Far from the Tree: Parents, Children, and the Search for Identity

by Andrew Solomon

“It seems that toxic levels of clozapine built up over time because his liver was not processing it.

At high levels, apparently clozapine can cause heart arrhythmia, and coma/respiratory arrest.

the medications we forced him to take, which he railed against and fought with all his spirit for most of his life, killed him.

William began to act erratically, their father refused to acknowledge what was going on.

admitted to Harvard

“He was subsisting on raw garlic and had knives sitting everywhere,”

my father saw him only three times in thirty years.”

usually clothed in just a towel, talking to himself; local teenagers would taunt him.

He can’t initiate conversation and he talks very little, but he seems increasingly able to understand.

That kind of denial, the way my father was—it ate him alive, and now he’s just a hollow wreck. A whole life slipped away, that didn’t have to.”

While autism

is characterized by an overabundance of synaptic connectivity, schizophrenia is marked by a dearth of

The negative symptoms appear to be tied to damage to the frontal and prefrontal lobes, where cognition and attention are based.

probably linked to increased second-trimester maternal viral infections.

1980s with some fifty thousand Swedish conscripts showed that those who had used marijuana more than fifty times were six times more likely to develop schizophrenia.

“It’s a contributing, not a necessary, cause. But some studies suggest that if you were able to eliminate cannabis, you could reduce world rates of schizophrenia by at least ten percent.”

some gene-environment combination causes the neurotransmitters dopamine, glutamate, norepinephrine, serotonin, and GABA to become dysregulated, leading to excess activity in one dopamine pathway.

This induces psychosis and other posi...

Artificially releasing too much dopamine can provoke the symptoms of schizophrenia even in healthy subjects; suppressi...

Antipsychotic medications block the ability of the brain to process high levels of neurotransmitters in some areas;

All successful antipsychotics lower dopamine levels, but lowering dopamine is not by itself enough consistently to remit all of the symptoms of schizophrenia, and new research focuses on drugs that will affect particular receptors for glutamate and other transmitters.

Though cognitive behavioral therapy (CBT), which teaches people to redirect their present thoughts and behaviors, has the strongest track record, many other talk therapies have powerful exponents, and the law professor Elyn Saks has written movingly of her

redeeming experiences with psychoanalysis in her battle with schizophrenia.

if you can get someone with schizophrenia into a rational mode for some time, the positiv...

The theory is that much as someone who loses speech in a stroke can relearn talking through speech therapy, someone with psychosis may be abl...

(Zyprexa)

the rate of developing schizophrenia was somewhat reduced; it also made many people who might not have gone on to develop the syndrome obese, sluggish, and glassy-eyed.

George Clark is a physicist at MIT who works on theoretical astrophysics; he is both kind and almost entirely occupied by intellect.

married in 1980, each had a problematic daughter.

Charlotte’s daughter Electa Reischer, the same age as Jackie, was disjointed and bewildering, but would not receive a diagnosis for another eighteen years.

Jackie had once been so promising, whereas Electa had b...

Electa’s psychosis was contained by medication, but she suffered endless side effects. Her weight ballooned to over three hundred pounds.

A few months later, Jackie hitchhiked from Massachusetts to New York to surprise her estranged mother. When her mother asked her how the trip was, she said she was “only raped

five times.” Charlotte said, “Of course, you never know what to believe. You don’t know what happened and neither does she.”

Eventually, clozapine came along. “She’s very sweet, now that she’s medicated,” Charlotte said.

Jackie was instantly engaged, intense and full of questions, while Electa was a manatee, vast, slow-moving, benign. Jackie substituted words for no particular reason, calling her car “my visa,” for example.

George Marcolo had a lot of friends in high school in New Jersey.

pothead in his teens, and in his senior year he took LSD.

he took four. “After that, things sort o...

which I guess was alrea...

George remembered, “November first, 1991, when I was at Boston College, I woke up and I felt like I was on acid. I had not taken anything or done anything. That didn’t go away for eight years.”

At the time, George accepted that; now he is outraged. “If I heard somebody say, ‘I feel like I’m on drugs, but I’m not on drugs,’ I’d be like, ‘We’d

better get you check...

“I was afraid they’d think I was insane. I substituted alcohol and pot for medicine. Everything was amplified. Food tasted really bad. If I had taken meds back the...

he kept up a 3.7 average ...

“He said he knew what the neighbors were thinking about down the street,” Giuseppe recalled. Bridget was bemused. “Still, I didn’t think there was psychosis,” she said.

George, thirty-five when we met, was on clozapine and had regular blood tests.

“I still get a little paranoid when I’m in public, but I can function. My parents have been very vigilant on my medicines, and they pay good attention to my behavior.

If Dad’s home and I’m going to talk to them, I go in another room. I don’t like it when people see me talk...

“George is laughing with them and I say, ‘George, cut me in, let me know what everyone’s saying,’ and we joke a bit about it.” Bridget said, “It doesn’t...