Conquering Schizophrenia : A Father, His Son, and a Medical Breakthrough

Rating:
Summary: "Conquering Schizophrenia" is thoroughly dishonest book.
Review: "Conquering Schizophrenia" lauds Zyprexa as conquering schizophrenia. The truth of the matter is that Zyprexa is a very, very unpleasant medication. Zyprexa is better than other antipsychotics, but that is faint praise. Jeff, the author's son, is left with negative symptoms but those are the worst symptoms. The book takes the E. Fuller Torrey line. Someone with schizophrenia is dumber than a pigeon. A pigeon given something good presses the lever. Someone with schizophrenia given something good refuses medication. When everyone is off dopamine antagonists then a book with the title "Conquering Schizophrenia" can be written.

Rating:
Summary: title is a misnomer
Review:

"Conquering Schizophrenia: A Father, His Son, and A Medical Breakthrough", published by Knopf, January 1998, is a father's account of the life of his son Jeff.  Jeff's break came at age twenty-one.  The book chronicles the next twenty-five years along two interwoven paths: the events in the lives of Jeff and his family and the evolution of the mental-health field during this time --its trends, controversies, therapies, medicines, practitioners, advocacy groups, agencies, economics, politics, etc.

The father/author, Peter Wyden, has published a dozen books and was formerly a writer for Newsweek. He writes in a concise, organized, journalistic style that is mercifully free of any self aggrandizement that might have been expected (he candidly acknowledges his missteps) and of any excessive sentimentality (the story itself speaks eloquently of the emotions, frustrations, struggles and celebrations that were there throughout).  He levels some very valid criticisms without being strident.  It is carefully crafted with detailed back-of-the-book chapter notes, bibliography and index for the reader who wants to dig deeper.  It is very up to date, mentioning situations as of Fall, 1997. (Of course we Internet devotees want to know how things are going this morning.)

I strongly recommend this book highly to anyone whose life has been affected by schizophrenia or by any other serious mental illness. I have been struck over the last four years (our 23-year old son was diagnosed with schizophrenia four years ago) how much I read about one mental illness that relates to the others.  (Incidentally, I have no connection to the publisher or author. I wish I did know the Wydens personally).

Jeff was treated by over 50 docs over the 25-year period. He was "treated" in every imaginable theater from the renowned Menninger Clinic, where at the time of Jeff's stay early on, probably did more harm than good, to a run-down half- way house, where he was helped greatly by a dedicated, compassionate social worker.

His symptoms when bad were very bad. He once broke a nurse's nose. He was not an easy patient and not an easy son. But those that got to know the real Jeff were very fond of him. And to his father, even after spending 25 years of struggling with Jeff over meds, docs, hygiene, etc., maybe to some extent because of those struggles, Jeff was a hero, a theme often repeated.

Family support helped (and I suspect help greatly) throughout. There were some talk/cognitive therapies here and there that helped deal with some of the problems of the underlying illness. Jeff's manic periods were helped by lithium. There were other meds that I cannot recount. A breakthrough came with Clozapine, though negative symptoms, especially lack of motivation, remained and a purposeful day, much less the possibility of a job, were not on Jeff's radar screen and he spent his hours at the half-way house. The "conquering" word in the title refers to the next breakthrough which came with Olanzapine in 1996.  Some of the negative symptoms begin to remit. The book ends with Jeff beginning to take some steps into the mainstream world and he gets involved with a local church program and one day asks his dad "Do you think you could get me a watch? I'd like to get my days organized". (!) You would have to read the whole story to understand what a wonderful ending (beginning) this is.

Perhaps I wouldn't have divulged the ending if the book only dealt with Jeff's situation. It would have been a great book if limited to just the Jeff story. Many of us could identify and empathize and imagine our own books.  Not to take away from the story, the real strength of this book for me was the second interwoven thread that dealt with the many aspects of the mental-health system as it evolved over the same twenty-five-year period and the interplay of that with Jeff's life.  The author was relentless in his researching, advocating and mainly getting to know individuals who could help his son. He knew or got to know many of the movers and shakers, those at the tops of their fields, and gleaned from them a detailed and realistic survey of the battlefield on which his son found himself. I have spent a lot of time myself the last few years reading, surfing the Web, meeting, etc., but was left with a lot of questions and perhaps was left without a a good overall perspective of how the many pieces interact.

The author does a masterful job of covering many areas and gleaning the salient features, good and bad, things you are never going to read in a journal or hear admitted for the record. For example, from a discussion with Dr. Solomon Snyder, the inventor of Prozac: "One question has run through Snyder's professional life: What exactly causes schizophrenia? ... 'We know so little he said', he said sadly. 'There's a screw loose, but we don't know which screw.'" I think I would like to have known this four years ago rather than having to discover it over time. The book is filled with nuggets like this.

The wide-ranging areas covered include: the slow, grudging acceptance of using meds for treatment, later the doctrinaire rejections by the biological guys of the talk therapy guys, (thank goodness my son's doc is dual-track), the fights over wording of the DSM-III, the history of anti-psychotic meds (amazing twists and turns), meds in the pipeline, the R. D. Laing school, orthomolecular treatment, psychosocial treatment, electro-convulsive therapy, schizophrenogenic mothers,"Toxic Psychology" book, "One Flew Over the Cuckoo's Nest" movie, Marilyn Monroe, atrocious experiments and abridgment of patient rights, sexual abuse, the history of the National Alliance of the Mentally Ill, the champions of mental health legislation in Washington, the big, profitable, competitive pharmacy business (Eli Lily sales of Olanzapine in 1997 about $850 million), the National Institute of Mental Health, various studies and meta studies (and the ongoing puzzlement), interviews with consumers, interviews with the big names, etc.

He writes of many problems/challenges: the general stumbling nature of the progress in this field, the unknown causes of the illness, the problems of diagnosis and the diagnostic categories, questions about treatment, side- effect tradeoffs, stigma, managing the managers, family stresses, under funding of research and support agencies and the crushing work loads, poverty- producing expenses, bureaucracy, on and on.

I found the book very satisfying in many ways. It most of all helps sustain our hope. And makes us appreciate the fact that despite all the difficulties we families are facing in 1998, times and prospects were much worse just a few years age. It chronicles a story we can relate to and can compare to our families' stories.  It always held up the humanity, the personality of Jeff.

It shines a light on the battlefield that still has its challenges and dangers but through which we can now walk with more confidence and with a better chance of survival or even conquest.

I wish the best to the Wydens and to all the many families doing battle.

Rating:
Summary: title is a misnomer
Review: author spends a great deal of time (xxx? pages) oscillating between blaming mental health professionals and presenting himself as a devoted father (perhaps too devoted?--i.e. overly responsible?)...furthermore schizophrenia is not "conquered" at the end of the book...rather only the right drug is found--which eliminates symptoms but which, contrary to popular belief, does not "cure" mental illness (since the patient is only well as long as he is medicated)

Rating:
Summary: A veritable encyclopedia of psychiatry and mental health
Review: Before you ransack the library trying to get straight about mental illness, just read Peter Wyden's "Conquering Schizophrenia - a Father, his Son, and a Medical Breakthrough." Wyden, a writer, tells of his son Jeff's 25-years of crippling psychosis, and his story vibrates with passionate critique of the mental health system. His journalist's piercing eye fixes the target, while the other eye darts around, taking us on a back-street tour of psychiatry's history, players, and struggles as Wyden searches for perspective on this arena.

What is the target? Is it Jeff himself, who went from warm,extroverted child to introverted, erratic youth, then back to a more normal, properly medicated 46-year old man? Is it mental illness itself? Which illness? Jeff's was diagnosed as "school phobia," "anxiety," "depression," "schizophrenia - paranoid type," then "malignant case of manic-depressive." Perhaps it is psychiatry itself, with its "foibles,follies, and failures," and its oddly noble persistance in the face of overwhelming enigmas?

In any case, the target keeps moving. This conveys Wyden's sense of confusion and hair-pulling frustration through the dozens of psychiatrists, neuroleptics that ravaged the body while they calmed the mind, the hospitals, and halfway houses that make up Jeff's existence. He shows us the "split" between modern medicaters who treat the physical, and the traditional Freudians who believe only in the unconscious and psychoanalytic. He describes the bizarre events of pharmacology finds and the equally bizarre trip through FDA approval. He narrates the bitter 20-year feud between Dr Spitzer and proponents of DSM series and the older therapists who call it a "straightjacket."

The sound and fury, based on the void of the unknown, rages on. There is an abyss between etiologies, and chaos about categories. Signs of schizophrenia dovetail so slyly into signs of manic-depression (hallucinations, hyperagitation) that even "experts" can't say which is primary. Medications for one cross over for the other. "My learning curve was turning erratic," complained Wyden when Clozaril came on the scene. ". . . Anything might work. Anything might fail. . . There are no true experts."

At the book's end, Jeff is converting from Clozapin to the newer Olanzapine (the "breakthrough"), and seems to be emerging from his demi-world into a more responsive, organized person. His real diagnosis is still up for grabs.

The real breakthrough is hope, for today and for tomorrow, hope that research and medicine can cut through the profound devastation of a broken brain. Wyden has painted a realistic picture of major mental illness - ambiguous, unpredictable, messy, and bankrupting. Only those who have traveled that tunnel of despair can appreciate the candle of this seemingly promising advance.