Paranoid Schizophrenia: How Accurately Does the Film A Beautiful Mind Portray It?


In the film A Beautiful Mind based on the life of the American mathematician John Nash, the audience gets a glimpse into what life is like for a person living with schizophrenia. We follow Nash in his day-to-day life and discover that his closest friend and roommate, Charles, and his spy identity, are all products of his hallucinations. As the film progresses, we witness his symptoms become more severe to the point where he was always paranoid and almost hurt his wife because the voices in his head told him to do so. But how accurate is this media portrayal of schizophrenia? 

First, let’s start with the question: what is schizophrenia? According to the DSM-5, schizophrenia is a mental disability distinguished by continuing episodes of psychosis. The age of onset is usually in one’s mid- or late-twenties. Major symptoms include hallucinations, delusions, and disorganized thinking. Other symptoms include apathy (lack of feeling), decreased emotional expression, and social withdrawal (Patel et al, 2014). We can see examples of these in the movie, in Nash’s poor social skills and avoidance of social situations, his lack of emotions and interest in anything other than his studies, and most importantly, his constant hallucinations about interacting with imaginary friends and foes. These all dated back to Nash’s years in graduate school.

The specific subtype of schizophrenia that John Nash had is paranoid schizophrenia, which is characterized by the constant belief that others intend to harm the individual. Before Nash was diagnosed and when his condition had been the most severe, he believed he was working for the Department of Defence on a classified mission to locate a bomb placed by Russian spies on U.S. soil. The paranoid symptoms are most evident when he hallucinated a car chase and gunfight at night between him and the imagined Soviet spies. His heightened suspicion after the imagined incident, such as staring through the blinds from time to time, is evidence that these hallucinations had caused significant impairments in his life, his job, and his relationship with his wife. 

What causes paranoid schizophrenia? One case study found an association between paranoia and grandiosity, the unrealistic perception of one’s importance, and the high value of their possession that others would harm them for it (Lake, 2008). We see Nash deluding his own importance through his imaginary secret mission at the Pentagon. When these delusions were challenged, he believed that the psychiatrists were communist spies intended to kill him. These are in parallel with the study’s conclusion that grandiosity precedes paranoid schizophrenia. 

Besides its accurate depiction of one’s experience with schizophrenic symptoms, A Beautiful Mind also did an exceptional documentation of the prognosis and treatment of the disease. If untreated, the condition can gradually worsen. However, since Nash didn’t have many attachments and his imagination required him to keep his “mission” a secret, his condition went unnoticed by others for a long period. Although schizophrenia can be treated with antipsychotic drugs, complete recovery is very rare and relapses are common. We see that Nash’s positive symptoms (behaviors that are added) such as hallucinations and delusions were reduced through taking medication regularly, whereas when he stopped taking his medication, his symptoms worsened. Nash was also put through insulin shock therapy, which is a prime treatment method at the time until it was deemed ineffective and replaced by narcoleptic medicines (ABC News, 2006). Another potential outcome of schizophrenia is that the emotional support of family members and close friends will likely decrease the chances of relapses in the future (Caqueo-Urízar et al, 2015). This is demonstrated in the film when Nash’s wife, Alicia, chose to take care of him and believed in his ability to overcome his hallucinations, and Nash becoming more able to cofunction with his imagination while staying intact with reality. 

In conclusion, A Beautiful Mind portrays the experience of individuals with schizophrenia in a non-stigmatized way while pertaining to the general truths of the disease’s symptoms, course, and treatment. One important thing to recognize is the fact that, despite struggling with schizophrenia, John Nash led a functioning lifestyle and won the Nobel Prize. His story and the film adaptation are what we often do not see in media representation of mental illnesses. Hopefully, in the future, we will see more media portrayals like A Beautiful Mind that aim to educate the public about people with schizophrenia as well as their beautiful individuality.

 

References

ABC News (2006). How Realistic Is ‘A Beautiful Mind’?. ABC News. https://abcnews.go.com/GMA/DrJohnson/story?id=126426&page=1

Bell, David (2019). “John Nash.” Living With Schizophrenia. http://livingwithschizophreniauk.org/john-nash/#:~:text=Although%20Nash%20continued%20to%20work,and%20conversations%20became%20increasingly%20disturbed.&text=The%20psychiatrists%20treating%20Nash%20came,were%20both%20grandiose%20and%20persecutory

Caqueo-Urízar, A., Rus-Calafell, M., Urzúa, A., Escudero, J., & Gutiérrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: challenges and solutions. Neuropsychiatric disease and treatment, 11, 145–151. https://doi.org/10.2147/NDT.S51331

Lake C. R. (2008). Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review. Schizophrenia bulletin, 34(6), 1151–1162. https://doi.org/10.1093/schbul/sbm132

Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: overview and treatment options. P & T : a peer-reviewed journal for formulary management, 39(9), 638–645.

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