Gaining on Insanity

kw: book reviews, nonfiction, mental health, quests

Mental health, or its lack, runs in families. Not all offspring of an afflicted person, or couple, will manifest the disease, but the chances are higher. Being bipolar (thankfully at a moderate level), I recognize that my mother was also bipolar, but my father and brothers seem to be unaffected, and my son is remarkably stable, thank God!

Patrick Tracey is not so fortunate. Several of his family members are schizophrenic, though he himself is not. In Stalking Irish Madness, Searching for the Roots of My Family's Schizophrenia he chronicles the disease in his grandmother, two sisters and an uncle, and his grandmother's great-grandmother. His grandmother was a Sweeney, of a family in which madness is well known, and the earlier ancestor was an Egan, probably the most-afflicted surname. The variant Madigan actually refers to the "Mad Egans".

The author is not schizophrenic, though his writing shows evidence of paranoid tendencies. However, knowing his family history, is it paranoia to decide against having offspring, who'd have a great chance of mental illness? This is similar to a cousin of mine, who had her tubes tied because she didn't want to have offspring who might carry or suffer her extreme allergies.

By the way, not all schizophrenics are paranoid; the designation "paranoid schizophrenic" is a distinct category. Schizophrenics in general are those who are so troubled by various kinds of hallucination that they cannot function normally. Many hear voices, but not all. The afflicted among Egans and Madigans are so troubled by voices that they cannot pay much attention to "real life" around them. The author's sister Austine is almost catatonic, being so overwhelmed with voices that she seldom hears anything else, while his other afflicted sister, Michelle, cheerfully carries on dialog with her voices, but can include "outside persons" in the conversation.

Other schizophrenics see things others don't see, or hallucinate other senses such as touch, taste or smell. In all cases, the diagnosis is typically given when the hallucinations dominate the person's life. Whatever the sort of hallucination, in schizophrenics it rises to the level of obsession, and is typically accompanied by delusional thinking.

Sometimes the delusion is itself the affliction; this is the case with paranoid schizophrenics such as a friend of mine. He is able to function normally for various periods of time, but unless he takes his medications, he frequently "flips out" and may flee imagined persecution. He once held a steady job as an electronic engineer, and was doing side jobs. When he found out that some of the devices he was making were being used for illegal gambling, he became convinced that he was a target of organized criminals, and fled halfway across the country. Later checking uncovered that the supposed "mafiosi" were in no way organized, but were a couple of petty criminals. But he has not moved back, nor has he obtained long-term employment since.

The stereotypical schizophrenic is the raving, voice-ridden "nut" that one might see on a street corner. Considering that one person in a hundred is afflicted by overpowering voices, we all know at least one. However, not all who hear voices are schizophrenic. I'll offer myself for an example. In the hypomanic phase of my bipolar cycle (I seldom experience full-blown mania), I hear voices whenever I shut my eyes, but not with my eyes open. I can seldom understand the words, or at least I don't recall what they say. In quiet circumstances, particularly with subdued light (like a business meeting with PowerPoint in progress!), I tend to drift into a state of lucid dreaming, with both visual and auditory sensations. I can usually tell the difference between such hallucinations and reality…usually.

Thus, it seems Pat Tracey is saner than I, or perhaps more circumspect. Much of the book's content narrates his travels through Ireland, seeking information about his ancestors and their sanity, and the prevalence of madness among the Irish. He is drawn eventually to a well in farthest western Ireland, called Gleanna-a-Galt. Its waters are reputed to heal the mentally afflicted. He gathers some of the water to take to his sisters. He finds that the water contains a high level of lithium. That is known to help bipolar people, and can help many schizophrenics also, so the well's reputation is probably well founded.

When he returns home, he slips some of the water to each sister, but gives no report about its effectiveness. It is sad to think they got no help from it, but it is better for bipolar. Among those I know who have bipolar disorder, lithium salts are the most consistently effective treatment, though the therapeutic dose is a nearly toxic level; it has to be watched. The amount in Gleanna-a-Galt well water is much lower than the amount given medically.

The author's conclusion is that schizophrenia's cause is not wholly genetic, but rather that certain genetic types are more likely to react to stressful circumstances by "flipping" into a hallucinatory state, and they never flip back. I see the affliction in all its forms as several extreme manifestations of ordinary variations of human experience, particularly in the tendency to dream lucidly.

Some people, like my solidly stable wife, seldom remember dreaming in sleep, though sleep researchers assure us that everyone dreams for part of every night's sleep. People like myself dream frequently, often remember the dreams, and may begin dreaming before being fully asleep. Others find dreams popping up while they are fully awake. When such dreams cause trouble, they become symptoms of schizophrenia.

Although schizophrenia means "divided mind", the experience is really one of being divided from common experience, because of the distractions of the hallucination/dream. Dissociation of a personality into more than one seeming entity is a different condition entirely, though it often happens that one or more of the dissociated fragments becomes a distraction to the "main person", leading to a condition that is schizophrenic in effect, whether that is the correct DSM diagnosis or not (DSM is the acronym for the Diagnostic and Statistical Manual of Mental Disorders).

While Patrick Tracey could not find out everything he sought, nor effectively treat his sisters, he did come to terms with the disease and its history in his family. His trek to Ireland was a kind of flight, and at its end, he is at peace to return home, to help his family cope as best they can with the incurable. While I hope and pray for his sisters, as well as others I know who are so afflicted, I know that the disease seldom leaves, and is quite resistant to all treatments. Pray with me for continued medical progress, and perhaps breakthroughs!