Which illness frightens you most? Cancer? Stroke? Dementia? To judge from tabloid coverage, the condition we should really fear isn’t physical at all. “Scared of mum’s schizophrenic attacks”, “Knife-wielding schizophrenic woman in court”, “Schizo stranger killed dad”, “Rachel murder: schizo accused”, and
“My schizophrenic son says he’ll kill… but he’s escaped from secure hospitals 7 times” are just a few of dozens of similar headlines we found in a cursory internet search. Mental illness, these stories imply, is dangerous. And schizophrenia is the most dangerous of all.
Such reporting is unhelpful, misleading and manipulative. But it may be even more inaccurate than it first appears. This is because scientists are increasingly doubtful whether schizophrenia – a term invented more than a century ago by the psychiatric pioneer Eugen Bleuler – is a distinct illness at all. This isn’t to say that individuals diagnosed with the condition don’t have genuine and serious mental health problems. But how well the label “schizophrenia” fits those problems is now a very real question.
What’s wrong with the concept of schizophrenia? For one thing, research indicates the term may simply be functioning as a catch-all for a variety of separate problems. Six main conditions are typically caught under the umbrella of schizophrenia: paranoia; grandiosity (delusional beliefs that one has special powers or is famous); hallucinations (hearing voices, for example); thought disorder (being unable to think straight); anhedonia or the inability to experience pleasure; and diminished emotional expression (essentially an emotional “numbness”). But how many of these problems a person experiences, and how severely, varies enormously. Having one doesn’t mean you’ll necessarily develop any of the others.