an autodidact meets a dilettante…

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A bit about schizophrenia – a very bizarre ailment

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Having, for a book group, read a strange novel written a little over 50 years ago, by Doris Lessing, Briefing for a descent into hell, the title of which may or may not be ironic, and being reasonably interested in the brain, its functions and dysfunctions, I’ve decided to use this post to update my tiny knowledge of schizophrenia, a disorder I’ve had some acquaintance with.

Lessing’s book may or may not be about schizophrenia, because it doesn’t concern itself with labeling any mental disorders, or with the science of brain dysfunction in any way. The focus is upon the imaginative world of an Oxbridge academic, a lecturer in classical mythology or some such, who, having been found wandering about in some Egdon Heath-type landscape, with no identification papers or money, and a lack of proper lucidity, is brought into a psychiatric facility for observation and treatment. The vast bulk of the book is told from this individuals’s perspective. Not that he tells the story of his illness, he simply tells stories – or Lessing tells stories on his behalf. Somehow the reader is allowed to to enter the main character’s inner landscape, which includes a voyage around the Pacific Ocean, another voyage around the solar system (conducted by classical deities) and harrowing, but fake, war-time experiences in the Balkans. Along the way we’re provided with the occasional dazzling piece of insight which I think we’re asked to consider as the upside, or mind-expanding nature, of ‘madness’ – somewhat in the spirit of Huxley’s Doors of Perception and Timothy Leary’s psychedelia. At the end of the book the professor is returned to ‘normality’ via electric shock treatment, and becomes, apparently, as uninteresting a character as most of the others in the book, especially the doctors responsible for his treatment, only known as X and Y. 

So, there are problems here. First, Lessing’s apparent lack of interest in the science of the brain means that we’re at a loss to know what the academic is suffering from. Madness and insanity are not of course, legitimate terms for mental conditions, and Lessing avoids using them, but offers nothing more specific, so we’re reduced to trying to deduce the condition from what we know of the behaviour and ramblings of an entirely fictional character. I’ve come up with only two not very convincing possibilities – schizophrenia and brain tumour. A brain tumour is a useful literary device due to the multifaceted nature of our white and grey matter, which constitutes the most complex organ in the known universe, as many an expert has pointed out. A benign tumour – one that that doesn’t metastasise – may bring on a multiplicity of neurons or connections between them that increase the ability to confabulate – though I’ve never heard of such an outcome and it’s more likely that our ‘imagination’ is the product of multiple regions spread throughout the cortex. Schizophrenia only really occurs to me here because the professor was found wandering ‘lonely as a cloud’, far from home, having had his wallet presumably stolen, so that it took some time to identify him. This reminds me of a friend who has from this condition, and has suffered a similar experience more than once.

One of the symptoms of schizophrenia is called ‘loss of affect’, which means that the sufferer become relatively indifferent to the basics – food, clothing and shelter – so caught up is he in his mental ramblings, which he often voices aloud. It’s rare however, for schizophrenia to make its first appearance in middle-age, as appears to be the case here. Another reason, though, that my thoughts turned to schizophrenia was something I read online, in reference to Briefing for a descent into hell. I haven’t read any reviews of the book, and in fact I had no idea when the book was published, as I’d obtained a cheapie online version, which was undated. So in trying to ascertain the date – 1971, earlier than I’d expected, but in many ways illuminating – I happened to note a brief reference to a review written when the book came out, by the US essayist Joan Didion. She wrote that the book presented an ‘unconvincing description of mental illness’ and that the book displayed the influence of R D Laing. A double bullseye in my opinion. 

I read a bit of R D Laing, the noted ‘anti-psychiatrist’ in the seventies, after which he went decidedly out of fashion. His focus was primarily on schizophrenia – as for example in his 1964 paper ‘Is schizophrenia a disease?’ – though he treated other psychoses in much the same way as ‘a perfectly rational response to an insane world’. This is doubtless an oversimplification of his views, but in any case he seems to have given scant regard to what is actually going on in the brain of schizophrenics. 

Since the sixties and seventies, though, and especially since the nineties and the advent of PET scanning, MEG, fMRI and other technologies, the field of neurology has advanced exponentially, and the mental ailments we suffer from are being pinpointed a little more accurately vis-à-vis brain regions and processes. I’ve noted, though, that there’s still a certain romantic halo around the concept of ‘madness’, which after all human society has been ambivalent about since the beginning. The wise fool, the mad scientist and the like have long had their appeal, and it may even be that in extremis, insanity may be a ‘reasonable’ option. As for schizophrenia, maybe we can live with our ‘demons’, as was apparently the case for John Nash after years of struggle, but it’s surely worth trying to get to the bottom of this often crippling disorder, so that it can be managed or cured without resort to disabling or otherwise unhealthy or inconvenient dependence on medication. 

Schizophrenia is certainly weird, and its causes are essentially unknown. There’s a genetic element – you’re more likely to suffer from it if it runs in the family – but it can also be brought on by stress and/or regular drug use, depending no doubt on the drug. It’s currently described as affecting a whopping one in a hundred people (with enormous regional variation, apparently), but perhaps if we’re able to learn more about the variety of symptoms we might be able to break it down into a group of affiliated disorders. There is no known cure as yet.

One feature of the ‘neurological revolution’ of the last few decades has been the focus on neurotransmission and electrochemical pathways in the brain, and dopamine, a neurotransmitter, was an early target for understanding and treating the disorder (and may others). And that’s still ongoing:

Current research suggests that schizophrenia is a neurodevelopmental disorder with an important dopamine component.

That’s from a very recent popular website, but research is of course growing, and pointing at other markers. A reading of the extensive Wikipedia article on schizophrenia has a near-paralysing effect on any attempt to define or describe it in a blog post like this. Glutamate, the brain’s ‘most abundant excitatory neurotransmitter’, has been a major recent focus, but it’s unlikely that we’ll get to the bottom of schizophrenia by examining brains in isolation from the lived experience of their owners. Genetics, epigenetics, stress, living conditions and associated disorders, inter alia, all appear to play a part. And due to its strangeness, its apparent hallucinatory nature, its modern associations of alienation and dystopia  – think King Crimson’s ’21st century schizoid man’ and much of the oeuvre of Bowie (mostly his best work) – it’s hardly surprising that we feel something of an urge to venerate the schizoid personality, or at least to legitimate it. 

Meanwhile, research will inevitably continue, as will the breaking down of intelligence and consciousness into neurotransmission pathways, hormone production, feedback loops, astrocytes etc etc, and ways of enhancing, re-routing, dampening and off-on switching neural signals via increasingly sophisticated and targeted medications… because a certain level of normality is optimal after all. 

Meanwhile, I’m off to listen to some of that crazy music….


Written by stewart henderson

December 1, 2022 at 9:16 pm

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