On October 25th, 2014 I had one of my professional paradigms and prejudices confronted and shattered. I was in Cincinnati to attend a psychiatric CME program on treating resistant mental disorders. No other biological psychiatric disorder is as difficult to treat to perfection and recovery as schizophrenia. In residency, I was taught the rule of thirds for schizophrenia – where one third will recover completely, a further one third would improve over time, and one third would not show any measurable improvement. In my entire four year residency at Mayo Clinic I had one patient with schizophrenia who was totally normal on a very low dose of an antipsychotic; she was also dating and employed. Up until now, that has been the sum total of my exposure to true success in treating schizophrenia.
At then end of the conference on October 25th, Dr. Henry Nasrallah, MD, interviewed Bethany Yeiser, BS, and her mother Karen Yeiser, RN. We were told that Bethany was a young woman who had “recovered from schizophrenia.” I must admit that I was a little skeptical. As Bethany began talking on stage with Dr. Nasrallah, I heard a little bit of Bethany’s classic psychotic break, classic downward drift, and the hellish demons of madness she encountered (replete with command auditory hallucinations, visual hallucinations, tactile hallucinations, paranoia, and four years of homelessness). She was literally locked into her own world, incapable of rationally taking stock of her situation, delusionally believing that somehow or another things were going to work out alright and she would be famous at her college one day. She rejected all overtures from her parents who she had estranged but who continued to love her and care about her.
I was so impressed in hearing Bethany and meeting her that I immediately purchased her book, Mind Estranged: My Journey from Schizophrenia and Homelessness to Recovery, as well as her mother’s book, Flight from Reason: A Mother’s Story of Schizophrenia, Recovery, and Hope (by Karen Yeiser, RN.) I read Bethany’s book in two days. It is a gripping read, and an amazing “You are there” view of what it is like to be inside the mind of someone in the throes of a delusional and paranoid psychosis.
Bethany’s fall from a level of optimal psychosocial functioning, down to the pit of madness, and back to a high level of functioning and a sanity which now appears perfectly restored is breathtaking. In listening to her interview, and in reading her book, I learned that she went to college at 15 years of age, was a talented violinist who was the concertmaster of her community orchestra in her college town in California, was a published bench science researcher, and was a scholarship attendee at the major university in California where she was in school. As her schizophrenia symptoms began to take hold, she slowly began losing her grip on reality, ultimately stopping going to class, was unable to concentrate or meaningfully function, and she subsisted on food that she scavenged. She lived homeless for four years, and at the same time, inside of her delusions, believed that she “wasn’t like those homeless people”… even though she was.
Her story of mental health treatment, the torture of two years of failed or intolerable drugs with side effects, and her final stabilization and recovery on clozapine is breathtaking. The level of her recovery is similarly breathtaking. In person, she is charming. Her language and stage presence is commanding. And her music is beautiful. At the end of her interview with Dr. Nasrallah (both the conference organizer and the treating psychiatrist that brought her out of her madness) and her mother, Bethany played the theme from Schindler’s list on her violin (video link HERE). (You will have to read the book to find out what happened to her first two violins. Hint: nothing good.)
I thoroughly enjoyed her book and what I learned of her life on any number of levels. As a testament to the human spirit, it is an example of “the hero’s journey” as Joseph Campbell would have called it. It is a quest: a quest to return to reason, to function, to her parents’ love, to music, and to beauty. It is a quest to once again inhabit the sanctuary of a beautifully functioning, articulate, and creative mind. It is as well, to the psychiatric and mental health profession, a word of caution: people with schizophrenia and other psychoses can be made whole. Until we have tried literally every medication at our disposal – now or in the future – we cannot give up.
Finally, Bethany’s book, and life, is a beacon of hope to those whose minds are compromised by a major mental disorder. There is hope. Recovery is possible. And, similarly, to those families who care so desperately for their loved ones who have been felled by a mental illness: there is hope. Recovery is possible. Don’t stop trying. Don’t stop believing. Don’t stop pushing for total and complete recovery.
I am incredibly grateful to Miss Yeiser for writing this book. Every mental health care professional, patient, and family member of a loved one with a major mental illness should read it.