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Addiction, anxiety, mental health.

How do we address our traumas and how do we begin to move forward?

The path to healing and understanding is through candid conversation.

I'm Aisha Sultan, and this is Things We Don't Talk About.

Most people have heard the word schizophrenia, but very few know what it actually means to live inside it or beside it.

Some people confuse what we see in the movies with what happens in real life.

Others are too ashamed to discuss it openly.

But silence and misunderstanding isolates patients and their families who love them and don't know how to help.

Schizophrenia touches millions of Americans.

For every person living with it, there are parents, children, and siblings trying to make sense of something no one ever explained to them.

Today, a young man will share what it was like to grow up with a father whose mind worked in ways he couldn't understand.

There was fear, confusion, and love that never went away.

And we'll talk to a medical expert who will help us understand what schizophrenia actually is and what support and recovery looks like.

I'm joined by Jeshua Pearson, who grew up with a father with schizophrenia.

Hi, Jeshua.

Hi, how are you?

Great, great.

Thanks for sharing your story with us.

Now, when was the first time that you noticed something was not right?

Yes, so I was 13 years old.

I was in high school.

This was around the time where my grandmother, my dad's mom, had actually passed away.

And I want to say it was the day after she died.

It was late, it was pretty late.

And my dad had believed to a phone call.

And he was laughing and he was very excited.

So I was curious to know who was making my dad laugh and smile.

And I was actually kind of happy, you know, especially after hearing the tragedy that it happened.

And I remember he said that, "Hey, I will be right back."

And he went to the bathroom.

And so me being a 13-year-old boy and very curious, I wanted to know who my dad was talking to.

So I picked up the phone and I said, "Hello."

Nobody answered.

And matter of fact, the phone wasn't even on, actually.

That must have been a shock.

How did you feel?

What was going through your mind when you realized that nobody was on the phone?

I was confused, shocked.

I had a lot of questions.

I just didn't know what to feel, actually.

I wanted to actually ask my dad, but I was a little nervous, so I just kept it to myself.

You just kept it to yourself.

And then when was the next time that something happened where you sort of realized, "Oh, something is not right"?

Yes.

This was around when I was 15, around 15 years old.

I just came home from school.

My parents told me that they were on the way.

And 15 minutes later, my mom and dad, they pull up, and my mom just comes into the door.

They both are arguing, actually.

She says to me, "Jess, when your dad and I are getting a divorce, and I was just thrown off," she just said, "I can't do this anymore."

I remember seeing my dad packing up his clothes.

He packed up all of his clothes, and he got into the car and he left.

And I asked my mom, I said, Where, where's Dad?

Where's Dad going?

What is happening right now?

And she said, I just can't do it no more, Jeshua.

I know.

I'm sorry.

He tried to get out the car, he was talking to himself.

And I just couldn't take it anymore.

I'm so sorry.

That must have been so confusing and painful.

Do you feel like at that moment that you had anybody yourself that you could talk to or ask anything about what was happening?

Of course, being an only child, it was definitely hard to even open up, express myself.

At that time being, I had friends I could talk to about certain things, but even with that much weight, I felt uncomfortable talking to them about it because I couldn't even understand it myself.

And being a teenage boy, being in a black family, like how did that, how does that play in culturally into the way people talk about things going on in their family?

Of course.

So I always grew up, you know, keeping things within the family.

What happens in the family stays within the family.

I think a lot of us can relate to that.

Yeah.

And especially in the black household, for me, mental health was something that was never really talked about.

Of course, go to school, go to work, make good grades.

But the impact of how I feel internally, it was something that was frowned upon.

Well, and we don't really have a language.

We didn't grow up with the language and how to discuss it.

And I think a lot of us maybe came up in families where faith or like God was supposed to solve all of your problems, you know?

And so when was the first time that you actually heard the term schizophrenia and how did that even come about?

Yeah so I was 16, 17 years old and I actually heard it from my mom.

She was on the phone with my my aunt and they were discussing, they were just discussing some adult things and the situation, a few situations that happened even before I was born had been brought up and my mom said to my aunt, you know, Curtis' schizophrenia is acting up.

And she started to mention certain things that kind of replayed in my head where I started to see from the previous experiences from losing my grandmother or the divorce.

So that was the first time I heard it.

I still didn't fully understand it.

But I knew, okay, there is something else going on with my dad.

- How did you find out any more information about what that meant?

Did you just like Google it or?

- I Googled it.

I remember just even watching some documentaries on schizophrenia, especially kids around my age that might've been affected by it.

And of course, still being 17 years old, there was so much that I wanted to ask my dad himself.

But I just felt nervous because it was a sensitive topic.

And even with my mom, who was truly, this was something that bothered her for years upon years.

I didn't even feel comfortable asking her at that time.

- Wow, I mean, I think a lot of us can relate to that because our parents are the ones that are supposed to take care of us and they do take care of us.

And a lot of times it feels hard questioning them or asking them about personal issues, especially something that they're struggling with, definitely when you're a teenager.

And so how did things progress after that when you kind of have a name for this, but you're not really quite sure what you're supposed to do with this?

What happened in your relationship with your father after that?

So I would say there was a little bit of resentment towards my dad at first because I just wanted him to get better.

You know, I just wanted him to be better.

I wanted to have the dad that I grew up with as a kid that was playing, laughing, I could talk to about any and everything.

But there was some resentment that grew because, one, I've never seen my dad act like this.

I've never seen my parents argue like this.

And let alone, I never felt more alone, actually.

So, and there was also resentment built around the fact that I did not fully understand his condition.

- Yeah.

- So it was, the conversations that we tried to have, I was very short answered.

I would answer yes, no, or he would ask me, how am I doing?

Good.

Just kept it all bottled up.

- Kept it bottled up inside.

And in a way, maybe protecting yourself and not knowing what felt safe, what didn't.

Was there a situation where things sort of came to a head with you and your father?

Can you tell us about that?

- Yeah, so there was a situation that came to a head.

I wanna say this was probably around two years ago.

I remember my mom had picked me up.

And we were, I was actually dropping, they were using my car.

And I actually was about to drop them off at home.

And I remember my dad was just, he had a picture of Pope Francis in the back with the Bible.

And my dad is also religious too.

But I just remember on the way back, my mom is frustrated and I asked my dad, "Hey, what's going on?"

And he was just saying, "She's trying to take me away from Pope Francis and we're not going for this."

And I'm like, "Dad, this is a picture."

And he just became a little bit more aggressive in his tone.

And I was like, "Dad, you know, it's me.

You know, it's Jeshua, you know, and Pope Francis isn't here."

He was like, "I don't care what you say.

He is here."

And it was like, "Okay, well, we have to go to the hospital."

So we took my dad to a hospital, got him admitted.

And I want to say the next day he did call and he did apologize.

But it was still kind of hard to even process that.

Yeah.

That is scary and unsettling when someone is saying something that you clearly know is not happening, it's not true, and you can't get through to them.

And someone who you know you've been able to have conversations with before, who does have the ability to understand in that moment, you just can't get through to them.

Did you have anyone to talk to to process what you had been through?

Tell me how you were handling this.

This is a lot.

Yes.

You know, I didn't have anybody at that time being to really talk to.

The only time I had talked to somebody was during the first encounter of my dad having an episode after my grandma passed away, but that was only talked to somebody because of her and how that affected me.

But in regards to talking to somebody about what I was dealing with with my parents, I had it bottled up for years.

What do you wish people knew about schizophrenia and what it's like to have a parent or a family member that's going through that?

That they're still human.

That they are still loved.

That they are trying their hardest, just like the next person, to live day by day.

And I wish that somebody around my age, who was 13 at the time, felt comfortable enough to talk to somebody and allow them to express themselves and to remind them that they're not alone.

Do you think it would have also been helpful to have an adult that you felt like you could talk to about what was going on in your family?

- Of course.

- Because a lot of us don't even know that that's a safe thing, that that's something that is available to us, that we can do.

I think that probably would have been helpful to a lot of us as young people going through stuff, having somebody to turn to.

And where are you right now?

Where is your, with your relationship with your dad, with your own journey in healing from what is a very difficult situation to grow up with?

- Yeah, so my relationship with my dad has actually improved a lot.

We actually just went to the movies not too long ago.

He still has his moments where I can tell that something's a little bit off, but it's not to the point where I'm like, okay, I don't even feel comfortable talking to you.

And even with my own journey, I've made the decision to go to therapy myself.

- That's incredible.

- Thank you.

But to heal from my own wounds of dealing with things I had bottled up for years upon years for almost 13, 14 years now.

- Why was it important for you to talk about this now in a public way?

I feel like it's important because I come from a household where mental health wasn't talked about.

You know, as stated, it was, a lot of things were kept private.

And I believe that in order to heal, we have to be vulnerable.

We have to have these conversations.

And I would love for somebody who looks like me, feel comfortable enough to say, "You know what?

I can relate to this, and I need to talk to somebody."

Well, I mean, one, I think it's incredibly brave of you to share this personal story, and I think it's also a huge service.

It's a huge service, not just to your community, but to all of us, to hear that you can go through something and something really serious and things can get better.

Thank you so much for coming and sharing your story with us.

Thank you.

♪♪ - Welcome back.

Now we're joined with Dr.

Daniel Mamah, Professor of Psychiatry at Washington University School of Medicine.

Dr.

Mamah, thank you for coming.

And can you explain to us a little bit from the clinical side what schizophrenia is?

- Well, schizophrenia is a brain, a complex brain condition that affects how we think or perceive reality.

And so what that means clinically is that symptoms can typically involve hallucinations, hearing things or seeing things that other people don't.

Or it could involve delusions or paranoia.

- And what causes this?

- Well, we don't really know.

There's actually a lot of research that has gone into that, but we know that it tends to run in families.

So there's actually a very strong genetic component.

But there are also environmental effects.

Stress can be a big cause, as well as drugs.

Drugs can really contribute to it.

- And then how do people typically get diagnosed?

How long does it take?

How does that work?

- Well, there's no single test for schizophrenia.

Typically, it is diagnosed by an expert based on the pattern of symptoms over time.

- And then how do you get better?

- Well, medications are very important, but really it is a combination of different things that are really important for people with schizophrenia.

So in addition to medications, often therapy is really important to help young people sort of deal with the stress or maybe deal with their new condition that they have, as well as some social supports, helping individuals with school, with their social relationships or with work.

- When does it typically start?

- Well, it really varies from person to person, but typically it's a disorder that starts in the teenage years or in the early 20s.

- So a person can be totally fine in childhood or in their early adulthood, and just one day they're hearing voices or having delusions?

- That is the typical course of schizophrenia, that seemingly normally developing young person, somewhere around high school or college age, all of a sudden sort of develop these concerning symptoms.

- Can you tell us a little bit about what is actually happening in someone's brain that's making this happen?

- There's a lot of research that has gone into that, but what most research, what most people believe is that it is a disorder of an altered circuitry in the brain.

The way the brain is sort of communicating with each other seems to be altered.

- And then when somebody gets diagnosed, is any information given or support given to their families?

Because we heard from Jeshua how he was a teenager dealing with a really complicated, difficult situation at home, and really had no one to talk to.

- Right, that is the ideal circumstance, that the family is informed, the family is provided support.

Unfortunately, that doesn't happen in every case.

- Right.

- Yeah.

- And are there racial or socioeconomic differences in how people are diagnosed or the type of treatment options that are available to them?

- There is a disparity among certain communities.

Typically, black and brown communities, immigrant communities, tend to be diagnosed at higher rates.

- Why is that?

- Well, we don't know for sure.

I mean, some of it has to do with socioeconomic differences.

Some of it could be due to cultural differences and sort of accepting that one has an illness.

And then some of it has to do with sort of the unique stressors that pertain to certain communities.

- Communities that there might be more stress in certain situations that could trigger an underlying genetic vulnerability.

Also, I mean, I've heard this, and I hope you can address this a little bit, but could there also be some bias in the medical system towards certain communities that might make it more likely that certain behaviors get labeled wrongly?

- Yes, that is probably part of the problem.

It doesn't appear to be the only issue.

- Okay, can you say a little bit more about that?

Like, how does that manifest?

How can that happen in a clinical setting?

- Well, when somebody presents with a psychotic symptom, there are different kinds of disorders that can, there are different diagnoses that can be made.

Schizophrenia is not the only psychotic disorder.

One could have, say, bipolar disorder with psychotic features, and sometimes it can be really hard to categorize a patient into one or the other.

And so it is possible that some individuals may more likely be diagnosed with schizophrenia as opposed to a different kind of condition.

- Is there this like trial and error period in trying to find the right medications or trying to find the right treatment?

- Well, typically when somebody comes in, there is, the doctor tries to make the best decision regarding medication.

It's not always the one that ends up being the most effective.

And so there is a little bit of a trial and error, but sometimes it is based on effectiveness in family members or side effects.

- One thing that people have said to me that I know they're worried about side effects, about medicine that just makes them incapacitated or is too sedating or makes them unable to function.

Is that a concern that you hear and how do you address that?

- Well, we definitely wanna make sure that we listen to the patient.

If they are having side effects, we know that that can contribute to noncompliance with treatment.

- Right, people don't wanna take a medicine that makes them feel worse.

- Exactly, and so I think it's really important to kind of listen to them, and if it's possible, try to find alternatives.

- Is that, what are some of the most common concerns that you hear that people have with side effects, or side effects that you've encountered that people say?

- Well, I think often what people say is that it sort of makes them sedated.

They're not able to kind of do the things that they don't wanna do or it makes them not feel like themselves.

And then some people may say that it makes them not hear voices and they wanna hear voices.

- Oh, really?

- Absolutely.

So it's gonna be very different from person to person.

- Wow, and so is this a condition that is treatable long-term or what do long-term outcomes look like for people who have this?

- It tends to be positive.

I think the main key is if individuals are receiving treatment consistently.

The other thing is it's also very important to identify the problem early because we know that the earlier that you can identify and treat the person, the better the long-term outcomes are.

So those two things, early identification and consistent treatment are really the key.

- And so if you have those things, then a person can actually have like a normal healthy life?

- Right, and this is really important for people to know, that schizophrenia is treatable with the right kind of treatment.

And yes, people can have a healthy life.

They can have jobs and they can finish school and they can have normal relationships with the right kind of care.

- That is really important, I think, for people to know because, and I think a lot of Hollywood depictions of schizophrenia, people have an understanding of it that, oh, it can be so extreme and hard to control, but what you're saying is that that's not always the whole story.

- It's not always the whole story.

I mean, schizophrenia can be very dramatic, as we've heard earlier.

I mean, it can be very disruptive, but most of the time, that is prior to treatment.

With treatment, those things tend to-- - Do you find that families, family members that have grown up with a parent who has such a significant mental health condition, that they would also benefit from some kind of therapy or treatment themselves?

And can you say a little bit about what that trauma feels like?

- Right, I mean, this is something that a lot of times we forget about, is how this illness can affect your family.

If you have a son or a daughter with schizophrenia, it can be extremely difficult to see your child going through this.

If you have a parent or a sibling, it can be really difficult with the disorganized behaviors that come with it.

And yes, caregivers and family members also need support.

They need to be educated about the illness, that this is not a life sentence, that this can get better.

And a lot of times they themselves need therapy or support.

- How do you feel like we're doing as a society in terms of stigma related to this?

- I think it's still there, but it's definitely getting better.

I think the more that we have shows like this one and just talking about what mental illness is and the more people are aware of it, I think that has gotten better.

- And where do you think that stigma originally came from or what causes it to perpetuate?

- I think there's always been a thing with mental illness because it almost seems like it's not a real problem.

- Because you can't see it.

- You cannot see it.

It feels like you can control it and you're just making it up or maybe there's some spiritual cause and it's not really an illness.

And I think that's probably where it is.

And then also the fact that there is no sort of biological marker yet where people can see that this is illness.

Now that's changing, but I think that's probably part of the problem.

- So that's what I was gonna ask you about is what new research or therapy treatments are you excited about as it relates to schizophrenia?

- Well, I would say that there are probably two different things that I'm particularly excited about.

One is this idea of prevention, of trying to recognize people before they have their first psychotic break, when they are still in kind of their prodromal stage.

And there's been a lot of promise in that area.

Now if that happens, obviously, that means that we may be able to prevent schizophrenia altogether.

We may be able to prevent this problem.

- That would be incredible.

- So there's a lot of hope there.

And then the second thing is this idea of precision psychiatry, where we know that not everybody with schizophrenia has the same kind of a brain change.

Some people have this kind of, and trying to tailor medications, tailor treatments to your specific brain abnormality, that is expected to have better outcomes.

- Oh, right.

And if there are certain tests or ways to validate which medicines work best with different people, it would save a lot of suffering.

- Exactly.

- Because I know that people are less likely to take medicines or it affects their relationships more when they can't get on the right type of treatment.

Is there a message you would like to leave our audience with as when it comes to this issue?

- Well, I'd like to say that there's hope that schizophrenia can get better.

- Yeah.

- It does get better.

People are able to live normal lives.

I know it's challenging a lot of times to have a family member or a loved one, but with the right treatment, with the right care, there is a really good chance that things can get better.

- Thank you so much.

Thank you for coming and sharing that really important message and your insight and knowledge with us.

♪♪ - This program is funded in part by the following.