A member of my family who suffers from schizophrenia refuses treatment because the disease gives him delusions of health. He’s absolutely sure he’s not sick. It’s a classic Catch-22: the only way he can manage the symptoms of schizophrenia is to take medications, but those very symptoms keep him from taking them.
He thinks that a monstrous, malevolent pharmaceuticals industry produces these drugs in a conspiracy to get him hooked. As with many paranoid notions, there’s an element of truth in this one. Today Big Pharma pushes its products as insistently and seductively as any corporate enterprise bent on expanding its market share.
Reading Elyn Saks’ memoir, The Center Cannot Hold: My Journey Through Madness (Hyperion, 2008), helped me see that my relative’s refusal to take meds, even though his illness makes him miserable, isn’t because he’s stubborn or willfully ignorant. Saks, who suffers from paranoid schizophrenia, traces her rollercoaster relationship with the drugs prescribed for her disease. She’s a brilliant woman – Marshall scholar, Cambridge University alumna, Yale Law School graduate, attorney in a distinguished law department at the University of California – who describes her struggles with schizophrenia in impressive, penetrating detail. But she never achieves stable insight into her condition, or into the fact that only by taking prescribed medications can she work and live a relatively satisfying life.
Even after writing a book of remarkable insight and becoming a speaker on schizophrenia in forums throughout the U.S., Saks repeatedly quits taking meds once they start easing her symptoms. Why?
Like any patient taking a course of antibiotics, people with schizophrenia are tempted to stop once their symptoms ease up. Like other Americans conscientious about their health, they resist putting more chemicals than the absolute minimum into their bodies. Like anyone diagnosed with a serious, lifelong, potentially incapacitating illness, they want to believe it’s possible to heal. On top of all that, people with schizophrenia are regularly assailed by delusions most of us don’t suffer – that the best advice of the best doctors is utterly wrong and possibly evil.
Saks generally stays on track and returns to treatment because people she trusts are part of her life. They’re not medical experts, parents, or siblings; they’re ordinary friends and neighbors who care about her enough to spend sociable time with her on a regular basis.
I can’t spend time with my relative, whose paranoia about members of his family is intense, but I can have coffee regularly with someone else who is socially isolated by mental illness. Please see How I Started Freestyle Volunteering, tabbed above.