for the implant that William Parcher placed and discovers that it’s not there anymore.     Nash is not the only one who experiences distress due to his symptoms. His wife Alicia also suffers from all the difficulties that Nash is going through. She stands by him and tries to believe what he was saying is true but after finding out about Charles and his work with the government is not real in person, she tries to prove that he has delusions and hallucinations, but Nash becomes upset at her for not believing him. Again the biggest problem with schizophrenia that makes the treatment hard is that patients think that what they see or hear is real. He distances himself from his wife and even his newborn baby. Alicia at one point asks him to watch their baby and because he stops taking his medications he puts his baby in danger thinking Charles was watching the baby. After he almost killed his baby by accident he also hurts Alicia by running after her to stop her from leaving, he accepts to get back to the hospital again and signs commitment papers to receive therapy. Nash gets released from the hospital and goes to his old friend Martin from Princeton to ask if he can work in the library even though he still has some hallucinations and delusions going on. As the time goes on, he learns to cope with his illness and learns to ignore his imaginary characters. Psychiatric comorbidities such as substance abuse, anxiety and depressive symptoms, posttraumatic stress disorder, panic disorder, and obsessive-compulsive disorder are common among patients with schizophrenia (Miller & Buckley, 2014). However, the biggest problem Nash seems to be suffering from is social problems such as unemployment, trouble holding a job, leading a normal and independent life, and how he feels depressed due to being not able to work like he used to. Etiology     Although there has been a variety of research done on the causes of schizophrenia, the answer is still not clear. Researchers suggest that to develop an accurate etiology, dimensions of a multipath model such as heredity(genetic influences on brain structure and neurocognitive functioning), psychological characteristics, cognitive processes, and social adversities and how they interact with each other must be considered (Sue, Sue, Sue, & Sue, 2016).     As most cases, the cause of Nash’s disease is not known. My possible explanation for his development of schizophrenia is as follows; 1)Recent research on the biological component of schizophrenia suggest that genetics and heredity play an important role in the development of schizophrenia (Sue, Sue, Sue, & Sue, 2016). Considering Nash’s son also suffers from paranoid schizophrenia, genetic factors seem to be implicated (Dailymail.com, 2015). Research also points out to abnormalities in neurotransmitter transmission as well as the structural abnormalities in brain (Sue, Sue, Sue, & Sue, 2016). According to the biological component of schizophrenia Nash’s disease might result from excess dopamine activity in certain areas of the brain as well as the greater loss of cerebral gray matter and enlarged ventricles. 2) On top of Nash’s genetic disposition, there might also be environmental stressors that triggered his schizophrenia. Stress is one of the main psychological triggers of schizophrenia (Causes of Schizophrenia). In Nash’s case, being socially awkward, his obsession over finding a unique theorem, even his marriage and the birth of his child might have caused him into a schizophrenic episode. It is also essential to know Nash’s family background and if he was a victim of child abuse or bullying since these cause a lot of distress in an individual, however, the movie doesn’t mention anything about his family. Treatment     Treatments used for schizophrenia are usually a mixture of therapies that are chosen by doctors and psychiatrists to reduce the frequency and severity of symptoms and decrease the chances of the symptoms to occur again. In the movie, Nash undergoes insulin shock therapy and antipsychotic pharmaceutical drug therapy. Nash was involuntarily subjected to a series of insulin shock therapy sessions, where he was administered a high dose of insulin to remove glucose from the bloodstream and where he would eventually lose consciousness leading into an insulin-shock coma. A sugar solution would be used to bring the patient back to a conscious state. Nash refused to receive further treatment and described the insulin shock treatments as torture. At the time there were not many treatments possible for schizophrenia so I understand why they administered insulin shock therapy, however, today the therapy is not being used due to it being very unscientific as well as dangerous and expensive (Jones, 2000). Nash was released from the hospital on condition that he would take antipsychotic medication. He also wasn’t happy taking his medications because they made him feel “foggy” and he was no longer able to work anymore. I find the usage of antipsychotics useful since the research has suggested that even though medications do not cure schizophrenia, they reduce symptoms and patients become able to function efficiently by blocking dopamine receptors in brain. However, it is important to note that antipsychotics have various side effects which cause some patients to stop taking their medications.     The treatments I would recommend are psychosocial treatments such as Cognitive Behavioural Therapy and mindfulness training and community treatments. Psychosocial treatments focus on social functioning and how patients can be reintroduced to the society by helping them overcome their difficulties in communication, self-care, motivation, and social relationships. Cognitive Behavioural Psychotherapy has been known to be one of the most efficient types of psychotherapy (Sue, Sue, Sue, & Sue, 2016). Cognitive therapy tends to focus on reducing frequency, severity, and distress of positive and negative symptoms of schizophrenia. It teaches them coping skills so patients can identify their negative beliefs and develop alternative options. Mindfulness training helps patients to accept their symptoms in non-judgemental manner and enhances feelings of self-control by reducing negative symptoms. In Nash’s situation, with mindfulness training, he would learn to deal with the noises in his head and tell himself that they are not real. On the other hand, community treatments also have been found useful to treat schizophrenic patients. Assertive Community Treatment(ACT) helps people with severe mental illnesses to keep up with their appointments and medications until they can get back on their feet since most patients tend to stop taking their medications and stop going to their appointments after they get out of the hospital. ACT makes sure these patients are responding well to outpatient therapy and starting to be able to function well in society.Conclusion     Overall I think A Beautiful Mind presents a good understanding of schizophrenia. It is very hard to show the symptoms of schizophrenia on screen accurately since hallucinations and delusions take place in one’s mind. However, from the beginning of the movie until the end we witness how’s it like to go through life with schizophrenia. The movie also reflects the right views and treatments of schizophrenia at the time to give the audience an accurate view of how being a schizophrenic patient was like in order to educate people. The message I take from this movie is the importance of the willpower while coping with schizophrenia. While most individuals deny the fact that they are mentally ill, the ones who accept to truth suffer from the severity of the symptoms. The movie gives encouragement about how it is possible for schizophrenic patients to cope with their illness by actively participating in various treatments, learning to ignore and live with their hallucinations and delusions. There is nothing I would change, add or delete from the movie.