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The cost of schizophrenia can be measured on several scales. By some estimates, fully a quarter of the nation's hospital beds are occupied by schizophrenia patients. Many are chronic abusers of drugs and alcohol, the result of desperate attempts to medicate themselves. The illness can therefore become a one-way ticket to the bottom of the socioeconomic ladder. A third of America's homeless are afflicted, as are about 3% of prison inmates and nearly 6% of those in maximum-security facilities (compared with 1% of the general population). The disease takes a mortal toll as well. About 1 in 4 schizophrenics attempts suicide; 1 in 10 succeeds.
Schizophrenia typically makes its appearance sometime between the ages of 15 and 25, a period when the frontal lobes of the brain are rapidly maturing. Contrary to popular belief, the disorder has nothing to do with "split personality." The term schizophrenia (Greek for split mind) was coined in 1908 by the Swiss psychiatrist Eugen Bleuler and refers to a splitting of the capacity for thought.
The onset is insidious. Victims may begin dressing strangely, sleeping at odd hours, withdrawing from friends and family, whispering to invisible companions or talking back to the television set. They become paralyzed by irrational fears or subject to suspicions that other people are monitoring their thoughts. Eventually the symptoms can no longer be dismissed as the moody vagaries of youth.
Felt from the inside, schizophrenia is terrifying. Here is how one 22-year- old victim described it: "Sometimes people are taking away parts of my body and putting them back. Sometimes I think they are going to kill me." The young man would see huge rats scurrying about his room, and believed others were reading his mind. He heard voices he attributed to "just God and Jesus, but sometimes they sound like my mom and dad."
For families who have watched a child grow and flower, the effect is devastating. "At 15 my son returned to the day of his birth," says a father in Brook Park, Ohio. "He crawled on the floor, and his mother had to diaper him. He withdrew to his room and wouldn't come out except to eat. Once, his voices told him to grab a little girl in a store and undress her. Many times I saw my wife with bruises. I've learned a lot about schizophrenia since she died. I think living with my son killed her."
What causes such bizarre behavior remains mysterious. For centuries schizophrenics were believed to be possessed by devils or even angels. St. Teresa of Avila was probably a schizophrenic, and so perhaps was the prophet Ezekiel, who, in addition to his many apocalyptic visions, said he heard a divine voice command him to sleep on his right side for 390 nights and then switch to his left for 40. Some archaeologists believe that holes drilled in prehistoric skulls represent efforts to release the demons of madness. During the Middle Ages, those who heard voices were frequently burned at the stake. As recently as the 1950s, psychiatrists blamed the disorder on parents, specifically a cold, "schizophrenogenic" mother, though Freud himself had concluded that the illness had biological roots.