Assessment of Mental Illness in the Movie 'A Beautiful Mind'

This article delves into the assessment of mental illness, specifically schizophrenia, as depicted in the movie "A Beautiful Mind." The film portrays the life of John Nash, a Nobel Laureate in Economics, who suffers from paranoid schizophrenia. The article explores the disease's etiology, pathophysiology, and treatment methods, highlighting the impact of schizophrenia on the individual, family, and friends. It also examines the stigma associated with the disease and the importance of education and awareness in mitigating its negative effects. Through a detailed analysis of the movie, the article provides insights into the challenges faced by individuals with schizophrenia and their loved ones, emphasizing the need for comprehensive care and support.

Assessment of the mental illness in the
movie “A beautiful mind”
Contents
Introduction:...............................................................................................................................................2
Understanding the disease, its etiology and patho physiology:..............................................................3
Assessment and treatment of schizophrenia:.........................................................................................5
Impact of schizophrenia on the individual, family and friends................................................................6
Stigma associated with schizophrenia:....................................................................................................9
Conclusion:................................................................................................................................................11
References:................................................................................................................................................12
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Introduction:
A mental disorder or disease is a behavior or state of mind which causes loss of touch with
reality (psychosis) in an individual. This article is centered on the assessment of the disease
focused on the movie “a beautiful mind”. The lead character of John Nash, a Nobel Laureate in
Economics is shown to suffer from paranoid schizophrenia. Schizophrenia is a serious mental
condition from which nearly 1% of the total world population suffers (Ju et al, 2016). The movie
emphasizes how schizophrenia turns John's life upside down affecting his personal and
professional life. The movie shows John's fight against the disease, his treatment method, and
the barriers he faced in his fight against his mental condition. Paranoid schizophrenia is the
most common form of schizophrenia. Schizophrenia is a mental condition in which the patient
suffers from delusions accompanied by hallucinations (Karrow et al, 2014). The patient mainly
starts hearing not – existing voices and starts believing in them. Besides the above-mentioned
symptoms, the patient also shows the absence of certain symptoms i.e. negative symptoms.
Disorganized speech, disorganized behavior, executive function deficits, working memory, and
recognition memory are cognitive symptoms which are seen less frequently (Ju et al, 2016). Due
to the auditory- hallucinations these patients can sometimes even be seen talking to “no
one”.The paranoid delusions in the schizophrenia tend the patient to think that everyone
around them is trying to harm them (Karrow et al, 2014). This is the condition from which John
in the movie suffered. Initially, he assumed he was working for United States Department of
Defense against the Russians under a mysterious supervisor by the name of Parcher. He starts
feeling he is being followed by the Russian intelligence and his family is constantly under threat.
His delusions even lead to the wreckage of his family and hurting his loved ones. A similar
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condition is experienced by most of the schizophrenia patients. Many tend to indulge in
dangerous criminal acts overpowered by these delusions (Peterson et al, 2014). The
entertainment industry is helping such patients by increasing the knowledge about
schizophrenia by making movies directed at the condition of individuals suffering from it.
Understanding the disease, its etiology and patho physiology:
Till date, it is not known what causes schizophrenia but a combination of genetics, brain
chemistry, and the environment is assumed to the cause of the disease. Prenatal exposure to
viral infections, low oxygen tension during childbirth, early separation from parents, viral
infection in infancy, sexual, verbal or physical abuse during childhood is assumed to be the
causes. A history of schizophrenia in the family, older age of father, birth complications,
autoimmune disorders, consumption of psychoactive drugs in teenage time is thought to be the
triggering factors for schizophrenia. Cannabis smoking is also assumed to be one of the causes
of schizophrenia (Karl et al, 2017). John’s professional life was rocketing sky high when he
abruptly fell victim to schizophrenia. His professional and personal life became suspended. He
even created an imaginary roommate and niece. In a study (Austin, 2017) it was seen that
individuals with higher I.Q are more prone to mental illness. This can be credited to the fact
that they are more responsive to the environment. Here in the movie under consideration " a
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beautiful mind" the lead character John plays the character of a highly educated economics
laureate with scholarship in mathematics. Although not proved, but this can be assumed as one
of the reasons for the character's schizophrenia. Again the correct path physiology of
schizophrenia is not yet understood, however, it is assumed that Dopaminergic, glutamatergic
and GABAergic neurotransmitter systems might be affected. The N- methyl- D- aspartate
receptor which is a major glutamate receptor subtype might be the causative factor. Abnormal
modulation of NR1 has been seen in the patients with schizophrenia (Ju et al, 2016). It is
assumed that the disease is caused due to the dysfunction of the interneurons, abnormalities of
the immune system and inappropriate myelination of the nerves. Besides these above-
mentioned theories regarding the abnormal functioning of the systems, latest researchers have
shown certain subtle average changes in the volume of certain areas of the brain in patients of
schizophrenia is seen as compared to other individuals. Patients with schizophrenia had a
smaller hippocampus, amygdala, thalamus and intracranial volumes. They also showed an
increase in lateral ventricle volume and pallidum (van Erp et al, 2016). Schizophrenia can lead to
suicidal tendencies, self-injury, obsessive-compulsive disorder, aggressiveness (although rare)
depression, social isolation, legal or financial or professional or personal problems etc. Here in
this movie " a beautiful mind" found working for the made up secret United States Defense
association more than his real job at MIT. He becomes obsessive about his new cooked up
decoding work and isolates himself from the real life. He almost drowns his toddler in the tub
out of ignorance and manages to injure his wife and newborn. As a result of which his wife
decides to flee with his baby.
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Assessment and treatment of schizophrenia:
In one particular scene in the movie, John is delivering a lecture at Harvard University. He on
sighting Dr. Rosen attempts to flee assuming Dr. Rosen is leading Russians to kill him. In this
attempt, he punches Dr. Rosen and has to be forcibly sedated to cool him down while he
continues to assume the health care center as a Soviet center. Hallucinations and delusions are
common in schizophrenia. Only does here Dr. Rosen confirms John's wife Alicia of John's
disease. John is put on a course of insulin shock therapy which he stops taking after some time
as the side effects of the medication make him lethargic and unresponsive. As he discontinues
his treatment his disease relapses. Later on, in the John accepts his disease and understands
that he has been creating characters which did not exist in his mind. He decides to fight the
disease without taking medication and his wife supports his decision. It takes him a decade to
completely win over his mind without taking medications and he finally learns to ignore the
characters he had created. There is no permanent treatment of paranoid schizophrenia and
requires lifelong treatment with neuroleptics (Polymeropoulos, 2017). According to the research
(Hasan et al, 2015) comorbid depression, suicidality can be caused due to biological treatment
including antipsychotics and other pharmacological preparations in schizophrenia patients.
Many patients have difficulty in accepting their diseased condition. So was shown in the movie.
For successful treatment, a schizophrenic needs help and care from doctors, psychiatrist,
psychotherapists, nurses, family members, pharmacist, psychiatric nurses and social workers.
Patients tend to become non- compliant towards the neuroleptic therapy due to the side
effects. Similar was the situation of John who had discontinued his medication due to increased
lethargy and unresponsiveness. The neuroleptics also increase blood pressure, cholesterol,
blood sugar and the patients tend to increase weight. The main treatment of schizophrenia
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includes neuroleptics, electroconvulsive therapy, psychotherapy, hospitalization and speech
therapy. In a research (Haddad et al, 2014) it is seen that non- adherence to the treatment in
schizophrenia is very common and often neglected by the clinician as it causes social isolation,
stigma, comorbid substance misuse, depression, decreased responsiveness and increased
lethargy. Non- adherence to the treatment plan affects more than one- third of the
schizophrenic population and John was no exception to it. Decreased compliance to the
treatment or discontinuation of the treatment causes increased the risk of relapse, re-
hospitalization, self-injury and decreased the quality of life. John too after discontinuing his
medication due to its side effects started experiencing hallucinations again. Research shows
preliminary evidence that cognitive therapy via psychological interventions can be an
acceptable and effective method of treatment for those who do not wish to opt for
antipsychotic medications (Morrison et al, 2012). Although adequately powered randomized
control is yet required. A similar method was adopted by the lead in the movie "a beautiful
mind" who chose to counsel himself and controlled his mind by psychological interventions
instead of medications. He had full support from his wife in doing so and eventually after a
decade he could settle back in his normal life and could keep his demons at bay. It has also
been observed that the relapse rate of schizophrenia is reduced by twenty percent if family
intervention is included in the treatment (Pitschel-Walz et al, 2015).
Impact of schizophrenia on the individual, family and friends
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In the biographical drama film, “a beautiful mind” John Nash is depicted as a successful Nobel
laureate, with a scholarship in mathematics. Success and fame were at his feet. Eventually with
the progress of schizophrenia his life suffered turmoil. He isolated himself from society and
started taking pleasure in his imaginary service to United Nations Department of Defense than
his job at university. He even had once almost drowned his toddler in the bathtub while he was
engulfed in working for the secret agency he had cooked up in his mind. Not only that, he
stayed in constant fear of being attacked by the Russians. He also feared that Parcher- one the
creations of his schizophrenic mind is trying to kill his wife. In an attempt to save her from this
imaginary attack he trips his wife and baby. After this incident John's wife decides to flee
further complicating his personal life. All such incidences are common in a schizophrenic. The
movie exactly shows the hardships of life of a schizophrenic. He also creates characters in his
mind like his roommate, his niece etc. Some of those characters inspires him and gives him
courage for e.g. his imaginary niece motivates him to propose to Alicia. While a few like Parcher
or Dr. Rosen continue to scare him. He even attacks Dr. Rosen in an event where he had to
deliver lecture as he thought Dr. Rosen was a Soviet agent trying to kill him. All such
hallucinations and delusions make life of schizophrenic as well as family and friends difficult.
Schizophrenia and related mental illness are associated with increased incidents of violent
crimes, suicides, and premature deaths (Fazel et al, 2014). Chances of violent behavior are
expected to be seven times more than the normal in this disease. As we can see in this movie
John turned aggressive when he was being taken to health care center after the mishap at the
Harvard University and had to be forcibly sedated to control him because of his delusions. Very
little is known about the triggering factors of such outcomes though. In a study it is seen men
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and women with schizophrenia tend to commit suicide in the first five years of the diagnosis of
the disease (Fazel et al, 2014). Risk of violent crimes is more in schizophrenic patients with
substance abuse (Fleischman et al, 2014). One other distressing complain from the
schizophrenic patient is disturbance in sleep (Li et al, 2017). The patients complain of insomnia,
nightmares and specific psychotic experiences. As already mentioned above, John always
stayed in fear of being killed or followed. In studies insomnia is frequently found associated
with paranoia. Patients complain of having nightmare at least once in a week (Li et al, 2017).
These cause impaired quality of life in patients with schizophrenia. Not just the control of
psychosis, these patients require a treatment focused at need of sleep too. Sleep deprivation is
associated with increased chances of impulsive behavior and risk-taking. Such a condition can
not only be troublesome for the patient but also family and friends. As for e.g., Alicia had to
almost single-handedly raise their child while putting on with the eccentric behavior shown by
John. Schizophrenia is a devastating illness and often leads to loss of social functioning in the
patients. This illness also has a negative impact on a person's family life including fear, an
embarrassment to the family on the revelation of the symptoms, burden of care and finance of
the therapy and the stigma associated with the disease living with a schizophrenic can
sometimes get on one's nerves (Shamsaei et al, 2015). According to the study about ninety
percent of the families feel they are burdened in mild to moderate range while caring for a
schizophrenic. The main problem that the family faced was the cost of the treatment. Other
than that legal problems including violence, loss of productivity due to disability and
impairment were reported to be the main issues the families faced while taking care of
schizophrenic patient. The families also missed leisure and family interactions. So it can be
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stated that schizophrenia affects not just the patient itself but also family and friends. The
families are seen to suffer from increased levels of stress, emotional reaction, disrupted
households, and social stigma. These studies have shown that patients tend to lead a better and
healthy life in health and social care centers than staying with family. However other studies
prove that family intervention in schizophrenia treatment produces more fruitful result
(Pitschel-Walz et al, 2015).
Stigma associated with schizophrenia:
It is observed that patients with schizophrenia suffer from decreased self- esteem and resilience
and high levels of hopelessness (Wartelsteiner et al, 2017). This is one the reasons for increased
number of suicides in schizophrenic. As mentioned above schizophrenics tend to suicide within
first five years of their diagnosis of disease. Studies have shown increased incidences of mood
changes, anxiety as well as association with bipolar disorder in schizophrenics. People with
schizophrenia also show traits of depression. Treatment of schizophrenia should include
methods to uplift their self esteem. A patient-centered care and full support to the patient from
friends, family and care provider can work magic. Even John, who was shunned from his work
at university due to his problem made a comeback in the university with support from wife and
friends. Studies have also shown very little awareness among the general people regarding
schizophrenia, psychosis, depression or psychopathy (Furnham et al, 2015). This leads to a
general misconception "madman". People generally favor social or psychological treatment
than medications and blame early childhood trauma or stress for conditions like schizophrenia.
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There is lack of acceptance of the fact that schizophrenia is a dreadful disease and anyone can
fall victim to it. Findings show that there is need for educating the general population about
schizophrenia and other similar mental disorders. Such an act will make the quality of life better
for not only the schizophrenic patient but also for the friends, family, and caregivers of the
patient. Freedom from the social stigma will help increase in self- esteem and development of
pride in the schizophrenic patient. Studies also show that there are certain misconceptions
about the etiology of the disease among the normal population like psychological, sociological,
theological or biological. Many believe that schizophrenia is associated with possession with
ghosts and spirits and society tends to alienate the patient and the associated friends and
family. Education regarding such misconceptions will not only help provide a good quality life to
the patient but also will lead to early diagnosis of the disease. Many a times schizophrenics fall
prey to alienation from society and family too. So was the case of John in the movie. Alicia after
being fed up with John's paranoia and ignorance which caused drowning of their baby in the
bathtub decides to leave John too. Schizophrenic patients tend to be narcissists, impulsive,
emotionally unstable and have unstable relationships. In the movie even when John was at
heights of his professional career suffered from instability in relationship. Not only did John
suffered from alienation from his friend and had troubled relationship with Alicia, he himself
chose to shut himself up due to his paranoia. He daily worked on the secret mission he had
made up in his mind and posted letters secretly. He grows obsessive about the hidden codes he
assumes are present in newspaper and articles. He even ends up drowning his kid thinking
Charles, another fragment of his imagination is watching over the baby. Social stigma includes a
complex framework of public, self and structural components. Effects of social stigma can be
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reduced of social education and cultural relevance (Corrigan et al, 2014). An understanding of
problems caused by social stigma can greatly reduce its negative effect on the patient.
Educating about mental health, cultural competence, and family engagement can mitigate
social stigma’s ill effects on care-providers and lessen their burden. Understanding of stigma is
crucial for acceptance of the disease and treatment by the patient and is fruitful in increasing
care engagement. Getting rid of stigma will help the vulnerable seek out treatment.
Conclusion:
This assignment has helped assess the disease in focus in the biographical drama film “ A
beautiful mind” by Ron Howard. The lead character in the movie John Nash suffered from
paranoid schizophrenia – a mental condition with which about one percent of the total world
population suffers. This assignment has cleared the understanding of the etiology and the
pathophysiology of the disease also has pointed towards the need for increased researchers in
the field of schizophrenia for a better understanding of the disease. This assignment has made a
clear picture of the problems faced by the family, friends of a schizophrenic and what can be
done to make the life of care providers easy. It has cleared many misconceptions about the
disease and also helped shed light on the sufferings of a schizophrenic patient. This assignment
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has also indicated the positive role of the entertainment industry in increasing the knowledge
and educating the general population by creating awareness about mental illness. Such an
attempt will help the vulnerable to seek professional help. By assessing this movie it is made
clear that having a mental illness is common and anyone can have it. Also, it is indicated that
having a mental illness is no way associated with lower I.Q. Assessment of this movie has
helped increase knowledge of the disease schizophrenia and the condition or mentality of
schizophrenics and will help in providing an updated health care to them.
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