Inside Out: Looking at schizophrenia’s inner chaos

Mary Beth Gardiner
Published: November, 2003

Man with flies and snake, crayon drawing from the 1920s by Heinrich Anton Müller, an artist and inventor who spent much of his life in a Swiss psychiatric hospital under treatment for delusions and other symptoms of schizophrenia.

Courtesy of the Collection de l’Art Brut, Lausanne, Switzerland

What’s going on in the mind of a person with schizophrenia has been the subject of researchers for nearly a century. Some believe that the divergent thought processes at the heart of creativity are cousin to the delusions and hallucinations that characterize the disorder. Other, more fundamental thought processes are affected in schizophrenia, too, including some essential to navigating daily life. Surprisingly, perhaps, it is largely this cognitive impairment that prevents those with the disorder from participating in society.

Affecting around one percent of the population worldwide, schizophrenia does not discriminate by race, socioeconomic status, or intelligence. The illness typically surfaces in early adulthood, and may impact a person’s ability to think clearly, manage emotions, and interact with others. Most people with the disorder suffer chronically or episodically throughout their lives, plagued by symptoms and medication side effects, as well as by stigma and the pain of lost opportunities for relationships and careers. One of every 10 people with schizophrenia eventually commits suicide.

Though its cause is still uncertain, most scientists in the field agree that schizophrenia is a problem with brain growth and development. Technological advances in neuroscience, genetics, and brain imaging are yielding convincing evidence of altered brain anatomy and chemistry.

Yet the picture of when and how neurological snarls occur remains vague: Is nascent brain circuitry affected in the womb or some time later along the developmental timeline? Genes are involved, but is the initiating event biological or environmental?

Of a split mind

Our understanding of schizophrenia has come a long way since German psychiatrist Emil Kraepelin first documented the disorder in the late 1800s. The symptoms are by now well characterized, yet misconceptions still abound. The Greek-derived name translates to “split mind,” but the illness has nothing to do with split or multiple personality disorders. The “split” in this case refers to the inability to separate reality from delusion and the illogical from the reasonable.