It is far better to grasp the universe as it really is than to persist in delusion, however satisfying and reassuring.
—  Carl Sagan

The Brain Bank - Schizophrenia: Setting the Misconceptions Straight

I’m not going to lie, I do enjoy films like ‘Fight Club’ and ‘Me, Myself and Irene’, and I agree that ‘Dr Jekyll and Mr Hyde’ is a classic novel which should be read by all. But putting entertainment aside, presenting those with schizophrenia as violent individuals with split personalities does not help public understanding of the illness. Such widely believed misconceptions are only amplified further by the media. A prime example was the recent story in The DailyMail about a paranoid schizophrenic who murdered a young man. The paper nicknamed the perpetrator the ‘cannibal killer’; a catchy title which leaves no doubt in the reader’s mind that individuals with schizophrenia are a danger to others. But these views are both mistaken and highly damaging to the 21 million individuals living with schizophrenia around the world today. Hopefully the evidence presented here can go a little way towards dispelling these misconceptions.

Misconception number 1: people with schizophrenia have a split personality

The most common misconception about schizophrenia is that people with the illness have a split personality; that is, they may be their normal selves one minute and then seem like a completely different person the next. In a survey carried out by the National Alliance on Mental Illness (NAMI), 64% of Americans said that they share this belief.

However, what people are actually describing when they talk about a split personality is a condition known asdissociative identity disorder (DID; previously multiple personality disorder). People with DID generally present with around 13–15 different personalities and, in some cases, have even been known to have up to 100! Those with schizophrenia, on the other hand, tend to suffer from hallucinations and paranoia, often hearing voices or believing that someone is ‘out to get them’. The two conditions are very different and should not be confused.

Of course, this misunderstanding is not helped by fact that the term ‘schizophrenia’ means ‘split mind’ in Greek. The name was, however, coined a long time ago, before the symptoms of schizophrenia were properly understood. A significant number of experts in the illness now believe this term is inappropriate and agree that schizophrenia should be renamed.

Misconception number 2: all people with schizophrenia are violent

The belief that all people who suffer from schizophrenia are violent is another widely held misconception. Going back to NAMI’s survey, around 60% of Americans identified violent behaviour as a symptom of schizophrenia. Why is this the case?

Putting aside the obvious influence of films and media, there are studies which have found a correlation between mental illness and violence. Swanson, for instance, concluded in his 1994 study that those with a mental illness, including schizophrenia, were twice as likely to be violent as the general population. This correlation, however, could be explained by the presence of co-existing substance abuse, rather than the mental illness itself. In fact, only 7% of the individuals in the study who had a mental illness but did not use drugs had shown violent behaviour.

More recent investigations by Swanson (2002) and Elbogen (2009) further support the argument that factors other than mental illness may predispose an individual to violence. These studies found that, apart from substance abuse, factors associated with violence in the mentally ill included homelessness, physical abuse and unemployment. Mental illness alone was found to be unrelated to violence and those without any co-existing risk factors were no more likely to be violent than someone from the general population.

On the same topic, the belief that individuals with schizophrenia are violent towards others is not necessarily the case either. In fact, people with schizophrenia are more likely to hurt themselves than those around them, having an 8.5 fold higher suicide risk than the general population.

This is certainly not the first article hoping to dispel the misconceptions that people with schizophrenia are violent or have a split personality, nor will it be the last. But with popular films, such as ‘Fight Club’ and ‘Me, Myself and Irene’, and headline news stories reinforcing these misperceptions, it’s going to take a lot of work to change public view of schizophrenia. Perhaps the introduction of a new name could help dissociate schizophrenia from these stereotypical portrayals, allowing us to be entertained by stories like ‘Fight Club’ or ‘Dr Jekyll and Mr Hyde’, without letting them shape an inaccurate public perception of a mental illness.

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Spesso mi chiedono perché sono sempre così isolata dal resto del mondo. La mia risposta è sempre la stessa: perché mi piace la solitudine. Ma la sai una cosa? Se incontri un ragazzo solitario, non importa quello che ti dice, non è perché gli piace la solitudine. È perché ha già provato a mescolarsi con il resto del mondo e la gente continua a deluderlo.
The child destined to be a writer is vulnerable to every wind that blows. Now warm, now chill, next joyous, then despairing, the essence of his nature is to escape the atmosphere about him, no matter how stable, even loving. No ties, no binding chains, save those he forges for himself. Or so he thinks. But escape can be delusion, and what he is running from is not the enclosing world and its inhabitants, but his own inadequate self that fears to meet the demands which life makes upon it. Therefore create. Act God. Fashion men and women as Prometheus fashioned them from clay, and, by doing this, work out the unconscious strife within and be reconciled. While in others, imbued with a desire to mould, to instruct, to spread a message that will inspire the reader and so change his world, though the motive may be humane and even noble – many great works have done just this – the source is the same dissatisfaction, a yearning to escape.
—  Daphne du Maurier