Go Ad-Free
logoThe People's Perspective on Medicine

Show 1373: Malady of the Mind

People with schizophrenia, the malady of the mind, do best with early diagnosis and treatment as well as adequate social support.
Current time

Malady of the Mind

0% played% buffered

This week, our guest is one of the country’s leading experts on schizophrenia, Dr. Jeffrey Lieberman. He teaches at the Vagelos College of Physicians and Surgeons, part of Columbia University, where he studies the treatment of mental illness. His research led to the therapeutic strategy of early detection and intervention for a malady of the mind, schizophrenia.

You may want to listen through your local public radio station or get the live stream at 7 am EDT on your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on February 12, 2023.

Schizophrenia, Malady of the Mind:

Names for schizophrenia and explanations for why it occurs have changed over the centuries. But we can trace this mysterious mental illness back through human history. For most of that time, those suffering have been stigmatized, isolated and mistreated. Now, though, we have the possibility of effective treatment that could greatly change people’s lives.

According to Dr. Lieberman, schizophrenia has afflicted a similar proportion of the population in different countries and cultures for a long time. Now, however, rates in the US are beginning to rise. He suspects that widespread access to cannabis, ketamine and psychedelic drugs like psilocybin might be pushing vulnerable adolescents over the edge.

What Is Schizophrenia?

This mental illness is characterized by delusions and disorganization in thought patterns, failure of logic in the train of thought and sometimes hallucinations–hearing or seeing things that others do not perceive. If a person suffers repeated bouts of these mental breakdowns, they may end up with impaired mental capacity due to the harm done their brains.

The Importance of Early Diagnosis:

The polygenic brain disorder we call schizophrenia rarely appears before puberty. It is most likely to show up in adolescents and young adults, which can interfere with a timely diagnosis of this malady of the mind. Many youngsters may struggle around this time, while they are striving to establish their individual identities. They may not be living at home; as a result, parents might have a hard time noticing clues that a young person’s brain is going awry.

Without early diagnosis, however, a person cannot get prompt treatment. Starting effective treatment in a timely fashion and getting adequate social support is critical for the individual’s chance of recovery. While once the prognosis was thought to be bleak, we now have evidence that early, coordinated treatment can be very effective and protect the brain from harm.

The Failure of De-institutionalization:

If you have ever heard of Dorothea Dix, you know that this country once had sizable facilities dedicated to treating people with mental illness. In 1955, these housed some 550,000 individuals. In the 1960s and 1970s, however, most of these institutions were phased out. The motivation was doubtless, in part, to put an end to abuses like those depicted in the novel, One Flew Over the Cuckoo’s Nest. For this move to have served people with a malady of the mind, though, we would have needed to establish outpatient treatment facilities and psychosocial support. For the most part, these are inadequate. Consequently, too many people with mental illness including schizophrenia may end up homeless or in some kind of trouble.

Violence and the Malady of the Mind:

Politicians frequently respond to a violent act such as a mass shooting by blaming mental illness. Without more comprehensive care for those with schizophrenia, however, it is nearly impossible to determine who might be on the verge of a violent act so that it could be prevented.

Treating Schizophrenia:

There are a number of medications that doctors prescribe for people with schizophrenia. Most work on dopamine receptors; the most obvious differences among them relate to their side effect profiles. One antipsychotic drug, clozapine, is more effective than the others. Because it may occasionally cause a blood disorder, however, it is underutilized.

There are three essential components for effective treatment. First, the patient needs an effective medication. But that is only the start. In addition, people with schizophrenia need psychosocial services to help them put their lives back together. Third, and possibly most important, they need the consistent support of a significant other.

As a society, we need to take this malady of the mind seriously. Early detection and appropriate treatment can change the course of a person’s life. Beyond that, we need to provide residential services that offer people with schizophrenia safe places to recover from their delusions.

This Week’s Guest:

Jeffrey Lieberman, MD, is Professor and Constance and Stephen Lieber Chair in Psychiatry at Columbia University, Vagelos College of Physicians and Surgeons. Dr. Lieberman’s research has advanced the treatment of mental illness and led to the groundbreaking therapeutic strategy of early detection and intervention to prevent the onset of schizophrenia. While on the faculty of the University of North Carolina at Chapel Hill, he led the CATIE Study the largest study ever funded by the United States National Institute of Mental Health comparing the effectiveness of drug treatments for schizophrenia.

His research is published in over 800 scientific articles and 20 books including the critically acclaimed Shrinks: The Untold Story of Psychiatry and MALADY OF THE MIND: Schizophrenia & the Path to Prevention.

Portrait of Dr. Jeffrey Lieberman, author of Malady of the Mind

Jeffrey Lieberman, MD

Listen to the Podcast:

The podcast of this program will be available Monday, February 12, 2024, after broadcast on Feb. 10. You can stream the show from this site and download the podcast for free.

Download the mp3.

Rate this article
4.6- 18 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
Tired of the ads on our website?

Now you can browse our website completely ad-free for just $5 / month. Stay up to date on breaking health news and support our work without the distraction of advertisements.

Browse our website ad-free
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.