A Short Glance at Schizophrenia

This past Thursday at an event I moderate, Movies Worth Talking About, we screened and discussed the 2011 feature Take Shelter, starring Michael Shannon and Jessica Chastain. Bill Carolla, the Director of Media Relations for NAMI (National Alliance on Mental Illness) has described the film as “a nuanced, accurate portrayal of the onset of schizophrenia and the impact on a man’s family” and also pointed out how rare such film treatments are.

In a nutshell (also drawing from Carolla’s article), here’s what happens:

“In a small town in Ohio, Curtis LaForche (Michael Shannon) has nightmares that he tries to hide from his wife. He has apocalyptic visions of storm clouds and lightning – and growing paranoia. He loses himself building a storm shelter in his backyard. His strange behavior strains family relationships; he loses a friend; he is fired from his job.”

It is a serious, engaging film about a crucial subject that I highly recommend.

Fletcher Mann, Director of the Greenville chapter of NAMI, wrote me a note, offering seven important facts that help put perspective on the scope of the problem:

  • We don’t know for certain the causes of schizophrenia, but there does appear to be a genetic component.
  • About 40% of individuals with the illness will recognize the symptoms before family and friends do.
  • A) People usually seek help from a family physician first. B) Most of those physicians are not able to treat schizophrenia, but they can help rule out other causes of the symptoms and then make a referral to a psychiatrist. C) But there is a great deal of stigma associated with going to a psychiatrist.
  • There is a significant shortage of psychiatrists in this country, especially in rural areas. Even Greenville County, the most populous in the state, has the lowest per capita rate of psychiatrists in South Carolina. SC is the first nation that is experimenting with “telepsychiatry”. Emergency Room or other hospital personnel examine a person and then call in to the Medical University of South Carolina, which has a 24-hour on-call psychiatrist. The psychiatrist makes a more detailed examination via phone or video-conference and then prescribes immediate medication.
  • Most of these medications are expensive. The older, cheaper generics cause all kinds of side effects (some temporary and some permanent), which then require additional medications to treat the side effects, which then have their own side effects and might require a third medication. The better, newer medications are more effective with fewer side effects, but much greater expense. Insurance might cover the costs but co-pays are usually high. Public mental health centers rarely have or prescribe these newer medications due to the costs.
  • Sleeplessness is very common with most mental illnesses, and it is one of the biggest triggers for psychosis. Think of the stress of lack of sleep on a “normal” healthy person and then magnify that for a person with mental illness. Sleep deprivation is one form of torture. People die from lack of sleep.
  • Losing one mental health provider and having to start over with another provider happens frequently in public mental health centers, and it is a very big setback to treatment. I can’t think of any other area of medicine where knowing a person’s history and establishing a doctor-patient rapport is more important, especially with schizophrenia and even more especially with paranoid schizophrenia. With the lack of funding for mental health systems, the increase in population, and the shortage of psychiatrists, then the system is overloaded.

If you, a family member or friend is struggling with any form of mental illness and you don’t know where to turn, let me seriously recommend NAMI as a good starting point. Each local chapter provides its own resources and can also refer you to additional resources in your area. Their web address is www.nami.org.

If you have observations to add to this small article, I’d really appreciate them.

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Filed under Film analyses, Film analysis, Health Care, Mental health

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