However, when the subject matter pertains to the devastating mental disorder schizophrenia, it’s important that the makers of the entertainment are conscientious about how the disease is portrayed. There’s already a lot of stigma about schizophrenia in society, including the misguided notion that schizophrenics are running around with uncontrollable, violent alter egos.

Movies like Me, Myself & Irene (promotional photo shown above) don’t do the schizophrenic community any favors. Other movies, like The Soloist, appear to have given much more thought to the complexities of this disease.

In this post, I’ll try to give a simple explanation of what schizophrenia is and how it affects people’s lives, then I’ll do a rundown of movies and books that tried to depict schizophrenia and either failed miserably or made a respectable effort.

In short, no one can tell us why schizophrenia occurs or what exact biology is responsible. We know what schizophrenia looks like: it’s a breakdown of thought and emotion leading to significant social dysfunction. I think it is safe to say that schizophrenia must be characterized by at least two of the following:

1. Hallucinations. (You hear things [most common], see things, smell or taste things that no one else can sense but you.)

2. Delusions. (You may feel like you’re being persecuted in ways that seem bizarre to others; e.g. “I can’t go out in public because the CIA wants me dead and they have people outside my house watching me.”)

3. Disorganized thinking or speech. (Your train of thought is nearly impossible to follow because your speech is incoherent and you switch tracks mid-thought.)

4. Disorganized or catatonic behavior. (Your behaviors are illogical or inappropriate, or you have a flat affect.)

Paintings of cats done by 20th century artist Louis Wain, over a period in which he developed schizophrenia. The effect of the disease on his perception is apparent in his art.

A combination of factors, from genetics to environment to drugs, have been suggested to explain why schizophrenia afflicts people. A genetic link is almost certainly involved, with over 40% of schizophrenics’ identical twins also having the disease (as compared to the 6.5% risk shared by first-degree relatives). Urban living during child- or adulthood has been shown to increase the risk of schizophrenia two-fold. Cannabis use has even been implicated as having a causal role in schizophrenia development. Half of the world’s 24 million schizophrenics use drugs and/or alcohol to excess, but it is difficult to say how much of this behavior can be attributed to coping mechanisms.

So, I never set out to do a study on the depiction of schizophrenia in entertainment media. But I did come to realize that I’ve seen a number of movies and read a novel that all gave unique representations of this disorder…some of those representations were enlightening, and some were cringe-worthy. Below, I will grade works of art and describe what they did right, or, what they did very, very wrong.

1. Me, Myself & Irene. To be fair, I think I’ve only ever enjoyed 20-25% of Jim Carrey’s
movies. Me, Myself & Irene falls into that 75-80% that is almost unwatchable. The synopsis is that Carrey plays the role of a state trooper who is mild-mannered and lovable, until he goes off of his medicine and becomes abusive and violent. The movie that was “pure fun” for Carrey was viewed by the National Alliance for Mental Illness (NAMI) as “irresponsible.” The premise is that Carrey has “advanced delusionary schizophrenia with involuntary narcissistic rage” and is a “schizo” (according to his love interest in the movie, Rene Zellwegger).

What the audience sees is a guy who is normal and likable while on his medication, but when he’s off of it, he poops on his neighbor’s lawn, suckles at a stranger’s breast, and generally has uncontrolled rage. This, unsurprisingly, did little to help the societal stigma that schizophrenics are violent, dangerous people to be feared. In fact, if anything, Carrey’s character in the movie is closer to being a crude, insulting depiction of someone with dissociative identity disorder (aka multiple personality disorder), rather than someone with schizophrenia.

“We’re certainly not out to make fun of anybody,” Carrey said of the film. No, you’re just propagating negative stereotypes about a horrible disease by targeting the very age group with the peak incidence of the disorder, and telling the world that these people are dangerous (and maybe not so much worth helping, since that wouldn’t be as funny). The movie made $150 million worldwide, so a lot of people got the message.

Grade: F-

2. A Beautiful Mind. It was clear to me that this movie was making a more serious, sincere attempt at depicting schizophrenia. The main character, John Nash, was a real person, an actual schizophrenic, and a Nobel laureate at that. The real John Nash was plagued by paranoia, such as the idea that everyone who wore red ties was part of a communist conspiracy against him. He saw himself as having a special purpose, with schemers and enemies trying to persecute him.

Director Ron Howard goes to great lengths to make the viewer understand the all-consuming paranoia that a schizophrenic can feel. And Russell Crowe garners incredible sympathy for schizophrenics with his role. However, it seems like it was only for entertainment purposes that John Nash was seen to vividly hallucinate multiple individuals with constant personalities that stay with him for years and years. Not only that, but the John Nash of the film thinks everyone else sees his hallucination-people and is shocked to find out that others don’t accept reality as he understands it.

A true schizophrenic is much more likely to have auditory hallucinations, which he doesn’t expect others to hear, than to have “imaginary friends” that he believes are fully real. Still, there’s a reason multiple high school teachers made me watch this movie: it takes schizophrenics seriously, and depicts them as people you can respect and even begin to empathize with, even if the movie does take certain creative liberties in the name of entertainment value.

Grade: C+

3. The Soloist. Also based on a true story, The Soloist portrays Nathaniel Ayers, a  prodigy musician who develops schizophrenia and becomes homeless. Ayers inspires numerous newspaper columns (written by Robert Downey, Jr. in the movie), and I won’t ruin the ending for you, but rest assured that you will laugh with, cry over, and root for Jamie Foxx‘s Ayers.

Although the movie only has a Rotten Tomatoes score of 56% (i.e. it’s deemed “rotten” by movie reviewers), this is mostly attributed to a “lack of narrative focus.” The outstanding performance by Foxx is vibrantly complex and, moreover, clinically accurate. Efforts are made throughout the movie to reference Ayers’s childhood and to show the gradual build of his schizophrenic tendencies even from a young age, when he chooses to live in his basement and always be surrounded by his instruments.

Foxx plays a schizophrenic who is both believable and lovable in The Soloist.

One of the most beautiful things about this movie is that before you know anything about Ayers’s illness, you know about his incredible gift for music, and he’s inherently likable because his love of music is so pure. Even once the viewer starts to see the rapid, unexpected shifts in Nathaniel’s moods or the rambling, topic-jumping nature of his monologues, it’s impossible to write him off as just “crazy” — his insights about his home city of Los Angeles are spot-on, and he asks compassionate and worldly questions during his conversations with LA Times columnist Steve Lopez (played by Downey, Jr.). Even Nathaniel’s hallucinations are exclusively auditory (as is most common with schizophrenia) and his voices tell him that others can hear his thoughts (a belief commonly held by schizophrenics).

Clearly, people did their research into the nuances of schizophrenia before setting out to make this film. One could criticize the nature and believability of the friendship between Ayers and Lopez, but I think this movie does much to propagate a view of schizophrenia that makes more room for compassion, kindness, and aid, and leaves little space for fear and ostracism.

Grade: A

This post is getting long, but I just want to make one more plug for a novel that is truly spectacular in that it not only represents a schizophrenic in a factual, dynamic way, but it makes this representation through the eyes of this schizophrenic’s identical, mentally healthy twin brother. In this novel, I Know This Much Is True by Wally Lamb, the narrator goes through life as the privileged twin, preferred by their stepfather and more quick to make friends, but he is also fiercely protective of his less socially adept brother. As his brother develops schizophrenia, a progression which is written with attention to the typical age of onset and early signs of the disease, the healthy twin shoulders increasing amounts of the burden of care for his brother.

This novel does a stellar job of showing the reader that schizophrenia is far from a disease of the individual; schizophrenia affects everyone in a schizophrenic’s life, and even people outside of it. Add to that the fact that the identical twin brother is mentally sound, and thus suffers from the worry of becoming sick and the guilt of not being sick, and you have a book that paints an impressively complete picture of life with this disorder. Selected for Oprah’s Book Club in 1998, I Know This Much Is True is an intensely emotional, comprehensive, and profound read. Don’t be put off by the daunting 928 pages – it’s worth the time, and I definitely give it an A.

In summary, watch whatever you want, read whatever you want, but when it comes to at-risk groups in our society, know what’s real and what’s just for your amusement.

Stay nerdy

Picchioni MM, & Murray RM (2007). Schizophrenia. BMJ (Clinical research ed.), 335 (7610), 91-5 PMID: 17626963

van Os J, & Kapur S (2009). Schizophrenia. Lancet, 374 (9690), 635-45 PMID: 19700006

Large M, Sharma S, Compton MT, Slade T, & Nielssen O (2011). Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Archives of general psychiatry, 68 (6), 555-61 PMID: 21300939

[Interested in this topic? At the bottom of this post you can find more resources on the intersection of politics, big business, and the public's perception of science.]

Try Nerdy is intended as a completely apolitical blog, but it turns out that politicians sometimes speak out on nerdy topics; the most well-known of these instances happen to involve members of the Republican party. I am not here to critique the political strategy of politicians putting down pet projects, but instead I hope to tell you what you need to know to be able to decide for yourself whether those projects represent government money well-spent, or not.

“You’ve heard about some of these pet projects, they really don’t make a whole lot of sense and sometimes these dollars go to projects that have little or nothing to do with the public good. Things like fruit fly research in Paris, France. I kid you not.” (Emphasis mine)

So said Republican vice presidential candidate Sarah Palin on October 24, 2008, in a speech about running mate John McCain’s policies on children with disabilities:

Palin was most likely referring to research about the olive fruit fly, which has wiped out tons of olive trees across Europe and is now a serious threat to California’s olive trees, an industry worth $66 million per year in a state with many recent bankruptcy issues. The flies were probably introduced accidentally by some French import to the state, so in 2008 California Representative Mike Thompson (D) earmarked $200,000+ dollars to study the fly in France. The idea was to research ways to stop the olive fruit fly from destroying the olive tree economy in California, and to study the fly in a location that had many more years of experience with the pest: the place from which the flies most likely came in the first place.

“233 million for a bridge to nowhere. Outrageous… Three million to study the DNA of bears in Montana. Unbelievable… A million dollars for a Woodstock Museum—in a bill sponsored by Hillary Clinton. Predictable… Who has the guts to stand up to wasteful government spending? One man. John McCain.”(Emphasis mine)

Senator John McCain (R) made several statements similar to these in speeches during his 2008 presidential campaign. This quote in particular was taken from one of McCain’s 2008 campaign ads, an admittedly poor quality version of which is here:

(Although the figure for the bear research was probably more like $5 million.) McCain was taking a shot at the Northern Divide Grizzly Bear Project, which is concerned with preserving the grizzly bear population. The project is based specifically in Northwest Montana, which is one out of six recovery zones for grizzlies, which are currently on the endangered species list.  One aspect of the project is to strategically place barbed wire in the Northwest Montana area to snag bear hairs that can be recovered later for DNA extraction. Sequencing this DNA can provide information about how many bears are in which parts of the region and what the male-to-female ratio is – important information for maintaining the grizzly bear species, which may or may not be McCain’s top priority.

“This year, they sprinkled in $2.5 million for potato pest management and research, $1.4 million to study mosquito trapping in Florida, and $800,000 for catfish genome mapping in Alabama. Taxpayers have been on the hook for this fishy earmark since 2001, for a total of $3.4 million.”(Emphasis mine)

Although not a politician, CBS News’ congressional correspondent Nancy Cordes had some tough words for government funding of several research projects in a piece she wrote last year: “Earmarks: Who Brought Home the Bacon?” Although the “potato pest management” is probably a story similar to the olive fruit fly problem and the “mosquito trapping in Florida” is most likely an attempt to curb mosquito-borne illnesses, it’s not immediately obvious what mapping the catfish genome would be good for (in Alabama or elsewhere). As it turns out, Alabama is the second biggest producer of fish by farming in the U.S., and catfish pull in $100 million to Alabama farmers and $125 million to Alabama processors annually. The earmarked project she mentions would map genes in the catfish genome that contribute to disease susceptibility, growth rate, and intelligence — then, hybrid fish could be bred to be healthier, grow faster, and be dumber (smart fish are harder to catch). The monetary benefits as a result of this project would potentially be substantial for Alabama fish farmers, who in the U.S. are considered part of the “heart of our country,” (as are olive tree farmers and potato farmers). Not to mention, the hybrid fish model could possibly be adapted to other areas of fish farming.

These brief stories only scratch the surface of how the interactions between politics and science can play out on the public stage. If you found this article at all enlightening, I suggest you check out these books that delve much deeper into these topics — do your research!
 
“Does the Bush administration ignore or deny mainstream research to please its conservative base? Have business groups and certain religious lobbies helped it do so? Does Bush-era treatment of scientists differ from that of Clinton, George H.W. Bush and Reagan? Has a Republican Congress passed laws designed to disable clean air and water efforts, and has it dismantled safeguards, such as the Congressional Office of Technology Assessment, meant to give legislators unbiased advice? Mooney’s passionate, thoroughly researched volume answers these questions with an urgent “yes.”"

“For those who think of science as an honest and objective broker in policy making, this volume paints a very different picture, and it’s not pretty. But it’s the ugly side of the regulatory process, where scientific research is often distorted to serve questionable ends, that badly needs greater exposure. This book is an eye-opener that not only documents the problems, but also takes great pains to make sensible proposals for reform that merit serious consideration.”

“Drawing together a host of little-known but dramatic cases, this landmark book documents more comprehensively than any previous study, what has been suspected for years: how extensively scientific data are misused and abused in regulatory and tort law. Society depends on science to guide public policy on health and safety, but as McGarity and Wagner show, many interest groups do all they can to influence –and undermine– independent and honest research. Bending Science shows just how far science has been corrupted, and offers a road to reform.”

“We live in an age of unprecedented disinformation, misinformation, and outright lying by those in power. This important book shows who profits by misleading the public-and who ultimately pays with their health.”

“For the past fifty years, science and technology supported with billions of dollars from the U.S. government have advanced at a rate that would once have seemed miraculous, while society’s problems have grown more intractable, complex, and diverse. Yet scientists and politicians alike continue to prescribe more science and more technology to cure such afflictions as global climate change, natural resource depletion, overpopulation…. Daniel Sarewitz scrutinizes the fundamental myths that have guided the formulation of science policy for half a century…but often fail to advance the interests of society as a whole.”

“University science is now entangled with entrepreneurship, and researchers with a commercial interest are caught in an ethical quandary. Science in the Private Interest investigates the trends and effects of modern, commercialized academic science.”
 
 
 
 
 
 
 
 
Lu J, Peatman E, Yang Q, Wang S, Hu Z, Reecy J, Kucuktas H, & Liu Z (2011). The catfish genome database cBARBEL: an informatic platform for genome biology of ictalurid catfish. Nucleic acids research, 39 (Database issue) PMID: 20935046

Interestingly, I almost never read nonfiction. Ninety-nine out of 100 books that I read will be fiction, but this book would have to be that 1 in 100 that isn’t. I am actually reading this book currently, and it’s my own fault for not starting it sooner. I received the book as a gift over a year ago, and I must guiltily admit that I shelved it in favor of my usual fiction…until I saw that it was Amazon’s editors’ pick of the year. But honestly, it shouldn’t have taken that much for me to give the book a try, because the synopsis is as compelling and original as any fiction — except that it’s real, and relevant to my work as a scientist.

This book tells the story of Henrietta Lacks, a Black woman who worked tobacco fields in Virginia in the 1930s and 40s. A poor woman with only a middle school education, Henrietta stoically faced a diagnosis of cervical cancer while striving to continue in her role as a wife and mother of five. Little did she or her family know that a sample of her cervical cancer would revolutionize research science by providing the first human cells to ever grow indefinitely in culture – an immortal cell line. Unfortunately, that fact spoke to the aggressiveness of Henrietta’s cancer, which killed her at the young age of 30 in 1951. What her family didn’t know, however, was that the cells of their beloved Henrietta lived on…and on, and on, and on. HeLa (Henrietta Lacks) cells were and still are bought and sold widely within the scientific community and have enabled numerous discoveries, including the polio vaccine and, somewhat ironically, advances in chemotherapy. I entreat you to imagine her family’s surprise and outrage when they finally were informed of all that had been accomplished with Henrietta’s cells – when they themselves were too poor to afford a doctor’s visit. So much more than just a biography, this book has pleasantly surprised me thus far with the honest, candid account that the author gives of her own challenges as an upper-middle class White woman attempting to tease out the details of this sensitive subject from Henrietta’s family and friends.

Some call Henrietta Lacks the most important woman in medical history. What I know is that I can probably get up right now and go find a vial of her cells in some freezer on the very floor where I do my work, as could just about every research scientist. It goes without saying that this is a book that every researcher should read, but anyone who has ever taken their own cells for granted will find this an eye-opening read.

Clearly inspired by her personal experiences, Genova‘s novel centers around Alice: Harvard psychology professor, wife, and mother. At 50 years of age she is highly respected amongst her colleagues as a world-renowned linguistics expert, and her problems seem no worse than would be expected – she wants to find more time to spend with her husband, and one of her three adult children wants to move to L.A. and take her chances on acting. However, when Alice starts forgetting little things here and there, like where she last had her Blackberry (and who doesn’t have this problem on occasion?), she tries to explain it away as menopause or maybe even a brain tumor. What she doesn’t expect is to be diagnosed with early onset Alzheimer’s Disease, which rapidly progresses and devastates her mental function.

Ultimately losing her professorship and the ability to recognize her family, Lisa Genova‘s Alice might bring you to tears, but in some ways that’s the point, and Genova has done her job - she makes you aware of the reality of this heartbreaking disease, and convinces you that it could happen to anyone at any level of society. For less than $5, it’s worth getting this novel for the appreciation it gives you towards neurodegeneration research. And maybe it will be as unforgettable an addition to your bookshelf as it was to mine.