If you have a schizophrenic family member, or one with bipolar illness, read this book.  Your first impression will be, “yeah, they’re like that.”  Then you’ll be fascinated as Elyn and her illness grapple.  Elyn Saks is a successful law school professor who tells the story of her schizophrenia from her first hallucinations as a teenager through her education, multiple hospitalizations and eventual academic career.    But, she’s also a stubborn narcissist who insists on having things her way, and some of her tribulations were her own fault.  Pharmaceuticals for schizophrenia improved since she was first medicated, but she fought them all the way.  Finally, near the end of the book she admits that only with medication can a schizophrenic control their illness.  We physicians have known that since the 1950’s, but Elyn had to learn it for herself.  Elyn, like most schizophrenics, doesn’t feel herself when she’s on medications, yet the hallucinations and paranoia off of meds makes her life miserable; so, her story is of life on and off meds.

We now know that an excess of the neurotransmitter dopamine is what causes all that unwanted brain activity.  I’ve heard schizophrenics talk about “looking through that window” at another world; the schizophrenic’s world.  Elyn gives us a glimpse through the window.  It’s fascinating.

As a physician who treats schizophrenics, and a novelist looking for characters, I wondered if a genius schizophrenic could solve a highly complex problem.  I brought the subject up at a psychiatric conference and the consensus was no, their organization skills are too impaired.  Elyn Saks answered it in the affirmative, and demonstrated that a schizophrenic can organize and deal with highly complex problems.

There are flaws.  Elyn comes from a wealthy family and was allowed to change physicians until she found one who wouldn’t put her on medication.  Her favorite was a French psychoanalyst who just let Elyn talk and took no action.  Psychoanalysis doesn’t work for schizophrenia, and it didn’t work for Elyn, yet she gives the impression that doctor shopping is beneficial for the mentally ill.  It isn’t.  Most of her psychiatric breakdowns were because she was off her meds.  Still, it’s the only book of its kind and I recommend it.