Schizophrenia

For those who are interested in learning more about Ronan’s mental health, I wanted to write a little bit about Schizophrenia. It’s not like in the movies which has largely gotten the condition wrong – people are not usually violent and it is not a dissociative (multiple) personality disorder. It is mostly marked by disorganisation and hallucination.

Schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms. It is often described as a type of psychosis, that is; the person may not always be able to distinguish their own thoughts and ideas from reality.

Schizophrenia usually takes hold after puberty with most people diagnosed in their late teens to early 30s. Often there is a gradual worsening before symptoms start, this is called the prodrome phase. Generally, symptoms can be divided into positive (things that start happening) and negative (things that stop happening) symptoms.

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“Positive” symptoms are changes that are added to normal behaviour - positive doesn’t mean that they’re good. Positive symptoms include:

Hallucinations: hearing, seeing, smelling or feeling things no-one else does. Most common is hearing voices. These might tell one what to do, warn them of danger, or say mean things to them. Multiple voices can even talk to each other. Many people imagine an “inner voice” but hallucination is marked as a clearly different voice that is not “you” talking/ thinking. A hallucinated voice may talk to you, at you or about you.
People with schizophrenia have described hearing voices like someone is standing right next to them. Voices can be critical, complementary or neutral; they might also give commands that are potentially harmful (usually only to the person hearing the voice) and they might even engage the person hearing it in conversation.
Voices can also present as thought-like or as if they are thoughts entering one’s mind from somewhere outside. Unlike ideas that come from inspiration, the thought-like voice is not one’s own and seems to come from outside one’s own consciousness, like telepathy.

Delusions: strange beliefs or paranoia that are easy to prove wrong but not always dissuadable to the person affected. E.g. someone is trying to control your brain through TV, 5G causes coronavirus, or believing you have superpowers.

Confused thoughts & speech and trouble concentrating: commonly, people with schizophrenia have difficulty organizing their thoughts. It can present like zoning out or distraction. When talking, their words can come out jumbled and nonsensical.

Different movements: jerking or jumpy movements. Sometimes movements may be repeated over and over again or someone might be perfectly still for hours (catatonia).

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“Negative” symptoms are changes that remove from one’s normal behaviour such as a loss of interest in things. They can be difficult to spot in the teenage years when emotional swings are more common and depression can have similar symptoms too. Negative symptoms include:

Self-neglect: forgetting to wash oneself or clothes or forgetting to eat and other such tasks.
Emotionless: a person with schizophrenia can appear impassive and detached or fail to show feelings. They may not talk much or sound blank; this is called "flat affect."

Withdrawal: when one stops making plans or becomes reclusive. Talking with a person with schizophrenia can be like pulling teeth, answers need to be pried out of them. They might also have trouble keeping a schedule or finishing tasks (if they get them started at all).

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“Cognitive” symptoms are thinking problems that concern how well the brain learns, stores and uses information. Someone with schizophrenia can have difficulty with their working memory and so loss track of facts. Trouble paying attention, organizing thoughts and making decisions are also common.


Well known people affected by Schizophrenia:
John Nash – Mathematician & Nobel Prize Winner; the subject of the Russell Crowe film A Beautiful Mind
Vincent van Gogh – artist best known for cutting his own ear off and then painting it; painting entitled Self-Portrait with Bandaged Ear
Jack Kerouac - author best known for the book On the Road; “Nothing behind me, everything ahead of me, as is ever so on the road.”

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The idea for the Ronan character came about a few years ago when I had recurrent experiences with hypnagogic and hypnopompic hallucinations; these are when you hear (see or feel) things as you are falling asleep or waking up. Most vividly, I recall hearing lying in bed at 2AM about to fall asleep when I heard Patrick Stewart in my room saying, “dancing as only to the morning sunset.”
Strange, right?

Ronan’s Schizophrenic hallucinations are much more complex, long-lasting and potentially life-altering. His voices are a combination of different kinds of voice I’ve read about. For simplicity, I have kept it as one voice which makes the intellect vs irreverence vs commentary of some of its dialogue more juxtaposed. Perhaps it should have been multiple voices to reflect these different ideas but I found conveying Ronan’s confused state of mind was complicated enough already.

I wanted readers to gain an understanding of the voice without writing a lecture within the story itself. I hope visitors to this blog have gained an appreciation for what Ronan’s experience is all about.
I hope readers have enjoyed this short discussion and gained a little insight into Schizophrenia. There are innumerable online resources to get help if you are affected, know someone affected or just want to learn more. Resources vary depending on your geographical region – finding help is what the internet was invented for.