Posted: September 10th, 2024

Schizophrenia Over Time: Experiences Living With The Illness

Elyn Saks’s Journey with Schizophrenia

Schizophrenia, a complex and often misunderstood mental illness, affects millions of individuals worldwide. The experiences of those living with this condition vary greatly, challenging the notion of a one-size-fits-all approach to treatment and support. Elyn Saks, a prominent legal scholar and mental health advocate, has become a beacon of hope and understanding in the field of schizophrenia research and awareness. Her personal journey with the illness provides valuable insights into the onset, associated features, development, and course of schizophrenia, as well as the long-term challenges and necessary supports for individuals living with this condition. This paper examines Saks’s experiences with schizophrenia, explores the use of diagnostic tools, and discusses treatment planning considerations, while also addressing the influence of identity characteristics on the schizophrenia experience.

Elyn Saks’s Experiences with Schizophrenia

Onset and Early Manifestations

Elyn Saks’s journey with schizophrenia began in her teenage years, with the first significant symptoms emerging during her time as an undergraduate student at Vanderbilt University (Saks, 2007). The onset of her illness was gradual, characterized by increasing cognitive disorganization and the emergence of delusional thoughts. These early experiences align with the typical age of onset for schizophrenia, which often occurs in late adolescence or early adulthood (Kahn et al., 2015).

Associated Features: Positive and Negative Symptoms

Throughout her life, Saks has experienced both positive and negative symptoms of schizophrenia. Positive symptoms, which involve an excess or distortion of normal functions, have been particularly prominent in her case. In a recent interview, Saks described her psychotic episodes as “waking nightmares” filled with bizarre images and frightening occurrences (NPR, 2013). These episodes often involved vivid hallucinations and delusions, such as believing that she had killed hundreds of thousands of people with her thoughts.

Negative symptoms, characterized by diminished normal functions, have also been present in Saks’s experience, albeit less prominently. These have included periods of social withdrawal and difficulty in expressing emotions, which have impacted her personal and professional relationships at various points in her life (Saks, 2007).

Development and Course

The development and course of Saks’s schizophrenia have been marked by periods of acute psychosis interspersed with periods of relative stability. Despite achieving remarkable professional success as a law professor at the University of Southern California, Saks continues to experience periodic psychotic episodes throughout her life (Psychology Today, 2024). This pattern underscores the chronic nature of schizophrenia and the ongoing challenges faced by individuals living with the illness, even when they have access to effective treatment and support systems.

Saks’s journey also highlights the potential for individuals with schizophrenia to lead fulfilling and productive lives with appropriate treatment and support. Her academic achievements and advocacy work demonstrate that severe mental illness does not preclude success and meaningful contributions to society (USC News, 2023).

Diagnostic Tools and Treatment Planning

Clinician Rated Dimensions of Psychosis Symptom Severity

The Clinician Rated Dimensions of Psychosis Symptom Severity measure would be a valuable tool in confirming a diagnosis of schizophrenia in a case like Saks’s. This instrument assesses eight domains of psychotic symptoms: hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, negative symptoms, impaired cognition, depression, and mania (American Psychiatric Association, 2013). In Saks’s case, particular attention would be paid to the hallucinations and delusions domains, given the prominence of these symptoms in her reported experiences.

WHODAS 2.0

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) would provide a comprehensive assessment of Saks’s functioning across various life domains. This tool evaluates six areas of functioning: cognition, mobility, self-care, getting along with others, life activities, and participation in society (Üstün et al., 2010). For Saks, the cognition and getting along with others domains might be particularly relevant, given the impact of her symptoms on her thought processes and social interactions.

Treatment Planning and Individualization

Long-term Challenges

Individuals living with schizophrenia, like Saks, face numerous long-term challenges. These include managing ongoing symptoms, coping with the side effects of medication, maintaining employment and relationships, and combating societal stigma (Veling et al., 2019). Saks’s experiences highlight the importance of continuous treatment and support, even during periods of relative stability.

Social, Family, Vocational, and Medical Supports

A comprehensive treatment plan for Saks would include a range of supports:

Social supports: Peer support groups and social skills training to help maintain and build relationships.

Family supports: Family psychoeducation to enhance understanding and support from loved ones.

Vocational supports: Supported employment programs to assist in maintaining her academic career.

Medical supports: Regular psychiatric care, medication management, and monitoring of physical health, as individuals with schizophrenia are at higher risk for certain medical conditions (Correll et al., 2017).

Influence of Identity Characteristics

An individual’s experience with schizophrenia can be significantly influenced by various identity characteristics. For instance, gender may play a role in symptom presentation and treatment response, with some studies suggesting that women with schizophrenia tend to have a later onset and better social functioning than men (Ochoa et al., 2012). Socioeconomic status can impact access to quality care and support services, potentially affecting long-term outcomes. Additionally, cultural and religious beliefs may influence how symptoms are interpreted and the willingness to seek professional help (Kirmayer et al., 2015).

In Saks’s case, her high socioeconomic status and level of education have likely contributed to her ability to access quality care and advocate for herself effectively. However, as a woman in academia, she may have faced unique challenges in managing her illness while navigating a demanding professional environment.

Conclusion

Elyn Saks’s journey with schizophrenia provides valuable insights into the complex and varied nature of this mental illness. Her experiences underscore the importance of individualized treatment approaches, comprehensive support systems, and ongoing management of symptoms. By sharing her story, Saks has not only contributed to a better understanding of schizophrenia but has also challenged societal perceptions of what individuals with severe mental illness can achieve. As mental health professionals, it is crucial to recognize the unique experiences of each individual with schizophrenia and to provide tailored, compassionate care that supports their personal goals and aspirations.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … & Stubbs, B. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large‐scale meta‐analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163-180.

Kahn, R. S., Sommer, I. E., Murray, R. M., Meyer-Lindenberg, A., Weinberger, D. R., Cannon, T. D., … & Insel, T. R. (2015). Schizophrenia. Nature Reviews Disease Primers, 1(1), 1-23.

Kirmayer, L. J., Bennegadi, R., & Kastrup, M. C. (2015). Cultural awareness and responsiveness in person-centered psychiatry. In Person Centered Psychiatry (pp. 77-95). Springer, Cham.

Ochoa, S., Usall, J., Cobo, J., Labad, X., & Kulkarni, J. (2012). Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophrenia Research and Treatment, 2012.

Saks, E. R. (2007). The center cannot hold: My journey through madness. Hachette UK.

Üstün, T. B., Kostanjsek, N., Chatterji, S., & Rehm, J. (2010). Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0. World Health Organization.

Veling, W., Counotte, J., Pot-Kolder, R., van Os, J., & van der Gaag, M. (2019). Childhood trauma, psychosis liability and social stress reactivity: a virtual reality study. Psychological Medicine, 49(11), 1889-1897.

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Schizophrenia Over Time: Experiences Living With The Illness
Experiences of schizophrenia are not homogeneous; there is wide variety in onset, course of illness, and combinations of symptoms. Social workers need to be able to understand the different manifestations and pathways of the illness to plan interventions. Social work services play a key role in stabilizing crises, supporting family coping, and influencing overall quality of life and outcomes of individuals with schizophrenia. In this Assignment, you practice applying this necessary individualization.

To prepare: In the Learning Resources, focus on the associated features, development, and course of the illnesses in the schizophrenia spectrum. Also focus on descriptions of the disorder and the way it develops for different individuals.

Choose two articles from the list in the Learning Resources that apply to treatment support and interventions for the schizophrenia spectrum and other psychotic disorders chapter in the DSM 5. Choose either Saks or McGough to focus on for this assignment.

Submit a 3- to 4-page paper, supported by at least 4 scholarly resources (See below) (not including DSM-5), in which you address the following:

Describe Saks’s or McGough’s experiences with schizophrenia. Identify onset, associated features (specifically referencing the positive and negative symptoms), development, and course.
Explain how you would use the Clinician Rated Dimensions of Psychosis Symptom Severity measure and the WHODAS to help confirm your diagnosis.
Explain how you would plan treatment and individualize it for Saks or McGough. Support your response with references to scholarly resources. In your explanation, consider the following questions:
What are the long-term challenges for someone living with the illness?
What social, family, vocational, and medical supports are needed for long-term stabilization?
Briefly explain how race/ethnicity, gender, sexual orientation, socioeconomic status, religion, or other identity characteristics may influence an individual’s experience with schizophrenia.
Resources to use: see attachments as well

https://doaj.org/article/79447faaaf064306bb8d200bf7897dda

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Tags: Elyn Saks, Mental Health Advocacy, Psychosis Management, Schizophrenia