While A Beautiful Mind is a perfectly good movie, I have problems with its portrayal of mental illness. Unfortunately, it’s also the movie that my mother has used to understand mental illness, including my own, for at least 15 years.
In it, John Nash, played by Russell Crowe, learns, in the most dramatic way possible, that he is a schizophrenic. He, a math professor at Princeton, is chased by “Soviet agents,” overtaken, subdued. An agent reveals himself to be a doctor: Nash isn’t in a Siberian gulag, he’s in a hospital, and he’s being informed that the CIA agent who has been giving him his instructions is not real. Not only that, but his college roommate isn’t real either. Nor is the little girl who has taken to following him around. They’re all lies, projected in perfect-3D by his sick, delusional mind.
He is drugged, the hallucinations go away. But the drugs make him dull and lifeless. They make it so that he cannot think. He then goes off the medication; the hallucinations come back. Finally, he resolves the problem entirely by refusing to recognize the hallucinations. They — the visions — try to engage with him, constantly, all the time, but he firmly refuses to parlay with them. The final scene of the movie has an elderly Nash walking out of the ceremony in Stockholm, Sweden, where he has just won a Nobel Prize in Mathematics for inventing game theory. He sees his three imaginary tormentors in the hallway as his wife is swaddling him in his coat. He gazes at them for a moment. His wife asks him what he saw.
“Oh, nothing,” he says. He turns back to her. “Nothing at all.”
My mother loves this movie, and interprets it in a particular way.
It shows real strength of character, she says, to stick with reality. To firmly stare down unreality, un-logic, madness, sadness, irrationality, and to tell yourself: no, I shall not descend down your path. I will stick with what is real, what is firm, what I know to be true.
My mother has made a career out of being a fierce defender of the truth. There is truth, there are lies, and that’s about it, according to my mom. There is science, there is un-science. There is objective truth, and then there are postmodern lies about the objective nature of reality.
The things that are real are good. The things that are lies are bad. Nash was correct to shun the visions, because how dare they interfere with the truth? Somewhere, an errant signal from Nash’s brain interrupted the unvarnished image that was beamed from his eyes to his occipital lobe, inserting an imaginary character, someone who never existed. This errant signal is wrong. It is morally incorrect. It is a lie, a dirty lie. Nash, rather than take the easy way out of drugging himself to quiet his overactive imagination, suppresses the hallucination through brute force. Instead of doing something that will quickly, painlessly, easily disintegrate the vision, he will torture himself by keeping the vision around, 24/7. And he will continuously make the choice to rebuke the vision every time he sees it — which is all the time. The way a Christian ritualistically condemns the Devil every Sunday, Nash must continuously pledge his allegiance, over and over again, to truth, to reality. He must shun the dark mark of unreality that plagues the edges of his vision.
He does this because he is cursed. He didn’t choose to be cursed. But he can choose to be pure. He can choose what he engages with and what he doesn’t.
Why can’t I do the same?
When confronted with panic attacks, when confronted with the sludge-like depression that overtakes me and renders me unable to move, when I lie on the couch in a daze — my partner tells me it’s like I’m on heroin, I’m simply that unable to respond to external stimuli — why can’t I just reason my way out of this? Why can’t I just — snap out of it?
After all, John Nash did it.
Only problem, of course, is that this particularly brutal, puritanical, cruel approach to treatment never happened. The film, like most Hollywood recreations of real-life events, takes extraordinary liberties with the truth.
Nash’s schizophrenia was a mild case. It resolved itself, not through Nash’s raw willpower, not through Calvinistic self-punishment, but for more mundane reasons: he grew out of delusional thinking as he aged. Schizophrenia tends, after all, to lessen in intensity as one gets older. Late-onset schizophrenia — and Nash only began experiencing symptoms when he was 30 — tends to have a better prognosis than a disorder diagnosed in someone’s teen years. Nash had protective factors that other people with schizophrenia largely don’t have, such as a loving family and spouse, and a very supportive community at Princeton University.
Fewer than one out of ten people with schizophrenia naturally make a spontaneous recovery — Nash was one of them. He was diagnosed in the late ‘50s; by 1970, he was not in any sort of treatment. He was able to resolve his illness without the use of medication or psychotherapy, which is deeply unusual.
There is no evidence that he used “willpower” to escape delusion. Rather, the delusions lessened on their own.
Two days ago, I woke up and got ready to leave my house, like I usually do in the morning. Instead, I found myself on the couch, a blanket covering me, tucked all around my body, constraining me like a straight jacket. This phenomenon has been explained to me a few times now. When people are confronted with stressors, they have a Fight or Flight response. But there’s a third option that most don’t know about, the Freeze response. I, mostly, tend to Freeze. I feel extraordinarily slow when I am frozen. It feels as if my veins are pumping pure sludge, not blood. My breath slows to a crawl. When someone speaks to me, I have a difficult time following their voice. I am told I seem a thousand miles away. I am told my gaze is difficult to hold. I am told my eyes roll up into my skull.
(Bipolar implies that the depression is accompanied by mania. And mine is. My mania never tends to fly that high, and as such, isn’t much of a burden — it’s actually a quite lovely experience. The problem with mania is that it ends, and it almost always ends with a violent crash.)
Let’s, as my mother has done since she saw A Beautiful Mind, apply a Nashian analysis to my mental illness.
If I were truly committed to beating this thing, I would endeavor to simply snap out of it. That this physiological response I have to increased stressors is something I should fight off in the moment. That the drugs I take to regulate all this — they are crutches, pure and simple. I should stare down the attacks, I should wrench myself off the couch. I should tell myself it’s in my head. I should get up, put on my walking shoes, I should move my body, fight against the lethargy I feel.
I should treat these attacks with the contempt they deserve, for having the audacity to slow me down.
I should recoil in horror from the thought of ever succumbing to this nonsense.
The problem with telling Nash’s story in such a way that implies he beat schizophrenia through willpower, rather than the visions fading on their own, is that it encourages other mentally ill people, especially those who experience psychosis, to try and beat their illness on their own.
“The notion that willpower can really overcome schizophrenia is ludicrous,” Dr. Ken Davis told ABCNews.com in 2006.
The prognoses for schizophrenia are grim. One third will make it to remission — defined as no bouts of psychosis for at least six months. One third will stay in and out of treatment for the rest of their lives. And one third will never know what’s happening to them.
The prognosis for depression, anxiety and bipolar disorder are much better. Seventy to 80% of those diagnosed with major depressive mood disorders will experience a “significant reduction in symptoms,” though the patient will have to try treatment a few times.
I am scared that I might be one of the unlucky ones, one of the 20% who won’t end up in remission from this illness. I’m scared John Nash — a man who heard voices that lied to him, a man who experienced crushing poverty as a result of his illness — might be better off than me.
After all, I first experienced symptoms when I was 19; real, serious, soul-crushing depression. It has come, without fail, once or twice (or even three times) a year, every single year, since I was a teenager. I am nearly 32. I am closer to middle age than I am to childhood, and it doesn’t matter what I do, doesn’t matter what I take, how I treat myself, how I strive, how I work, this illness graces my life no matter what I do.
No matter how well I recover from the bouts of depression — and I do, I do recover, otherwise, I would never have been able to achieve anything in my adult life — the cloud always returns. Always douses me in darkness.
I don’t know what to do about that.
I don’t know how to end this essay, except to tell you, and my mother, and everyone reading, that I’m trying. I’m trying to ignore my tormenters, the way the fictional John Nash did at the end of the movie. I’m trying to stay away from alcohol and things that I know make this worse. I’m trying as hard as I can to be better, to live better, to beat this thing. I know my mother’s interpretation of how to get over a depressive episode — through brute force and willpower — is not quite right, I know it’s off, but it’s not off by much. I know there’s something to be said for “fake it ‘til you make it.” Because you probably can’t brute force your way out of psychosis, but panic attacks and depressive episodes? Who knows.
But I know that when I wake up tomorrow, there’s a 50% chance I’ll stay in bed, because whatever is out there isn’t worth getting up for.
I know I said I’d turn paid subscriptions back on — I’m not. I don’t have it in me right now to run a successful, regular newsletter. Worrying about regularity is taking me away from the rest of the (better paid) writing I have to do. I’m also gearing up to get hired at some big terrible box store for the holidays — something that’s going to be tremendously anxiety inducing, and something that’s going to take a lot out of me.
Forgive me. I’m just not there right now.