Dr. Jeffrey Lieberman and the Quest to Prevent Schizophrenia
Could a new book offer a better look into a mysterious illness?
Have you ever had a moment when you watched someone start to hear something that wasn’t there? I have, and it’s actually quite terrifying. A friend of mine who was diagnosed with schizophrenia started hearing voices that told her to cheat on her boyfriend — my friend.
She followed suit because she couldn’t stop thinking about the voices. It destroyed her relationship with my friend. Then, the voices started to tell her not to fall asleep. Eventually, she was up for days at a time, barely a shell of her former self. She had to be forcibly hospitalized.
It’s absolutely shocking how quickly schizophrenia can ruin a life. But, what if there was a way to prevent its onset, and lead a healthy, happy and productive life? That’s the goal of Dr. Jeffrey Lieberman. He spent years working on his smash hit book, Malady of the Mind: Schizophrenia and the Path to Prevention.
I actually picked up his book on a friend’s advice.
It was interesting stuff. I was already generally aware that certain mental illnesses can sometimes be “triggered” into existence. I’ve casually heard of people who experienced the onset of bipolar disorder after severe trauma, or others who’d started to show signs of ADHD when their sugar intake increased. However, I often took these stories with a grain of salt.
Reading the book piqued my interest because it showed serious evidence that schizophrenia can also be triggered in some cases. For example, high THC, the psychoactive ingredient in cannabis, has been shown to trigger or worsen schizophrenia, especially in young males. Chronic use of drugs like PCP and methamphetamine can even cause schizophrenia, even in people who have no pre-existing vulnerability.
In some cases, disorders such as epilepsy and autoimmune encephalitis, or inflammation of the brain, can also trigger symptoms of schizophrenia — and because these cases require an entirely different treatment approach, doctors should take care to rule them out through genotyping at the time of a patient’s diagnosis.
All this being said, schizophrenia in its most common form is what’s called a polygenic genetic disease, meaning that instead of a single gene culprit, it is most often caused by hundreds of different genes conspiring in a myriad of ways.
Because of this complexity, modern medicine has yet to develop a concrete diagnostic test (though they are working on it), however, today we can use neuroimaging to gauge a person’s likelihood of developing schizophrenia. Even better, researchers are getting closer to developing a new class of drugs to prevent the onset of symptoms.
Recognizing the early warning signs and intervening early with the proper medication and treatment plan can change the course of a person’s life for the better. Contrary to common misconceptions, most cases of schizophrenia can be successfully treated when caught early.
In fact, 85% of patients who begin antipsychotic medication after their first psychotic episode experience substantial or complete remission of symptoms. In addition to medication, therapy, a stable living environment, and a strong support network are key to ensuring a patient’s long term success.
Could you imagine being able to overcome, or even prevent, something that tore your life apart piece by piece?
I’ve met my fair share of people on the streets who were homeless because they heard voices or other symptoms of a serious mental illness.I imagine most of these people are not being treated, maybe because they don’t have access to proper care, or because they’ve stopped taking their medication, which is common with schizophrenia.
Maybe they’ve become estranged from their families or friends that could help them. Maybe they’ve refused help.
As someone who has a debilitating mental illness, I often wonder what could have been if I was able to prevent my illness.
As someone who has been there, I get a certain amount of wistfulness when I think about the implications. Imagine what life would be like if we knew the triggers that cause onset and avoided them. Heck, most people don’t know that smoking weed can trigger it.
I often wonder about the “what ifs” of my own mental illness. Maybe I’d be more popular if I didn’t have it. Maybe I’d be able to work a high-paid, high-pressure 9-to-5. Maybe I’d be earning $200,000 a year as a C-level executive.
Then, I look at the people I know who have schizophrenia and remain on the streets. How many of them are there because they had an onset, didn’t realize what was happening, and didn’t get medical treatment?
How many lives would be different if only the signs were spotted sooner, if they’d gotten on the right medication earlier? How would their lives look if they had access to continued mental health care, and a strong support system in place to make sure they stuck to their treatment plan?
After reading this book, it’s hard not to wonder who they would be in another world. Maybe the guy talking to himself would be a corporate executive. Or, maybe he’d be singing alongside Beyonce.
Maybe, maybe, maybe. If only, if only, if only.
Lieberman’s book also got me thinking about how we treat mental illness today.
Since the 90s, we’ve seen a massive de-stigmatization of mental illness. Rather than do the socially-enforced masking of “everything is fine,” we’ve started to point out that it’s okay to not be okay. This is such a huge step in the right direction, but we still have work to do. Stigma is still a barrier for people seeking treatment, or even admitting they might need help, especially when it comes to serious mental illness.
If Dr. Lieberman kicks off a new trend of prevention and treatment, I’m all for it.Dr. Lieberman has dedicated his life and career to not only treating serious behavioral brain disorders, but reducing the stigma that surrounds mental illness.
Perhaps one of the most important elements of his book, Malady of the Mind, is in replacing the shame and stigma that’s always followed schizophrenia with real hope for achieving wellness.
We have the answers and tools to successfully treat schizophrenia right now, and perhaps just this knowledge alone could save a life.
