Mental Illness

Mental Illness

One in every hundred people will develop schizophrenia in their lifetime. At the beginning of the 21st century, three hundred thousand Canadians aged sixteen to thirty have been diagnosed with schizophrenia. The average time between onset of symptoms and fist effective treatment is one to two years, but be much longer.

Males and females are equally likely to be diagnosed with schizophrenia. But males tend to have an earlier age of onset, in the teens or early twenties for men, and in the twenties or early thirties for women. Nearly 80 per cent of people with schizophrenia experience a major depressive episode at some point in their lives.

Approximately four out of every ten people with a diagnosis of schizophrenia attempts suicide, and approximately one in ten people diagnosed with schizophrenia die of suicide, making it the leading cause of premature death for people with with schizophrenia. Besides, suicide in this population is rarely attributable to florid psychotic symptoms (hallucinations, delusions); it is more likely to occur in periods of remission or improved functioning. Depression and hopelessness are important factors in suicide by people with schizophrenia.

Tom Ko has worked with 160 families in his job as therapy supervisor at the Calgary Early Psychosis Treatment and Prevention Program. Many – but not all – of his clients are young enough to be living at home with parents and siblings. Ko, who has a master's degree in social work, encourages the whole family to attend psychoeducation sessions with him. “Not all siblings have strong emotional reactions to the illness,” says Ko, a social worker. “But all have some reaction to a psychotic illness in the family.”

How Siblings Are Affected

Here are some of the common emotions and issues raised by the siblings:

1. Anger of parents (“Why don't they take control and fix this?”) and at the unwell sibling (“Why doesn't he just get better?”) “They get angry a lot because things have changed, “Ko says. “They want their brother or sister back.”
2. Grief and sadness: “Because the family isn't the same, and they can sense that.” Ko says that children go through a grieving process just as parents do. “When things change and everything's up in the air, they do get depressed.”
3. Fear that they'll become mentally ill. “Not the seven-year-old but the fourteen-year-old says, “Will I get it?” And we are always upfront.” (Research shows that if you have a first-degree relative with schizophrenia, you in turn have a 10-per-cent chance of winding up with the disorder; this compares to a 1-per-cent chance for someone with no diagnosed relatives.)
4. Guilt that they contributed to their sibling's disorder, or made it worse. For example, two brothers may have been fighting just before one is diagnosed (which is not uncommon because the sibling relationship changes with the onset of symptoms). “We try to tell them, “ You didn't know; of course you got into fights; everybody does, but it didn't cause the illness.
5. Loss of normal family relationship: When parents are tied up with hospitals and meds and caring for their unwell child, says Ko, “It's easy to forget there are other kids involved... Often they (the siblings) will say “we used to have family dinners together, do this and that together.” We try to get them back to those family routines so that everything goes back to normal as much as possible.”
6. Confusion because they know something is wrong but no one is explaining what or why. “They find it very difficult to understand sometimes. They can tell their brother or sister is different, they can tell their family is different, and they wonder. But it just becomes a family secret that no one talks about. They want to know what's going on.”

People can recover. Most of the people who have recovered have been at the depths of depression or the depths of some other illness, and they have made it back to find a life worth living with meaning and purpose. Illustration by Elena.

Mental Disorder

Mental Disorder: What It Feels Like?

Unless you've been there, it can be pretty difficult to imagine what it's like to suffer from a mental disorder. What does it truly feel like to experience the delusions or voices that come with schizophrenia? To soar with the unbridled euphoria of a mania? To shake with the heart-numbing fear of a panic attack?

Short of actually having the disorder, there are very few ways of comprehending what it's like to be inside someone else's head. We could rattle off lists of clinical symptoms, but that would get dull pretty fast. It also wouldn't really give you a visceral sense of the experience.

Yet all of us are curious. Scientists, in fact, have tried to give other folks a taste of what mental disorder feels like. One of the most intriguing efforts is a virtual-reality setup which, using specially enhanced audio and visual effects, attempts to transport the subject into the mind of someone with schizophrenia. You actually hear those internal voices in a manner that those with the disorder say comes close to their reality.

Some sources will tell you that manic depression, or bipolar disorder, as it's also known, rarely shows itself much before the the age of eighteen. But ask any of my friends, reachers, or family – any of those brave souls who traveled with the ill person through his or her life – and they will vigorously dispute that claim.

A rapid cycler, mood changes are like gunfire in the trenches – bang, bang, bang. Light, dark, light, dark. Nobody knows if it's possible to switch a light on and off as quickly as brain manages to switch between euphoria and devastation.

These people spend part of their lives feeling as though they will never join the human race. It's as though they live in a cage where they can hear the world but the world cannot hear them. After years, they see this simply as a manifestation of their illness, which has a way of making the ordinary seem threatening and frightening. Paranoia is more than an occasional visitor. People affected have sat on the subway, convinced that others were laughing at them; they have left parties after an hour, certain that the guests thought the ill persons had no right to be among them. Manic depression can make that girl in The Exorcist (at her writhing, screaming, priest-hating worst) look like someone you would ask to babysit their three-year-old. But these people own their illness. And it will be part of them for the rest of their lives. People can't turn their back on it.

People have been asked if they see their illness as a tragedy, or at least as something that's robbed them of anything of vital importance. Sometimes they do. But stress is a killer; it can initiate the descent into depression, the rise into mania. These people have learned to be vigilant about avoiding those situations that will exacerbate their disease.

The illness also destroys relationships, chewing them up, spitting them out. These people mourn the friendships they have lost. Their behavior – especially when manic – has alienated friends and relatives. In some cases, the ill persons have never been able to reconnect with them.

And yet, many of them can't say that they think of themselves as tragically touched. It is like being born with red hair or brown, one eye or three; you know nothing different, so what does it matter^ We all have a cross to bear. They will carry their cross for all their life.

There's a saying you sometimes hear in the mental health world: Label belong on soup cans, not people. Illustration by Elena.

Hull Zero Three

Hull Zero Three

(by Greg Bear, excerpt)

Core Memory

Something in the hull recognises us and tries to do us a favour by reconnecting us with what we are supposed to know and feel. There’s a little confusion because there’s two of us, but that’s okay - the system can be creative if it has to, and with a little modification, there we are, back on Earth, young twins with our whole lives ahead of us, training to embark on a journey to the newly outfitted Golden Voyager. That’s the name of this Ship, I think - we think.

We’re going to become part of the crew. The destination crew.

My twin and I don’t always get along, but we went through gaining together, and we rely on each other for solving major problems - including women. Though of late we have been suffering through competition over a particularly lovely lass named -

(And here it gets strange, because that brings up fragments of future memories, the broken bits of my history available to Hull Zero One when I was - )

Don’t be silly. That’s just part of the terrible dream. You aren’t made in deep space - you’re frozen with al of your shipmates, your future partners in the colonies, and the Golden Voyager - 

Whatever. I can very clearly anticipate my parter in the staging area, boldly looking at me along the line of the first landing party, exchanging those excruciatingly meaningful glances of first adoration, then lifelong bonding. We are meant for each other - so why would my twin interfere?

But we have so much to catch up on. Mother and Father,, sister, education up through secondary, physical adaptation and augmentation, getting our freezing-down organs installed after first qualifications, long summer days at Camp Starfield, our first test freeze… We all come out healthy and whole, not even hungover, and now we’re ready for that installation flight out to the edges of the Oort cloud, to meet up with the chose moonlet, on which is trapped the growing frame of our Ship. This is a journey of almost nine months, because it’s illegal to light off bosonic drives within the system.

So clear. I suppose that even in my confusion and my conflicting emotions, seeing our unborn Ship for the first time, far out in the darkness where only starlight matters, fastened like a tiny golden octopus to the long end of the moonlet - seeing all this is useful, helpful, but why does it have to come attached to so much imaginer bullshit? I’m just fine without a backstory. I know the real story.

They pump us full of this continuity for psychological reasons – but why? They don't trust us. We're designed to be deceived.

We find spaces within the cramped living quarters, all three hundred of us, handpicked, tested, trained, passed – superior emotionally and physically to Earth's best and brightest, filled with that glow of knowing where we're going what we're going to do, flying in the most expensive goddamned object ever devised by the hands of humanity...

And as we go into the freezers to become time travelers into the future, to awaken five or six hundred years hence, we're filled with an overwhelming joy at our destiny, more intense than anything we've experienced.

Spaceships. Illustration by Elena.

Darwin's Dangerous Idea

Darwin's Really Dangerous Idea

Adaptation by natural selection is among the most successful and influential ideas in the history of science, and rightly so. It unifies the entire field of biology and has had a profound influence on many other disciplines, including anthropology, psychology, economics, sociology, and even the humanities. The singular genius behind the theory of natural selection, Charles Darwin, is at least as famous as his most famous idea.

You might think that my contrarian view of the limited power of adaptation by natural selection would mean that I am “over” Darwin, that I am ready to denigrate the cultural/scientific personality cult that surrounds Darwin's legacy. Quite to the contrary, I hope to celebrate that legacy but also to transform the popular understanding of it by shedding new light on Darwinian ideas that have been neglected, distorted, ignored, and almost forgotten for nearly a century and a half. It's not that I'm interested in doing a Talmudic-style investigation of Darwin's every word; rather, my focus is on the science of today, and I believe that Darwin's ideas have a value to contemporary science that has yet to be fully exploited.

Trying to communicate the richness of Darwin's ideas puts me in the unenviable position of having to convince people that we don't actually know the real Darwin and that he was an even greater, more creative, and more insightful thinker than he was been given credit for. I am convinced that most of those who think of themselves as Darwinians today – the neo-Darwinians – have gotten Darwin all wrong. The real Darwin has been excised from modern scientific hagiography.

The philosopher Daniel Dennett referred to evolution by natural selection – the subject of Darwin's first great book, On the Origin of Species by Means of Natural Selection = as “Darwin's dangerous idea.” Here I propose that Darwin's really dangerous idea is the concept of aesthetic evolution by mate choice, which he explored in his second great book, The Descent of Man, and Selection in Relation to Sex.

Why is the idea of Darwinian mate choice so dangerous? First and foremost, Darwinian mate choice really is dangerous – to the neo-Darwinists – because it acknowledges that there are limits to the power of natural selection as an evolutionary force and as a scientific explanation of the biological world. Natural selection cannot be the only dynamic at work in evolution, Darwin maintained in Descent, because it cannot fully account for the extraordinary diversity of ornament we see in the biological world.

It took Darwin a long time to grapple with this dilemma. He famously wrote, “The sight of a feather in a peacock's tail, whenever I gaze at it, makes me sick!" Because the extravagance of its design seemed of nu survival value whatsoever, unlike other heritable features that are the result of natural selection, the peacock's tail seemed to challenge everything that he had said in Origin. The insight he eventually arrived at, that there was another evolutionary force at work, was considered an unforgivable apostasy by Darwin's orthodox adaptationist followers. As a consequence, the Darwinian theory of mate choice has largely been suppressed, misinterpreted, redefined, and forgotten ever since.

Aesthetic evolution my mate choice is an idea so dangerous that it had to be laundered out of Darwinism itself in order to preserve the omnipotence of the explanatory power of natural selection. Only when Darwin's aesthetic vies of evolution is restored to the biological and cultural mainstream will we have a science capable of explaining the diversity of beauty in nature.

 (From the book The Evolution of Beauty. How Darwin's Forgotten Theory of Mate Choice Shapes the Animal World – and Us. By Richard O. Prum).

Given that sexuality is an instinct is traditionally defined as a hereditary behaviour unique to a species, varying little from one member to the next, the variety of our sexual tastes is curious. Photograph by Elena.

After the Apocalypse

After the Apocalypse

(Excerpt, short story by Maureen F. McHugh)

... Things didn't exactly all go at once. First there were rolling brownouts and lots of people unemployed. Jane had been making a living working at a place that sold furniture. She started as a salesperson, but she was good at helping people on what colors to buy, what things went together, what fabrics to pick for custom pieces. Eventually they made her a service associate, a person who was kind of like an interior decorator, sort of. She had an eye. She'd grown up in a nice suburb and had seen nice things. She knew what people wanted. Her boss kept telling her a little less eye makeup would be a good idea, but people liked what she suggested and recommended her to their friends even if her boss didn't like her eye makeup.

She was thinking of starting a decorating business, although she was worried that she didn't know about some of the stuff decorators did. On TV they were always tearing down walls and redoing fireplaces. So she put it off. Then there was the Big Disney World attack where a kazillion people died because of a dirty bomb, and then the economy really tanked. She knew that business was dead and she was going to get laid off, but before that happened, someone torched the furniture place where she was working. Her boyfriend at the time was a cop, so he still had a job, even though half the city was unemployed. She and Franny were all right compared to a lot of people. She didn't like not having her own money, but she wasn't exactly having to call her mother in Pennsylvania and eat crow and offer to come home.

So she sat on the balcony of their condo and smoked and looked through her old decorating magazines, and Franny watched television in the room behind her. People started showing up on the sidewalks. They had trash bags full of stuff. Sometimes they'd have cars and they'd sleep in them, but gas was getting to almost ten dollars a gallon, when the gas stations could get it. Pete, the boyfriend, told her that the cops didn't even patrol much anymore because of the gas problem. More and more of the people on the sidewalk looked to be walking.

“Where are the coming from?” Fanny asked.

“Down south. Houston, El Paso, anywhere within a hundred miles of the border.” Pete said. “Border's gone to shit. Mexico doesn't have food, but the drug cartels have lots of guns, and they're coming across to take what the can get. They say it's like a war zone down there.”

“Why don't the police take care of them?” Franny asked.

“Well, Francisca,” Pete said – he was good with Franny, Jane had to give him that - “Sometimes there are just too many of them for the police down there. And they've got kinds of guns that the police aren't allowed to have.”

“What about you?” Franny asked.

“It's different up here,” Pete said. “That's why we've got refugees here. Because it's safe here.”

“They're not refugees”, Jane said. Refugees were, like, people in Africa. These were just regular people. Gays in T-shirts with the names of rock bands on them. Women sitting in the front seats of Taurus station wagons, doing their hair in the rearview mirrors. Kids asleep in the back seat or running up and down the street shrieking and playing. Just people.

After the End. An empty room. Photograph by Elena.