The Collected Schizophrenias

Wang begins her first essay by commenting on the way people view schizophrenia and those with the disorder; it is painful for people to watch someone deteriorate mentally, and the disorder is often associated with a sense of doom. Schizophrenia is often spoken of in terms of the way it affects others rather than the person who has the disorder. Wang describes it as being in a dark room, apart from reality and external logic, and that being lost inside this reality must be faced with courage. Citing the National Institute of Mental Health (NIMH), Wang notes that 1.1% of Americans have schizophrenia, 3.7% have schizotypal disorder, and another 0.3% have schizoaffective disorder. Originally diagnosed with bipolar disorder, it took another 12 years to for Wang be diagnosed with schizoaffective disorder in her mid-twenties. She started experiencing auditory and visual hallucinations such as seeing demons or a train coming toward her and knew it was not normal. Wang also had trouble with concentration, brain fog, memory loss, and extreme fatigue.

Wang feels comforted by her diagnosis: “A diagnosis says that I am crazy, but in a particular way: one that has been experienced and recorded not just in modern times” (5). At the same time, she clarifies that mental disorders are sets of symptoms that happen to coincide frequently and are ultimately human constructs. Current dialogues around mental disorders question psychiatry itself, what it means to have a disorder, and how they are treated. She includes the DSM-V definitions of schizophrenia and schizoaffective disorder, noting that the latter is a combination of schizophrenia and either depression or mania. Eugen Bleuler named the disorder schizophrenia in 1908, and the word means “split mind.” This adds to the negative implications and stigmatization of the disorder, as does the use of “schizophrenic” as a casual insult.

Diagnoses have the power to change how people see themselves and how the world sees them. Diagnostic criteria and labels are constructed by doctors that patients trust and place power in. During her time working with the Stanford Department of Psychology, Wang performed research on subjects by diagnosing them using the standard Structured Clinical Interview. Subjects were turned away for not meeting enough of the specific criteria, and Wang realized that diagnosing mental illness is not as simple as the DSM makes it seem. In 2008, NIMH began an initiative to change the way mental disorders are diagnosed, turning to neuroscience and observable behavior.

The causes of schizophrenia and related disorders are only about 50% genetic, with the rest being left up to prenatal and early life stressors. Wang’s mother’s side of the family has a history of mood and panic disorders. Wang cites her experiences talking to healers and astrologers and how they and similar people often tote schizophrenia as a blessing or gift associated with creativity. She scoffs at this notion, believing that a firm connection with reality is more important than creativity. In her essay collection, Wang hopes to explore the “whys” and “hows” of schizophrenia and what people with the disorder can do to manage it.