Why Schizophrenia

The family support group meets at night in the basement of an elementary school.  Everyone looks a bit worn out, a bit out of place in a room splattered with rainbow alphabets, children's artwork and mobiles strung from the ceiling.  The group is perched in a circle, squirming a bit in chairs that were designed for tinier humans.  The room is packed tonight because there is a special guest speaker--a genetics researcher on schizophrenia.  He is here to recruit families to participate in a new study at his university.
 
At least that's what he thinks.  He can barely get a word in edgewise.  The crowd's arms are raised before he's made it through the second slide in his presentation: "My son was hit in the head by a baseball when he was little.  Do you think that could have been why he got sick?"  "His father was an alcoholic...I've always wondered if that played a part in it?"  "We think maybe my grandmother had the disease, too.  Will two first degree family members double my risk of inheritance?"  "What about diet?  My sister always had a bad reaction to [insert any possible food here]..."  Our speaker looks rather taken aback and stammers as he tries to shoot down a barrage of unscientific theories.

It is heartbreaking listening to them.  So much second-guessing, so much guilt and pain...and so very few answers.  Schizophrenia is twice as common as AIDS, but it is much less understood.  This probably has something to do with the fact that it receives ten times less research funding. What's more, hardly any studies seem to be performed on the hardest cases--patients lacking insight--because they're unlikely to provide consent in the first place.  I'm no expert, but it stands to reason that because of this any research sample sizes have been reduced roughly by half to begin with--the half that happens to be much sicker.  It doesn't inspire much confidence.  And so, many of us are left grasping at straws.

I can honestly relate to how the whole autism/vaccines myth started because I, too, have been down that road, and I don't recommend it to anyone.  The first time I heard about the connection between schizophrenia and toxoplasmosis, I became convinced that mom got sick through gardening.  Our neighbors had a free range cat that probably crapped all over our yard.  Dad thought it had to do with difficulties during labor, and it took some convincing to get my grandmother to put the earwax (yes, earwax) theory to bed.  But all our suspicions, as wild as they sound, were probably far too too simplistic in nature. 

Our best current guess is that schizophrenia is a bit like cancer--some of it has to do with genes that leave you more susceptible, and some of it has to do with environmental triggers.  Carrying the genes doesn't mean you'll get sick, and not all of the environmental factors will be triggers for everyone.  So you're left with a big pile of conjectures and conspiracy theories.  Which is pretty ironic, because the one thing most of us are paranoid about is becoming paranoid ourselves. 

It's pretty hard to not go there, though.  After an exhaustive and mostly unproductive stint of armchair research several years ago, I'd come up with the following checklist for my own personal risk factors:
  • Parent with illness: check.
  • Stressful childhood: check. (See: parent with illness.)
  • Older father: check.
  • Born in an urban environment: check.
  • Born in the winter: oh crap.
  • Maternal depression: I am so screwed. 
  • Epilepsy: not so much.
  • Toxoplasmosis antibodies: negatory.
  • Left-handedness: phew.
  • Marijuana/ LSD use: it's hip to be square.
  • Heavy alcohol use: only during prolonged exposure to my parents.
  • Antisocial tendencies: only during prolonged exposure to my parents. 

None of this is particularly useful knowledge to have.  My mom has managed to defy a lot of the odds--born in the summer, young dad, happy mom, no cats, right-handed, late onset--none of it mattered.  Most of the factors being targeted for investigation are beyond our control, anyway.  While geneticists have isolated several genes that they believe contribute to the disease, there are no genetic tests available for the public.  There is no smoking gun.  All the theories and late night reading in the world won't give you any answers--all it does is make you scared of cats and unwilling to eat brownies at social events.

But that doesn't stop the flood of questions here in the school basement, because there is such a strong need to make sense of what's happening.  There is such a strong need to feel like you haven't lost all control.  The people in this room have family members who are missing, in jail, unable to hold jobs, unable to stay in touch with reality...and they just want to know why.  Many of them have never been able to even speak to their relative's doctors.  Their hunger for something, anything to point to is almost palpable.
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