Schizophrenia is the most personally destructive and least understood of all the major mental illnesses. Its principal hallmark is extremely disordered thinking--the kind that robs many of its victims of the ability to keep a job, maintain a relationship or even hold a coherent conversation. The first serious symptoms typically begin sometime after puberty, in the late teens or 20s. Some but not all schizophrenics suffer hallucinations. Some but not all schizophrenics hear voices. The cause is undeniably physical--perhaps the unhappy combination of a genetic predisposition and an infection suffered in the womb. In any event, it's clear that the results can be heartbreaking.
In this way, schizophrenia affects far more than one person at a time. For a look at its extended impact, TIME visited one family to see how schizophrenia touched its members across four generations and how the family coped with the disease. In some ways, their story is uncommon--most schizophrenics don't have a family history of the disorder. In other ways, particularly in their struggle to deal with the stigma and isolation of a mental illness, the Beales of Howard, Ohio, are all too typical.
Ed Beale, 65, never knew his mother, Emma, a vivacious former schoolteacher with a knack for picking up foreign languages. When she was 30 and Ed was just 7 months old, she was committed to a psychiatric institution with what the family later recognized as schizophrenia. When Ed was 3, his dad told him that his mother had died soon after giving birth to him. Although she actually lived until 1973--when Ed was 36--he never met her, heard her voice or kissed her cheek.
Lying seemed easier than telling the truth. "His father wanted it to be a secret," says Ed's aunt Virginia Conrad, who eventually told Ed practically everything he knows about his mother. "There was a lot of embarrassment about it." For a while, Ed blamed himself for his mother's condition--he wondered if his birth had made her snap--but mostly he tried to banish her from his mind and go on with his life. He joined the Air Force and married his wife Velma. They had three children.
But the specter of schizophrenia returned with their third child, Peter. A happy, precocious youngster who learned to read in kindergarten, Peter focused less and less on school as he got older. It wasn't until after he joined the Air Force in 1985, however, that his life truly began to deteriorate. Peter remembers sitting next to another student in a training class and telling him about what seemed to him to be a wondrous, novel idea. "But then he just looked at me funny," Peter recalls. "He says to me, 'You aren't saying anything. You're just making noises.'"
Peter started having delusions that interfered with his military duties. "I often thought I was being followed or that people were hiding in the trees waiting to come after me." Eventually, he says, his thoughts were disjointed most of the time. "I couldn't focus on anything." Finally, the Air Force court-martialed him for dereliction of duty, and he was given a less than honorable discharge. Still, neither he nor his parents were ready to accept the idea that he had a mental illness--although by then his grandmother's history was no longer a secret. "Maybe we were trying so hard to forget," says Velma.