MALADY OF THE MIND

A renowned psychiatrist explains the process and history of a debilitating, pervasive mental illness.

Lieberman, a psychiatrist who has specialized in this field for 40 years and the author of Shrinks: The Untold Story of Psychiatry, argues persuasively that the public understanding of schizophrenia is limited. Affecting 3.3 million people in the U.S. and 78 million worldwide, it has little to do with split personalities, but it manifests with a range of psychotic behaviors and delusions. “Schizophrenia doesn’t discriminate,” writes the author. “It can strike the Ivy League-bound high school valedictorian as much as it can the impoverished kid from a broken home. Gender, race, ethnicity, affluence, education—none of these provides immunity.” Tracking the history, Lieberman notes that ancient texts mention it, and for centuries, it was associated with demonic possession. Even after it was identified as an illness, effective treatment remained elusive. Eventually, researchers shifted their focus to chemical imbalances. The first therapeutic drug was chlorpromazine (thorazine), which led to a generation of antipsychotics. It also pointed the way to understanding that schizophrenia is tied to a malfunction of dopamine neurotransmission in the brain—although there is also a genetic element that makes some people vulnerable. Unfortunately, as the author shows, research was hampered by the emergence of syndromes that were not actually schizophrenia but looked much like it. The science has come a long way, however, and schizophrenia is now treatable—but it must be identified and addressed as early as possible. Schizophrenia is progressive, and once it reaches a certain stage, permanent brain damage is almost inevitable. Lieberman provides a list of symptoms to watch for, and a program that he has developed has had a good success rate. As he did in Shrinks, the author presents an informative, authoritative package.

A compelling and engaging story that shines much-needed light into a dark corner of modern society.