DSM-5 Criteria of Schizophrenia in A Beautiful Mind

DSM-5 Criteria of Schizophrenia in A Beautiful Mind

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Abstract

This paper is about the movie: A Beautiful Mind. It illustrates the character of John Nash and how he was diagnosed with Schizophrenia using the DSM-5 diagnostic criteria. It discusses the disease at large: the causes, signs and symptoms and treatment based on the character in the movie. The paper also illustrates how Nash would be appropriate for The Menninger Clinic which I visited for the Inpatient Facility Presentation. The paper describes the support system Nash had in the movie as he continued with treatment. It goes ahead to explain the impact of the culture of the society Nash lived in after his diagnosis. Finally, I have provided a self-reflection regarding how I felt during and after I watched the movie and the impact the movie had on me regarding John Nash’s assessment.

Introduction

In the movie A Beautiful Mind, the main character, John Nash is a renowned Mathematician. Nash was very focused in achieving his goals and he believed that everything had a theory and every problem had a solution. He was named a mathematics genius by one of his professors after he came up with an original theory. He was however later diagnosed with schizophrenia and started treatment. He relapsed after secretly stopping his medication but that did not stop him from achieving a Nobel Prize in Economic Sciences.

Background of the Movie; A Beautiful Mind

The movie begins as Nash and his classmates are at Princeton University. He had earned his place at Princeton through scholarship together with a fellow student Martin Hansen. There are also other students who include Sol, Bender and Ainsley. Later, his roommate Charles Herman a Literature major arrives to their room drunk (Howard, 2001, 00:06:20). Nash and his campus friends go to the bar from time to time however as his friends are having fun, he was busy trying to solve an on original problem. He got his eureka moment when his friends tried to interact with a number of ladies at a club. He was employed at the MIT due to his new discovered theory. He chose Sol and Bender to join MIT with him (Howard, 2001, 00:22:40). He is later invited to the Pentagon to crack codes which he does very quickly. It is very evident that his job at MIT is a bore to him so when he is approached by a US defense agent he was elated. The agent’s name was William Parcher and he wanted Nash to find clues hidden in the newspaper by Russian Soviet agents. As he was teaching in MIT, he meets Alicia Larde, they fall in love and he marries her as per the advice of his friend Charles.

His social behavior is considered to be awkward. It is evident he was not an introvert because he went out clubbing with his friends and gave his opinion on different matters without fear (Howard, 2001, 00:18:37). He however got carried away many times trying to find theoretical solutions to everything. This is evident when he first joined Princeton and he interacted with other students, he tried to find a reasonable explanation why one of his course mates wore a terrible tie (Howard, 2001, 00:02:51). He was always very direct with people and could not engage with small talk. Many ladies found it annoying and he once got slapped when one of the ladies he tried to impress got offended. This was unlike the case with Alicia who liked his straight forwardness. Nash did not however understand his affections for Alicia and he approached her with a weird proposal where Alicia had to prove that she was willing to justify her relationship with Nash (Howard, 2001, 00:52:30). Her answer showed that they were clearly meant for each other. If it was another lady, I think Nash would have earned himself another slap. After he was diagnosed with Schizophrenia by doctor Rosen, we find out that William Parcher, Charles Herman and Charles niece Marcee are all delusional (Howard, 2001, 01:11:17). It is clear that his condition started when he was in Princeton and was not diagnosed and therefore deteriorated. He then has to start medication.

Diagnostic Criteria According to DSM-5

Risk Factors of Schizophrenia

According to DSM-5, Schizophrenia involves a variety of diseases, comprising hallucinations and delusions, that all include a loss of contact with reality. It also has an impact on an individual’s capacity to identify the signs and indicators of this disorder. Even though it’s a serious disorder, it can be treated, and several individuals who have it nonetheless lead joyful, fulfilled lives (Davidson, 2019). Even though the term schizophrenia is formed from Greek words split and mind, its meaning is very different from that of multiple personalities. Age and gender are factors considered during schizophrenia diagnosis. For women it is common in ages between 25 and 35 while ages between 15 and 25 for men. It is however not common in children but when it is diagnosed, it is usually very serious. Most people diagnosed with schizophrenia after the age of 45 are usually women. There are over 2.5 million new cases every year while there are over 22 million already diagnosed cases in the whole world (Viher et al., 2016). There are other risk factors that may bring about schizophrenia. One of them is being exposed to infections which attack the brain and the immune system. A lot of stress over a long period of time may also trigger the disorder. Other factors include the birth environment of a person. Being born winter increases the chances of getting schizophrenia. If your mother had diabetes, malnutrition and vitamin D deficiency while pregnant are also considered factors. Over the years being diagnosed with schizophrenia has often been linked to use of drugs such as marijuana.

In the movie A Beautiful Mind, Nash was seen having stress and anxiety when he could not find an original theory. It is at this instances that his roommate Charles would show up. The first time he appeared, he encouraged Nash to go out to drink in order to bond (Howard, 2001, 00:06:20). Another instance Nash was bored while working in the MIT then he met Parcher. In most times, Parcher offered Nash cigarettes to smoke as they discussed the Russian Soviets. After that Nash is often seen smoking.

Causes and Stages of Schizophrenia

The mental and physical health of an individual can be severely impacted by schizophrenia. This is because it interferes with your mind’s normal functioning, impairing your capacity for thought, cognition, and use of your perceptions, among other things. Because your mind isn’t functioning properly, schizophrenia frequently makes it difficult for you to manage many aspects of your regular living. Schizophrenia frequently ruins your personal, interpersonal, and occupational connections (Davidson, 2019). Additionally, it can make it difficult for you to organize your thinking, and you may act in ways that lead to increased probability of accidents or other diseases. Schizophrenia occurs in three stages. The first stage which is known as the onset involves some changes which include withdrawal, anxiety, lack of motivation and poor hygiene. The next stage is the active stage where the changes take full effect. The main visible signs include delusions, hallucinations, unusual movement and incoherent speech. People need to be portraying at least two signs to consider diagnosis. The last stage is known as residual where a person has some signs and symptoms but they don’t appear to be severe (Viher et al., 2016). At some point the person may seem completely healed. However, after some time the person goes back to the active stage.

Being a Mathematics genius, Nash puts pressure on himself to find solutions to different problems. This is seen when he tries to come up with an original theory in Princeton. His classmates had already submitted their theories but he took his time because he wanted his theory to be original (Howard, 2001, 00:15:45). After working in MIT for some years he got bored and needed something new to solve. That is when he was approached by the US defense agent. He even skipped teaching classes as he tried to find clues in newspapers.

Schizophrenia Diagnosis

Schizophrenia cannot be spread from one person to another. According to DSM-5, for a diagnosis to be done the person being diagnosed should meet a number of requirements. One of the requirements is two of the five main symptoms (Davidson, 2019). The symptoms need to have lasted for one month and their effects need to be evident after six months. The condition should have also affected their professional and social lives. The diagnosis requires a number of tests. One of the tests includes imaging tests of Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) scans. These tests are used to rule out brain tumors, stroke and brain injuries. Blood and urine sample tests are done to see if the changes are explanatory hence ruling out infections or poisoning. The mind’s electrical activity can be found and recorded using an electroencephalogram (EEG). This examination may aid in excluding diseases like epilepsy.

In the movie A Beautiful Mind, we first get to see him act weird when he is followed by Russians and even get shot at. He develops anxiety and even forces his wife Alicia to go live with her sister because he feared for her life since she was pregnant (Howard, 01:00:00- 01:02:40). He broke down when he was asked to give a speech at a university and Dr. Rosen and his team chased him down and restrained him. After the diagnosis, Dr Rosen explained that Nash got sick when he was in Princeton. Charles, his niece Marcee and Parcher were all in Nash’s imagination and therefore not real (Howard, 2001, 01:11:17).

Schizophrenia Treatment and Management

Although schizophrenia cannot be cured, it is frequently treatable. Individuals suffering from schizophrenia do occasionally make a full recovery from it. There is no way to predict who would experience a relapse of this ailment and who won’t, therefore this is not a cure. Due to this, medical professionals assume that the persons who recover from this condition to be in remission (Davidson, 2019). A mix of medicines, counseling, and subconscious approaches is commonly used to manage schizophrenia. While most mental health conditions can be effectively treated with therapy alone, managing schizophrenia typically necessitates medication. Early detection and intervention are crucial since they improve the likelihood of a successful conclusion. For the treatment of schizophrenia, there are primarily two categories of drugs; typical antipsychotics and atypical antipsychotics (Davidson, 2019). Dopamine, a neurotransmitter the brain utilizes for cell-to-cell communication, is blocked by typical antipsychotics, sometimes referred to as first-generation antipsychotics. Atypical antipsychotics are drugs that function differently from first-generation antipsychotics. They are also known as second-generation antipsychotics. These inhibit both the minds dopamine and serotonin, which are essential for communication.

A doctor may also recommend other drugs to address symptoms that develop concurrently with or as a result of schizophrenia symptoms. Additionally, they may recommend drugs to aid with antipsychotic drug side effects including tremors (Davidson, 2019).   The medical care practitioner is the ideal person to discuss any potential prescription drugs with. They are able to provide more detailed information about a particular issue, such as individual opinions, living conditions, and past health records. Cognitive behavioral therapy is one psychotherapy technique that can assist persons with schizophrenia maintain and deal with their disorder (Davidson, 2019). In addition to treating schizophrenia, long-term therapy can also help with related conditions including anxiety, sadness, or drug abuse. Healthcare professionals may advise adding electroconvulsive treatment (ECT) if a patient’s schizophrenia does not get better after attempting specific medicines and the patient is at danger for injuring himself or others. In instances where medicine alone would be too slow to work, this treatment can produce quick results.

After diagnosis, Nash was put under medication. His main medication involved an insulin shock therapy course before being subsequently freed. He secretively refuses to take his antipsychotic medicines because he is fed up with the side effects and resumes noticing Parcher and Charles (Howard, 2001, 01:30:11). His relapse caused him to start with the Russian Soviet again. He even left his baby boy in a bathtub with running water believing that Charles is watching him. Alicia arrived just in time to save their son. Alicia was almost running away with their child when Nash reveals that he sees that Marcee does not age and therefore she is not real. He realized that Charles and Parcher were not real. Nash goes back to Princeton where Martin Hansen allows him to work there as he learns to ignore the delusions (Howard, 2001, 01:45:49). He was later allowed to teach again and ended up winning the Nobel Prize for Economic Sciences because of his work on Game Theory. He was also honored by fellow professors.

Possible impact of The Menninger Clinic on John Nash’s Treatment

The Menninger Clinic would have been a good inpatient facility for Nash. Not only because it is one of the best had institutions in the United stated but also because its staff are up to the task (Delille, 2017). The clinic offers inpatient programs and outpatient therapy. This would have been good for Nash to avoid the relapse after treatment. If Nash had gone to the institution, he would have spent less days there as an inpatient. This was not the case in the movie because the hospital had to keep him for a long time. This can only be because health facilities were not well developed and equipped then (Delille, 2017). The clinic could have also offered family therapy to Nash’s wife Alicia who suffered immensely when Nash was diagnosed. It is her reaction that mostly prompted Nash into relapse, though it was not intentional. The clinic was would have also offered Nash a number of therapies and activities to aid him in the treatment journey making it smoother. In the movie, Nash was forced to deal with his delusions on his own by ignoring them even though he could still see them.

John Nash’s Support System in the Movie: A Beautiful Mind

Nash’s main support system is his wife, Alicia. She was the first person to identify that there were some weird traits portrayed by Nash. She investigated what her husband was working on when he was first diagnosed. As much as she had also come to believe the delusional people were real, she supported Nash when she found out they were false (Howard, 2001, 01:11:17). She cared for him when he came home after treatment and ensured that he took his medication daily. She was a bit broken watching Nash change but she loved him regardless. She also gave him a second chance when he relapsed and almost drowned their son. He was also by his side when he received the Nobel Prize in Stockholm (Howard, 2001, 02:04:34). I believe their love and partnership was to be admired. The other person who acted as Nash’s support system was Martin Hansen. They both got into Princeton under scholarship and were even rivals during their time there. After Nash relapsed and decided to go back to Princeton to work, Hansen welcomed him with open arms (Howard, 2001, 01:45:49). As much as Nash developed schizophrenia symptoms a number of times, Hansen motivated him and helped him where he could. After twenty years working in the library and auditing classes, Hansen allowed him to teach again. This is after Nash had learnt to ignore his delusions. Hansen was also there to support him as he received the Nobel Prize.

Impact of Culture on John Nash’s Diagnosis

From the movie A Beautiful Mind, the society was not aware of Nash’s disorder. This is because it was not diagnosed until some years after he left Princeton. His weird ways were considered normal to most people. His friends in campus made fun of how straight forward and a genius he was at the same time (Howard, 2001, 00:03:20). A person watching the movie would not have noticed that Charles, Marcee and Parcher were delusional because he talked to them and interacted with them in a normal way. They can only imagine how people watching him reacted. They probably thought him mad. This is clearly seen when he runs away at the lecture where he was a guest professor. Everyone in must have thought it was normal of him but not Dr Rosen (Howard, 2001, 01:11:17). When Hansen accepted him back at Princeton, he had a difficult time as he tried to ignore the delusions. He once had a huge confrontation with Parcher in front of a number of students. Hansen had to calm him down as the students continued to laugh at him. Some even made fun of his walking style around campus. It very clear that people could not easily understand Nash like Alicia and Hansen did. Before he was honored by fellow professors for receiving the Nobel Prize, he accepted that he was mad and that he was working through it (Howard, 2001, 02:00:05). As much as he was diagnosed with schizophrenia, they still awarded him the Nobel Prize.

Self-Reflection of the Movie; A Beautiful Mind

I learnt a lot from the movie. First of all, John Nash’s character is very admirable. He worked hard to achieve his dream. It was evident that he was focused to meet his goals. It started when he wanted to write an original theory to solve a mathematical problem. His classmates laughed at him but he did not give up. Whenever he failed or faced a challenge, he tried to find a reason why, just like with the Adam Smith theory of every man for himself (Howard, 2001, 00:18:37). As much as he was not the best social person, he was a good friend because when he got a job at MIT, he took his friends along with him. He was a family person because he tried to protect his wife and unborn child from possible danger. After diagnosis when he relapsed, he tried to save their marriage by stopping Alicia from leaving him. He also went back to Princeton and chose to ignore his delusions (Howard, 2001, 01:45:49). By doing so, he proved that the condition was part of him but not who he was. Despite the struggles he faced he still worked to beat schizophrenia. Nash’s wife Alicia is very admirable because of how she stood by husband. She even stopped Dr Rosen from taking Nash back to hospital when he relapsed (Howard, 2001, 01:40:12). She chose to stick by him and understand him. It was her idea that made him go back to Princeton in order to work on himself. Same case applies to Hansen who took him back after everyone knew of his diagnosis. Hansen was a definition of a true friend.

Apart from being inspired, I got emotional from time to time. It is like I was rooting for Nash all through even though I did not know he had schizophrenia. When he discovered the original theory, the joy on his face was very inspiring (Howard, 2001, 00:18:37). After attempting to date at the club where he got slapped, to seeing him date Alicia, it was so impactful. It showed that as weird as everyone can get there is a person out there for everyone. The way Alicia understood Nash was admirable. They were truly meant for each other. This is clear in his speech after winning the Nobel Prize when he dedicated it to her (Howard, 2001, 02:04:34). Alicia could not hold back her tears. Another inspiration was when he started teaching again. He knew he was not perfect but he was willing to work on it. It is also clear that he never did it for the money but for his own satisfaction (Howard, 2001, 01:56:55). In the process, he benefited his students who liked him. He was also quick to apologize to the people he wronged due to his disorder.

After watching the movie, I have come to understand Schizophrenia better. First not all abnormal behavior is normal. People with mental disorders also have a chance at life as much as most of these disorders are chronic. They need care and understanding. With the appropriate medication, they are likely to have positive impact in the society. Before watching the movie, I thought that people with mental disorders spent their time in the inpatient facilities and never came out. However, I have learnt that training the mind is a process and it needs a strong supportive system. People facing mental disorders have challenges since it takes time before they accept that they have a disorder. The society takes more time accepting them and understanding the care and support they need. There is still a lot of stigma around mental disorders since most people have no knowledge but them.

Conclusion

The movie A Beautiful Mind brings out the mental disorder in a renowned Mathematics professor John Nash. It is a very educational and inspiring story. It clearly illustrates that schizophrenia can take long to be diagnosed. Even after diagnosis and treatment, a person is likely to relapse if the treatment stops. People facing mental disorders require a good support system and a functional inpatient clinic during treatment. All in all people with schizophrenia can live fruitful lives and achieve their goals just like John Nash.

References

Davidson, M. (2019). Cognitive impairment as a diagnostic criterion and treatment target in schizophrenia. World Psychiatry, 18(2), 171.

Delille, E. (2017). < Varia> Teaching the History of Psychiatry in the 1950s: Henri Ellenberger’s Lectures at the Menninger Foundation. Zinbun, 47, 109-128.

Howard, R. (Director). (2001). A Beautiful Mind [Film]. DreamWorks Pictures, Universal Pictures.

Viher, P. V., Stegmayer, K., Giezendanner, S., Federspiel, A., Bohlhalter, S., Vanbellingen, T., … & Walther, S. (2016). Cerebral white matter structure is associated with DSM-5 schizophrenia symptom dimensions. NeuroImage: Clinical, 12, 93-99.