Mysteries of Mental Illness (2021) s01e01 Episode Script
Evil or Illness?
1
(grunting)
VIRGINIA FUCHS: My dad taught me
how to water-ski
when I was four.
I've done team sports.
I got involved in running
in high school.
(grunting)
While I was in college,
that's where I actually found
boxing.
(crowd cheering, applause)
I dedicated everything
to boxing.
(crowd cheering)
I won the Olympic trials for the
2021 Olympics.
♪
And now I'm in
the top three in the world,
so getting the gold
is definitely doable.
WOMAN:
What are you doing, Ginny?
FUCHS: I just felt like my feet
got very, very contaminated
and it made my anxiety
go to a ten.
It makes, it makes the world
feel like everything's
falling down.
I feel like I'm gonna throw up,
my heart's racing, I can't
I'm foggy,
I can't think straight.
(grunting)
Boxing is the only thing
that takes me away
from my obsessive thoughts
and my OCD world.
Like, I know
I'm a strong-willed person.
And I have good self-control
when it comes to boxing.
But when it comes to my OCD,
it's, like, no self-control.
I use, like, eight to 12
toothbrushes in one session.
Because I might brush it
for ten seconds,
be, like, "Oh,
the brush feels contaminated."
I don't know why
I get this thought.
It feels contaminated,
throw it away, grab a new one.
(repeatedly punching speed bag)
I'm, like, "Wow, Ginny.
"You can spar eight rounds,
"go hit the bag six rounds,
and go do a 30-minute run."
That's easy to me.
But I can't clean a countertop
and wash my hands
in ten minutes.
There's no way I would be able
to do that in ten minutes.
That would take me,
like, two hours.
♪
There's always a constant battle
in my head.
Like, "Ginny, let's stop,"
but I can't stop.
Even though I want to so bad.
♪
Blows my mind, almost.
(grunting)
I don't understand why I can't.
And that's what I'm still
trying to figure out.
(sniffs)
♪
JEREMIAH ROBINSON: Well, I was
diagnosed with bipolar,
PTSD, schizophrenia,
and depression.
♪
MATTHEW ROSENBERG: I've been
diagnosed
with co-morbid depression,
but it is secondary to the OCD.
LAURA DUNN:
Generalized anxiety.
I'm pretty confident that that
is my formal diagnosis.
NARRATOR:
Half of all Americans
are diagnosed with
a mental illness
during their lifetime.
I don't want to be viewed
as someone
who has a psychological problem.
MIA YAMAMOTO:
I felt completely alone.
Every single person
that you communicate with
tells you you're crazy.
Here I am saying, "You know,
my family would probably be
better off without me."
NARRATOR: For many,
the diagnosis of a
mental illness is made worse
by the stigma
that accompanies it.
We have a natural inclination as
human beings to be afraid
of the things
that we don't understand.
RYAN MAINS:
I didn't think mental illness
was something that happened
to normal people.
NARRATOR: And in the era
of the COVID pandemic,
even more Americans
grapple with mental illness.
RACHEL YEHUDA:
One out of every five people
that were treated for COVID
have developed
a mental health illness.
We know that there
are a lot of people
that have been traumatized.
SIDNEY HANKERSON:
Coronavirus has highlighted
health inequities in general,
and the rates of depression and
anxiety are through the roof.
NARRATOR:
Now, more than ever,
the cracks in America's mental
health care system are exposed.
JEFFREY LIEBERMAN: At this point
in time
in the 21st century,
we know more
than we ever have in history,
but at the same time,
far less is being done
than could be done.
Because treatment of people with
mental illness has always been
sort of separate and unequal.
There's so much stigma and fear
as it relates to mental illness.
People might do whatever
they can to say
it's anything but that.
NARRATOR:
Why?
Why does mental illness
carry such stigma?
KEITH WAILOO:
Lowering levels of stigma
has proven to be very difficult.
You see this intermingling of
social judgment
and medical judgment
always in the history
of psychiatry.
♪
NARRATOR:
The past holds clues to why
the puzzle of mental illness
is so hard to solve.
♪
Since the beginning
of recorded history,
people searched the body,
the soul, and the brain
for clues into
mysterious behaviors,
asking, "Are they evil
or illness?"
In fifth century BCE Greece,
Hippocrates,
known as the father of Western
medicine, wrote these words.
ANDREW SCULL: "It is the brain
which is the seat of madness
"and delirium of the fears
and frights
"which assail us.
"Insomnia and sleepwalking
of thoughts that will not come,
"forgotten duties
and eccentricities
"all such things result from
an unhealthy condition
of the brain."
NARRATOR: This was a radical
notion at a time
when most saw madness as a curse
from the gods.
SCULL:
This idea that so much of
what is essentially human
about us
runs through this thing
that sits inside our head
is a remarkable insight.
NARRATOR: Hippocrates believed
the health of the brain
depended on the health
of the whole body.
His ideas were inspired
by the culture of his time.
For the Greeks,
the four elements
air, earth, water, and fire
Were essential
to their understanding
of the world.
And Hippocrates claimed they
corresponded to four fluids
in the body called humors.
ANNE HARRINGTON:
Humoral theory saw a variant
of each of the four elements
operating in the human body.
♪
They were either
dry or they were wet.
And they were either hot
or they were cold.
The way to stay healthy is to
have everything in balance,
not too hot, not too cold
sort of the Goldilocks kind of
principle of good health.
NARRATOR: This theory would
shape the treatment
of the mentally ill
for more than 2,000 years.
AHMED RAGAB: Most physicians
believed these humors
affected the brain
and therefore affected
how people actually behaved.
For example, like, a person with
more black bile in their body
would be more depressed.
So it can lead to insomnia,
forms of hallucinations.
It can lead to a number of other
issues that we would identify
as mental illness.
NARRATOR: Doctors believed blood
carried the humors
throughout the body.
So they treated these imbalances
by bleeding patients
with leeches or knives.
But who was considered
mentally ill
was shaped by the culture
of the time.
COOMBS: Historically, medicine
in general and also psychiatry
have looked at themselves
as immune to the impact
of society and culture,
as if, that it would be
unbiased, right?
And totally just trying
to be scientific.
But you see
from the very beginning
ways that people try to make
sense of what they're seeing
that are completely shaped
and informed
by the ways in which the world
is biased.
NARRATOR:
One enduring bias embodied by
an ancient Greek diagnosis
targeted women
who behaved too emotionally.
SCULL: Hysteria is a diagnosis
that doesn't exist anymore.
It derives from the Greek word
for a womb.
There was a sense that the womb
wasn't fixed in place,
it could move about,
and part of the mischief it
created was upset in the body
and in the brain
and in the behavior of women.
NARRATOR: Even late into
the 20th century,
when the female anatomy
was better understood,
doctors continued to diagnose
women with hysteria.
RAGAB: The term hysteria has
expanded and shrank depending on
society and depending on
where women are.
In many cases, women simply
voicing their opinion,
participating in society,
or offending a prominent male
in their household
would be branded
as mentally ill.
♪
NARRATOR: The beliefs of the day
often shape the understanding
of mental illness.
WAILOO: In societies where
authority was organized
around religion,
it was common sense
that mental illness was either
divinely inspired or the product
of devilish intent.
NARRATOR: In the fourth century,
the rapid rise of Christianity
forged an enduring framework
that would shape how society
sees the mentally ill
to this day.
Early proselytizers
quoted the Old Testament,
warning non-believers,
"The Lord shall smite thee
with madness."
ALLEN FRANCES: One of the
problems
for the mentally ill
that came with Christianity
was that mental illness
was related to the morality
and the worthwhileness
and the sinfulness of the person
who was suffering.
So if life was a battle
between God and the devil,
the mentally ill were seen
as pawns of the devil.
NARRATOR:
When it came to treatment,
humoral techniques competed
with religious ritual.
GEORGE MAKARI: You would vet
these people, triage them,
like in an E.R.,
and try to figure out whether,
let's say, a delusion
was due to a supernatural spirit
that had invaded their soul
or a disruption of their body.
It was a critical
fork in the road,
because if it was a disruption
of their body,
you were going to send them
to the humoral doctors,
who would bleed,
who would do their thing.
If it was a possession
of the soul,
you needed to really be careful
with this person,
'cause the power of a witch
and of being possessed,
they can possess others.
FRANCES:
And so they were shunned,
and even worse,
they were often punished.
Sometimes with the best of
intentions exorcisms,
but exorcisms that might result
in death.
♪
SUSANNAH CAHALAN:
Anyone that doesn't fit into
the kind of archetype of what
a woman is supposed to be
is obviously ill
or sick/a witch.
That is a direct reflection of
the culture that it came from.
So psychiatry is a science
that grapples constantly
with cultural norms,
because it's really deciding
what's outside the kind of
spectrum of normal behavior
and what is inside it.
The question of what these
behavioral problems mean
has persisted, right?
The, "Why this person?"
"Why me?"
"There must be some meaning
associated
with this affliction."
So even though
our religious and social
and scientific authority
has shifted over time,
there is still this notion,
this quest for meaning.
♪
(indistinct chatter)
CECILIA McGOUGH:
If I lived in a different time,
I could have very easily
have been labeled possessed.
It could have cost my life.
When I was very young,
maybe five,
I remember seeing
shadowy figures.
I got very confused
and scared about what it was.
♪
I grew up in
a very religious community,
so I was embarrassed
about these hallucinations,
because I started thinking
that maybe this is a punishment,
maybe I did something wrong.
♪
NARRATOR: Cecilia McGough
turned away from religion
and towards science for answers
to the unknown.
McGOUGH: I loved school.
It was an escape for me.
And I became quite the nerd.
NARRATOR: When she was 17,
Cecilia fell in love
with astrophysics
and helped discover a type
of collapsed star
called a pulsar.
♪
McGOUGH:
That was an amazing opportunity,
but this was the same time
that my hallucinations
were becoming much more
prevalent.
(static hissing)
I started hearing
staticky whispers
and struggling with
scattered thoughts.
Up to, like, the moment,
I was, like, "Cecilia,
"it just might come up on the
screen as, like, you know,
"like, nothing's there, you
know, or, oh, there's a lot of
"RFI there, you know,
it must have been
some wacky radio signal,"
you know?
These symptoms progressed.
And then, I watched the older
adaptation
of Stephen King's "IT."
It really resonated with me,
because the kids
were seeing something
that the adults weren't.
And I started seeing,
like, these shadowy figures
very similar to the clown.
I think, like, something with my
consciousness sort of, like,
latched on to that figure,
and it's still a hallucination
that I struggle with 24/7,
even to this day.
♪
I kept these hallucinations
very much a secret.
♪
I was hoping that maybe if I
moved away, things will change.
But it was quite the opposite.
♪
In college, I tried to go to
different mental health clubs,
but no one was really talking
about hallucinations.
So it in a way
even stigmatized it more,
because I felt like if I can't
even open up about this
in a mental health space,
then, like,
is there something
that wrong with me?
♪
It was just a very dark time
in my life.
I wasn't just losing my future,
but I was also losing my mind,
and I didn't know if I wanted
to live like that.
♪
I thought it would be better
to just sort of end things.
♪
And I tried to take my own life.
♪
NARRATOR: A combination
of the Greek words
"split" and "mind,"
schizophrenia
is used today to describe
Cecilia's hallucinations
and scattered thoughts.
While this diagnosis only dates
to the early 20th century,
individuals have experienced
Cecilia's constellation
of symptoms
across time and culture.
This is the case for other
mysterious disorders, as well.
♪
In the 16th century,
St. Ignatius Loyola,
founder of the Jesuit order,
blamed himself for his
obsessive behaviors he called
"scruples" or "doubts"
about his faith in God.
Today, psychiatrists still use
the word "scrupulous"
to describe certain types
of obsessive behaviors.
And for many, the legacy of
self-blame persists.
FUCHS: I was diagnosed with OCD
when I was in sixth grade.
My family, they support me
all the way.
But I hid my OCD, 'cause
I was scared of getting judged.
I didn't accept it, and I was,
like, "That's not who I am.
I don't want people to know,
that that's who I am."
I came out to the public in 2015
at the Olympic trials,
because I knew that I was going
to be around, like,
my team members 24/7
and rooming with them.
So, I knew I wasn't going to be
able to hide it from them.
♪
(groans)
Okay, you know what?
That's not going to work.
I forgot I was out of
plastic bags, but I got an idea.
See, you wanna
When I'm out of something
and I need to do something,
I can figure out a way
to get around it.
(sniffs)
This thing in the middle,
the top of it is contaminated
to me,
because it doesn't really
get washed,
so I always have to cover that,
'cause it'd be impossible
to take that out
without my clothes touching it.
NARRATOR:
Obsessive-compulsive disorder
is characterized
by anxiety,
repetitive unwanted thoughts,
and compulsive behaviors.
ANGELA SMITH:
What we look at to determine
if something meets
the threshold of OCD
is the frequency and intensity
and level of distress
that it causes.
(Fuchs sighs)
So this happens with this, um,
washing machine.
My arm touched the side, so now
I gotta go wash it off.
SMITH: With Ginny,
her symptoms right now are at
a severe level, in that the
compulsions take up
several hours a day.
FUCHS: I'm so focused on
getting that clean feeling
of what it is at the moment,
I'm not realizing the mess
I'm creating around me.
The tip of this
just actually touched that,
which is contaminated to me,
so
I can't use, like,
the squirter thing.
I just have to take this off.
I could spend almost $500 a week
on just supplies.
And I go through soap a lot.
When I moved to the
Olympic Training Center,
so these past four years,
I've relapsed really bad.
It has hit me very hard,
to the point to where I feel
no control over it.
Coronavirus has not helped.
It's kind of made it worse.
I've my anxiety level is
(sighs)
From a scale from one to ten,
it's just,
I wake up with an eight and
I can't get it down to a one.
(sighs): Okay.
It's the only thing in my life
that is really, like
Almost, like, a good way
to describe it,
like, possesses me
It's kind of scary.
(humorless chuckle,
inhaling deeply)
♪
Don't
Hold on, I gotta concentrate.
Okay.
♪
(shudders)
Hate these washing machines.
So I bring myself down
a lot, like,
"I'm never going to be able
"to have a normal life,
"I'm never gonna be able
to own a house,
and I'm never gonna be able
to have kids."
And it's so distressful.
It takes so much energy.
I do that every day,
three to four times a day.
These items right here,
I have to rewash them because
it touched the in,
the rim of the washing machine
that I feel is contaminated.
But my therapist
tries to get me out of that
negative loop,
so I don't go down that hole.
♪
So, we're kind of manipulating
my mind, in a way.
♪
NARRATOR: Today,
therapy is a common intervention
used to "manipulate" the mind.
But the modern concept
of the mind
is only a few hundred years old.
In the 18th century
Known as "the Age of Reason"
people looked beyond religion
for clues into the mysteries
of mental illness.
England's King George III
ruled a global empire.
But when he was 50 years old,
he was racked with convulsions
and delusions,
and began speaking incessantly
until he foamed at the mouth.
MAKARI:
When King George III became ill
and started to spout nonsense,
it was exceedingly distressing
because he was supposed to be
close to God.
Initially, the doctors around
him
tried the usual
humoral remedies.
They bled him, they blistered
him, and it didn't work.
♪
MAKARI:
Everyone by this point knows,
you call in the humoral doctors,
you probably should get ready
for the funeral.
'Cause they're gonna kill you.
If you're not going to die
on your own,
they'll bleed you to death.
But King George's wife
took a chance.
She called in a doctor
named Francis Willis, who was,
you know,
rather obscure country doctor,
but he had adopted the methods
that had started
with John Locke.
John Locke is the first person
who says,
"There's a thing called a mind."
NARRATOR: Locke,
a philosopher and physician,
defined the mind as the source
of consciousness and identity,
and claimed it was part of
the natural
not supernatural world.
MAKARI: And because it's
a natural thing, it can be ill.
And this, he says,
is a kind of illness
that only the mind can have,
mental illness has nothing
to do with a soul.
We need to treat it.
You gotta attack
these incorrect ideas.
You've got to refute them.
And Francis Willis
has the gall to do this
to the king.
NARRATOR: Willis took Locke's
ideas and attempted
to manipulate the mind of King
George with physical force.
But a letter from the queen's
attendant reveals
this new therapy
was not so different
from the spiritual exorcisms
of the past.
SCULL: "The unhappy patient
was no longer treated
"as a human being.
"He was sometimes
chained to a stake.
"He was frequently beaten
and starved, and at best,
was kept in subjection by
menacing and violent language."
You know, as we've seen,
exorcism involved,
through some metaphysical means,
driving out the devil.
This is a more physical attempt
to force the patient back into
the world as it is,
not into the phantasmagorical
world that he is trapped in.
♪
MAKARI: Francis Willis printed
a coin that said,
"The king is restored."
And on the back, he might as
well have put, like,
"Francis Willis call me,"
because the coin said,
"This is the guy who did it."
Now, all throughout Europe,
there was this almost panic.
The English know how to treat
mental illness.
They can cure it.
This was, in a way,
the biggest moment
for the emergence
of a mental kind of medicine.
♪
NARRATOR: King George relapsed
12 years later,
but Europe embraced this
new kind of "mental medicine"
and its physical interventions.
(machine ratcheting)
The Industrial Revolution
was in full swing,
and every facet of society
turned to mechanization.
Following the trend, physicians
even invented machines
to cure madness.
♪
SCULL:
One is the swinging chair.
The patient was strapped
into the chair,
and started to spin faster
and faster and faster.
People vomited, they voided
their bowels and their bladders.
Their hair stood on end.
They lost consciousness
in the end.
There were all kinds of devices
like this.
♪
(water splashing)
CAHALAN: It's this approach
to trying to make something
in the mind a physical force.
Because if it's just kind of
metaphysical,
if it's just in the mind,
how do you fix that?
So by making it
a part of the body,
it kind of galvanized medicine
to try to treat it
in many misdirected ways.
(Lorina Gutierrez speaking
indistinctly, dog barking)
LIEBERMAN: Right now, there is
no objective biologic test
that can be used for
mental disorders.
We'd like to have them.
We desperately seek them.
It's the Holy Grail.
(Lorina speaking indistinctly)
NARRATOR: Even today,
many cases confound
both doctors and patients,
and people still search
the mind, the body,
and even the soul for answers.
LORINA: You know what I mean.
(Stephen Gutierrez murmurs)
LORINA: I'm talking about you,
I'm talking about you you.
STEPHEN: I don't know what
you're talking about.
I was working nights.
Lorina called me and
said she wanted me to come home
because she didn't feel good.
(Lorina speaking indistinctly,
dog barking)
STEPHEN:
By the time I got home,
she was not making any sense
at all.
Making up her own words.
(Lorina panicking)
STEPHEN: She kept saying the
word "fire" a lot.
(Lorina panicking,
speaking indistinctly)
STEPHEN: Religion is a big part
of our life.
So even though it might sound
crazy to a lot of people,
I thought,
"Could my wife be possessed?"
It did cross my mind.
We have holy water in our house.
I splashed her, it got her
pretty good in the face,
but nothing happened.
So I called up her doctor.
MARCUS HIGI: In Lorina's case,
you're left with, "Okay,
this has got to be psychiatric
and psychological."
That was the conclusion
that I came to.
A lot of the things
that started to come up
appeared to coincide with an
anniversary
of her mother's death and
an extremely difficult childhood
with a long history
of multiple episodes of abuse.
So it seemed like the
perfect storm
of a lot
of psychological issues.
NARRATOR: Lorina was admitted to
a psychiatric hospital.
But after nearly a week
on medications,
she showed no response.
STEPHEN: They did tell me
one day,
"We don't think this
is something psychiatric."
They said, "We think
it's something medical.
We need to send her back
to the hospital."
So they start over.
They were just trying everything
they can.
They came back and said,
"Look, we see something,
like a mass,
on one of her ovaries."
And they said,
"We found antibodies.
"In our lifetime,
we would never think
we would ever see any of this."
♪
NARRATOR: A team of specialists
uncovered evidence
of a rare autoimmune disease
attacking her brain
called anti-NMDA
receptor encephalitis.
For her, triggered by an immune
response to an ovarian tumor.
HIGI: What appeared to be a
psychotic break
was really just a symptom of a
storm of hormones
and chemicals that just
essentially
made her brain on fire.
NARRATOR: The disease was
virtually unknown
until journalist
Susannah Cahalan
brought it
to the world's attention.
CAHALAN:
I was the 217th person
to be diagnosed with this ever
in the history of the world
But I remember feeling so
ashamed about the psychosis,
about the hallucinations.
First was misdiagnosed as
bipolar disorder,
and then was misdiagnosed
as schizoaffective disorder.
And as I became more
and more psychotic,
I became a difficult patient
is what I was called.
There was a hopelessness.
But when I was diagnosed with
autoimmune encephalitis,
there was a shift.
You could recover from this
illness.
Whereas the implication with a
serious mental illness
is that it's something that you
have for the rest of your life.
LORINA: Please tell me I'm not
on fire.
STEPHEN: No, you're not.
Please tell me I'm not on fire.
STEPHEN:
You don't remember that one?
LORINA: This disease just took
over my mind,
heart, body, soul everything.
It took probably about five
months of me being home
for me to even really know
I was here in my house.
It's just very scary.
But who knows how many
individuals have ended up in the
psychiatric ward
being labeled with schizophrenia
or anxiety
or bipolar or what have you,
when there could be more of a
underlining medical issue?
You just never know.
♪
NARRATOR:
Lorina's case sheds light
on how biology and
mental illness are intertwined.
Was she suffering from
a physical or mental disorder?
Is there even a difference?
This question
has long puzzled science.
In the late 1800s,
a biological breakthrough
raised hopes
researchers were close
to finding
the root of all mental illness.
Advances in dissection revealed
the brain contained cells
called neurons.
And scientists discovered
different regions
controlled different behaviors,
like speech, movement,
and sight.
Would they find the source
of madness next?
This was the era of the asylum.
Hundreds were built to treat
and house the insane.
When patients died,
their bodies were often sold
to researchers.
They probed these corpses
and zeroed in on
a mental illness afflicting
about one in four
asylum patients:
general paralysis of the insane.
SCULL: This came with both
neurological symptoms
and psychiatric symptoms,
which were often
quite subtle at first:
difficulty articulating words,
shuffling gait.
You at the same time developed
these extraordinary
psychiatric symptoms.
You often believed
you were Jesus or Napoleon
or Mary, Mother of God.
And as this progressed, you
became increasingly paralyzed
and eventually you usually
choked to death.
Some psychiatrists thought that
general paralysis of the insane
was the end state
of all forms of madness.
NARRATOR: But then doctors
noticed a surprising connection.
Dissections revealed
that in many patients previously
treated for syphilis,
a common sexually transmitted
disease,
the infection had migrated
to their brains.
SCULL: It creates a sense that
biology may be a way forward.
If a quarter of all madmen
were really the result
of infectious illness,
what about the rest of them?
NARRATOR: Soon, advances
in imaging techniques
unlocked the details of single
neurons, and for the first time,
scientists found physical
evidence of diseases
like Alzheimer's
and Parkinson's.
CAHALAN:
But this idea that we
were going to make
this major breakthrough
in understanding all of madness
through biology,
through pathology,
um, that didn't come
to fruition.
♪
NARRATOR: Today,
ever more sophisticated tools
provide new clues.
Gene sequencing
may one day reveal
the genetic origins of
these diseases.
MRIs and PET scans offer insight
into how disorders
like schizophrenia
impact different regions
of the brain.
But there are still many
unknowns.
COOMBS: With schizophrenia,
not unlike any other diagnosis,
we know that there
are multiple factors,
but we don't know exactly,
you know,
which factors are playing out
more in which person.
How much of it
is, you know,
a biological component,
how much of it is social,
how much is psychological,
how much of it relates to trauma
and all different kinds
of aspects, is the question.
FRANCES:
So many genes are involved.
For schizophrenia, 150,
interacting in permutations that
are probably in the billions.
There's never
any specific genetic pattern
that explains a particular
clinical presentation.
We know more than we ever have,
but there's still a lot
that's not known.
And so that's a big reason
why the stigma persists.
♪
McGOUGH: I didn't talk about my
hallucinations at all.
After my first suicide attempt,
I didn't
feel comfortable.
It took me eight months after
that to finally get treatment.
I've had three near-attempts
since then.
NARRATOR:
Even after her diagnosis,
Cecilia tried to hide her
symptoms, but events intervened.
(sirens)
McGOUGH:
My second psych ward stay,
I had to open up afterwards
because the police
were involved.
They patted me down in front
of my roommates
and I had to convince
them not to put handcuffs on me.
I wasn't at all refusing to go.
I have no history of violence.
(sirens)
I believe I was gone
for ten days,
and when I came back,
people knew something was up,
and I had to set
the story straight.
So I opened up through
a social media post.
And that's when I started
realizing
that, you know,
this is something
that needs to be talked
about more.
So I'm Cecilia McGough,
I'm the blogger for
the "I Am Not a Monster
Schizophrenia Project."
I have a real problem
of getting trapped,
trapped in my bedroom, because
my hallucinations are the worst
when I wake up.
I'm doing this live stream right
now because it's important
that I do these live streams,
even when I'm,
when I'm struggling.
LIEBERMAN: There's extensive
data which shows that
if you're treated for an acute
episode of schizophrenia,
particularly early
or at the beginning
of your course of illness,
your response to treatment
is very good.
NARRATOR:
But if left untreated,
studies suggest schizophrenia
gets worse over time.
Cecilia didn't start therapy
or medication
until 15 years after
her first hallucinations.
McGOUGH:
This is my first video
since coming back from
my sixth psych ward stay.
NARRATOR: And like many living
with schizophrenia,
she's tried a variety of drugs
and therapeutic approaches.
Sometimes I feel
like it's a choice
for me to take my medicine,
go to sleep, be a good patient,
or stay up and do work,
because my medicine
makes me go to sleep.
LIEBERMAN: 80%-plus people will
have
a very significant response to
anti-psychotic drug treatment.
The thing is, is sustaining
that.
I tried different medications.
Some of them would make the
hallucinations worse.
COOMBS: With schizophrenia,
we believe that there's
a certain biological component,
but it's not the full story.
When I see those giant spiders,
that usually happens during
the medicine changes.
COOMBS: So what that means is
that, when we look at treatment,
we have to combine different
interventions
that target different types
of challenges.
♪
NARRATOR:
More than a century ago,
one doctor recognized
this complexity
and realized biology might
not have all the answers.
In the late 1800s, Sigmund Freud
was a frustrated neurologist
hoping to discover
the biological mechanisms
of thought and feeling.
MAKARI: The motor neuron had
been found,
the sensory neuron had been
found.
He thought for sure there's
gonna be a will neuron
and a memory neuron
and a thought neuron.
And he scribbled out
this thing called
"The Project for
a Scientific Psychology."
And then he looked at it
and he said, "This is a,
this kind of a madness, this is
all BS I'm making this up."
So Sigmund Freud is at the end
of his academic tether
when he gets this grant to go
to Paris and study with Charcot.
NARRATOR: When Freud met him in
1885, Jean-Martin Charcot
was the world's most prominent
neurologist.
At the Salpêtrière Hospital
in Paris,
he was trying to unravel
one of psychiatry's oldest
and most vexing diagnoses.
HARRINGTON: This was a hospital
for a lot of indigent, sick
women.
A group of those women had been
diagnosed with hysteria.
They suffered from
motor problems, paralyses,
and most dramatically, fall into
states of convulsion,
like someone with epilepsy.
MAKARI: Charcot, he thought
"You know, there's something
to this illness.
"I bet you
it's a neurologic illness
and it has discrete
neurologic stages."
He then tried to sort out
what those stages were.
NARRATOR: Charcot decided to use
a technique popular at the time:
hypnosis.
A trance-like state
was induced in patients
to control their minds
and bodies.
HARRINGTON: Hypnosis drew from
the exorcism rituals.
Exorcists often required
the demon to obey commands.
"Make this person go rigid!"
And the person would go rigid.
"Okay, now, demon,
now that you know
that I control you, begone!"
So hypnotists kind of
do a little bit of that, too.
Charcot uses hypnosis
to create on command
the various symptoms of hysteria
that he believes occur
naturally.
He can call them out on command,
and then he can photograph them,
or then he can demonstrate them.
MAKARI: Everyone wants to come
and see this.
And Freud goes there
and he's utterly blown away
by this stuff.
He writes to his fiancée,
"My brain is sated as after an
evening of theater.
No other human being has ever
affected me in the same way."
But that theater was not
all real.
The patients were figuring out
what the doctors wanted them
to do.
These apparently
spontaneous pictures
took two, three, four,
five minutes
to produce, and so
these figures had
to somehow learn
to hold these poses.
It was suggestion,
a bath of suggestion,
where what the doctors wanted,
the patients gave them.
And soon it seemed like that
was just the truth.
♪
NARRATOR: The medical
establishment dismissed
Charcot's work as unscientific.
MAKARI: And Freud goes back to
Vienna
just as Charcot's reputation
starts to really plunge.
And he comes out of it
with a new synthesis.
NARRATOR:
The notion that doctors can
tap into hidden parts
of a patient's mind
sparked an insight in Freud.
At the time,
society was starting
to embrace the concept
that humans and animals alike
possess innate instincts.
Charles Darwin had recently
introduced
the revolutionary idea that
evolution shapes
not just humans'
physical characteristics,
but their behavior.
FRANCES: Darwin said that we
have inborn tendencies
that developed during the
evolution
of our species, that
our behavior is just as much
a function of evolution
as is our body.
That was the home run.
♪
Freud applied
this Darwinian thinking
to clinical situations
by saying we had inborn
instincts
that were not always available
to consciousness.
The treatment is really
basically getting the person
to understand what was
previously unconscious
and to try to change
those patterns
through that understanding.
MAKARI: He said, "Whatever the
brain has to do with that,
"someday we'll find out.
"I'm just going to say that's
a black box
and I'm gonna track these things
psychologically."
And that's psychoanalysis.
NARRATOR: Psychoanalysis relies
on dream interpretation
and stream-of-consciousness
exploration
to resolve what Freud calls
neurosis,
the distressing conflict
between the conscious
and unconscious mind.
Finally,
after centuries
wrestling with the question,
"Is mental illness
an evil infestation
or a biological disorder?",
Freud argues it's part
of the human condition.
But how society applies
his ideas
changes as culture changes.
COOMBS:
We know for a fact
that when we're walking
and living our lives,
that there are all kinds of
behaviors and actions
that we do that are not within
our conscious awareness,
we just do them.
So why wouldn't that be the case
when it comes to unconscious
feelings, motivations?
So for me, sort of the lessons
and teaching of Freud
as it relates to some of that
is helpful.
Other things, not so much.
MAN (in film): Tommy wouldn't be
behaving as he is
if he weren't seriously upset
by something that we don't
understand at the moment
and that he's not aware
of himself.
NARRATOR: In the mid 20th
century, American psychiatrists
took Freud's ideas about
the importance
of early life experience
to the extreme.
After centuries of searching,
they claimed to have finally
found
the source of mental illness:
bad mothers.
WOMAN (in film):
You know it's the mother
who is responsible
for the child's character.
HARRINGTON: This does lead to a
kind of project
to identify the range
of ways that
mothers can harm their
kids' emotional development.
MAN (in film): She inflicts on
both her husband
and son the kind of punishment
she had.
- Poor child.
- And poor man.
HARRINGTON: It has a kind of
quasi-medical
sort of spirit to it,
because certain kinds of bad
mothering
lead directly to certain kinds
of messed-up kids.
MAN (in film): There's an angry,
frustrated woman.
HARRINGTON: There was a mother
that was blamed
for driving her children
into states of schizophrenia,
the "schizophrenogenic" mother.
There was a lot of controversy
over what
was exactly wrong with her.
But there was clarity
that there must be something
wrong with her,
because her children
were so sick.
MAN (in film):
He is placed on a couch
and urged to let his mind
roam freely.
NARRATOR: Through the lens of
this conservative era,
Freud's ideas were widely
adopted, but distorted.
PSYCHIATRIST: Now, tell me about
your mother.
NARRATOR: Psychiatrists saw the
need for new approaches
and built off Freud's use of
talk therapy.
FRANCES: Starting in the '50s
and '60s, there became
the addition of different
therapies
that focused less on unconscious
motivation
and more on the current
behaviors,
thoughts, and feelings,
with the idea that you might
have a quicker
and more efficient way
of promoting change.
SMITH: You are going to be
doing a cleaning, and we want
to try to achieve
not clean enough.
- Okay.
- Go.
NARRATOR:
To manage her OCD symptoms,
Ginny relies on one of these
different approaches,
known as
cognitive behavioral therapy,
or CBT.
SMITH: Not clean enough
NARRATOR:
CBT combines talk therapy
with a theory pre-dating Freud:
John Locke's notion
that it's possible
to identify problems
and manipulate the mind.
COOMBS: Cognitive behavioral
therapy is shown
to be really helpful
in how people build up
and bolster tools for themselves
to be able to, you know,
ask themselves and
challenge some
of their automatic thoughts.
NARRATOR: Ginny uses a form of
CBT called exposure therapy.
SMITH: Very different than lying
on a couch
talking about your mother.
That is just fine,
and it's relevant,
but the focus of exposure
therapy is to be in contact
with the thing that
you've been avoiding.
It's a very active kind
of treatment.
♪
NARRATOR:
Ginny's exposures include
using a single toothbrush
for two minutes
and touching dirty surfaces
she'd usually avoid.
SMITH: She's been in treatment
now with me somewhat on and off
over a year and a half.
And she, she is still in need
of treatment.
- I just feel weird.
- Mm-hmm.
NARRATOR:
Like many,
Ginny continues to search
for effective treatments.
SMITH: Sometimes it's a matter
of,
is medication being taken
consistently?
Sometimes the answer
has been no.
But I always hold on to hope
that things can be different
and we'll keep on working
for that.
It's a feeling, I don't know
how to handle this feeling.
Like, I feel like it's never
gonna go away
When I'm having a bad time,
I will go and do therapy with my
therapist every day.
Therapy for mental health
disorders, it's out of network,
so my insurance
doesn't pay much of it.
So that adds up.
If I resist those thoughts
sometimes,
it's, like, sometimes I get all
these other thoughts
that overwhelm my brain
that I, um
that I can't, like
that I feel stuck, like
I feel like I would just call my
coach
and say, like, "I can't
go to the gym."
♪
Well, I think society doesn't
help people
with mental health as much
as, like, physical problems,
because a lot of people
still don't understand it.
The United States Olympic
Committee,
they're willing to help me,
because they want to see me
succeed and win a gold medal.
So I'm lucky with that,
but most people don't get that.
Most of my therapists
that I've had
have been when I've been
in a psych ward.
I went to a therapist once.
But unfortunately, and this is
the case for a lot of people,
I couldn't afford to have
a therapist
and a psychiatrist
and support myself.
It is frustrating that sometimes
you have to make that choice
on what, what can you afford for
your mental health.
NARRATOR:
After centuries,
mental illness is still shrouded
in stigma and mystery.
Like millions,
Cecilia and Ginny
live with disorders
that are challenging to treat,
and managing difficult symptoms
dominates daily life.
I sometimes actually
take pictures of little spiders
with my phone, because I've
realized
that if I take a picture,
I don't hallucinate it on the
NARRATOR: Cecilia's social media
presence took off
I think that says "hello from
Spain."
NARRATOR: attracting
thousands around the world
living with schizophrenia.
WOMAN: Hey, Mr. Honey, don't
you drive too fast for me ♪
Turn the radio down
So you can hear me
NARRATOR: Cecilia left her
studies in astrophysics
and started the organization
Students With Psychosis.
It's a supportive community
that pushes back
against centuries of stigma.
MAN: We're starting a big
movement here tonight,
and, you know,
what we really want
to do is change policies
in the future.
(song continues)
McGOUGH: I think there can be
some parallels
between the discovery of pulsars
and also people realizing
that schizophrenia
is a medical condition.
When pulsars were first
discovered,
people were initially scared.
It was thought that they
were aliens.
But they realized that
pulsars can be used as, like,
these lighthouses in space,
a way to triangulate location.
It just shows how something
can be less scary
when we know more about it.
And I think the same can be
said about schizophrenia.
A lot of times, people
will look at me in fear after
I tell them
what I hallucinate,
but really, we all see,
hear, and feel things
that aren't there
when we're dreaming.
As much as I loved the research
I did with pulsars
I freaking love pulsars
I shifted gears
because I feel like I can
make more of an impact
or making this world better.
It helped make me feel less
alone.
When I look up at the sky,
there's still that hope.
WOMAN: So I can fly high
♪
NARRATOR: Only a few days after
Cecilia's event,
the COVID pandemic shut down
New York City and the world,
raising urgent new questions
about mental illness
and how society will respond.
WAILOO:
COVID-19 is a great revealer.
There is a sad and tragic
opportunity we have
to take stock
of what kind of vulnerabilities
exist
in our society and try to remedy
them.
At the same time,
looking back at history,
you wonder whether, you know,
Americans have the steel
to address the kinds of problems
that are being revealed
in our time.
♪
ANNOUNCER: Next, on "Mysteries
of Mental Illness"
CAHALAN: What is abnormal,
what's normal behavior?
What's illness?
RONALD BAYER:
The boundary is very fluid.
COOMBS: In the 1800s,
drapetomania was described
as an illness that led enslaved
people to seek freedom.
WAILOO: Societies decide
the lines of deviance.
YAMAMOTO:
I was not like everybody else,
so I thought
of course I was sick.
WALROND: In my 20s, I began
to experience depression.
You suffer in silence,
because, as a Black man,
there's not a desire
for one more label.
MAN (in film): One out of three
of you will turn queer.
MAN (in film):
Judgments have changed!
BAYER: People began to say,
"We're not sick
and you are oppressing us."
YAMAMOTO:
If I can survive this,
I'm going to be living the life
that I've always wanted to live.
ANNOUNCER: To order "Mysteries
of Mental Illness" on DVD,
visit ShopPBS
or call 1-800-PLAY-PBS.
This series is also available
on Amazon Prime Video.
♪
For more about "Mysteries of
Mental Illness,"
visit pbs.org/
mysteriesofmentalillness.
♪
♪
(grunting)
VIRGINIA FUCHS: My dad taught me
how to water-ski
when I was four.
I've done team sports.
I got involved in running
in high school.
(grunting)
While I was in college,
that's where I actually found
boxing.
(crowd cheering, applause)
I dedicated everything
to boxing.
(crowd cheering)
I won the Olympic trials for the
2021 Olympics.
♪
And now I'm in
the top three in the world,
so getting the gold
is definitely doable.
WOMAN:
What are you doing, Ginny?
FUCHS: I just felt like my feet
got very, very contaminated
and it made my anxiety
go to a ten.
It makes, it makes the world
feel like everything's
falling down.
I feel like I'm gonna throw up,
my heart's racing, I can't
I'm foggy,
I can't think straight.
(grunting)
Boxing is the only thing
that takes me away
from my obsessive thoughts
and my OCD world.
Like, I know
I'm a strong-willed person.
And I have good self-control
when it comes to boxing.
But when it comes to my OCD,
it's, like, no self-control.
I use, like, eight to 12
toothbrushes in one session.
Because I might brush it
for ten seconds,
be, like, "Oh,
the brush feels contaminated."
I don't know why
I get this thought.
It feels contaminated,
throw it away, grab a new one.
(repeatedly punching speed bag)
I'm, like, "Wow, Ginny.
"You can spar eight rounds,
"go hit the bag six rounds,
and go do a 30-minute run."
That's easy to me.
But I can't clean a countertop
and wash my hands
in ten minutes.
There's no way I would be able
to do that in ten minutes.
That would take me,
like, two hours.
♪
There's always a constant battle
in my head.
Like, "Ginny, let's stop,"
but I can't stop.
Even though I want to so bad.
♪
Blows my mind, almost.
(grunting)
I don't understand why I can't.
And that's what I'm still
trying to figure out.
(sniffs)
♪
JEREMIAH ROBINSON: Well, I was
diagnosed with bipolar,
PTSD, schizophrenia,
and depression.
♪
MATTHEW ROSENBERG: I've been
diagnosed
with co-morbid depression,
but it is secondary to the OCD.
LAURA DUNN:
Generalized anxiety.
I'm pretty confident that that
is my formal diagnosis.
NARRATOR:
Half of all Americans
are diagnosed with
a mental illness
during their lifetime.
I don't want to be viewed
as someone
who has a psychological problem.
MIA YAMAMOTO:
I felt completely alone.
Every single person
that you communicate with
tells you you're crazy.
Here I am saying, "You know,
my family would probably be
better off without me."
NARRATOR: For many,
the diagnosis of a
mental illness is made worse
by the stigma
that accompanies it.
We have a natural inclination as
human beings to be afraid
of the things
that we don't understand.
RYAN MAINS:
I didn't think mental illness
was something that happened
to normal people.
NARRATOR: And in the era
of the COVID pandemic,
even more Americans
grapple with mental illness.
RACHEL YEHUDA:
One out of every five people
that were treated for COVID
have developed
a mental health illness.
We know that there
are a lot of people
that have been traumatized.
SIDNEY HANKERSON:
Coronavirus has highlighted
health inequities in general,
and the rates of depression and
anxiety are through the roof.
NARRATOR:
Now, more than ever,
the cracks in America's mental
health care system are exposed.
JEFFREY LIEBERMAN: At this point
in time
in the 21st century,
we know more
than we ever have in history,
but at the same time,
far less is being done
than could be done.
Because treatment of people with
mental illness has always been
sort of separate and unequal.
There's so much stigma and fear
as it relates to mental illness.
People might do whatever
they can to say
it's anything but that.
NARRATOR:
Why?
Why does mental illness
carry such stigma?
KEITH WAILOO:
Lowering levels of stigma
has proven to be very difficult.
You see this intermingling of
social judgment
and medical judgment
always in the history
of psychiatry.
♪
NARRATOR:
The past holds clues to why
the puzzle of mental illness
is so hard to solve.
♪
Since the beginning
of recorded history,
people searched the body,
the soul, and the brain
for clues into
mysterious behaviors,
asking, "Are they evil
or illness?"
In fifth century BCE Greece,
Hippocrates,
known as the father of Western
medicine, wrote these words.
ANDREW SCULL: "It is the brain
which is the seat of madness
"and delirium of the fears
and frights
"which assail us.
"Insomnia and sleepwalking
of thoughts that will not come,
"forgotten duties
and eccentricities
"all such things result from
an unhealthy condition
of the brain."
NARRATOR: This was a radical
notion at a time
when most saw madness as a curse
from the gods.
SCULL:
This idea that so much of
what is essentially human
about us
runs through this thing
that sits inside our head
is a remarkable insight.
NARRATOR: Hippocrates believed
the health of the brain
depended on the health
of the whole body.
His ideas were inspired
by the culture of his time.
For the Greeks,
the four elements
air, earth, water, and fire
Were essential
to their understanding
of the world.
And Hippocrates claimed they
corresponded to four fluids
in the body called humors.
ANNE HARRINGTON:
Humoral theory saw a variant
of each of the four elements
operating in the human body.
♪
They were either
dry or they were wet.
And they were either hot
or they were cold.
The way to stay healthy is to
have everything in balance,
not too hot, not too cold
sort of the Goldilocks kind of
principle of good health.
NARRATOR: This theory would
shape the treatment
of the mentally ill
for more than 2,000 years.
AHMED RAGAB: Most physicians
believed these humors
affected the brain
and therefore affected
how people actually behaved.
For example, like, a person with
more black bile in their body
would be more depressed.
So it can lead to insomnia,
forms of hallucinations.
It can lead to a number of other
issues that we would identify
as mental illness.
NARRATOR: Doctors believed blood
carried the humors
throughout the body.
So they treated these imbalances
by bleeding patients
with leeches or knives.
But who was considered
mentally ill
was shaped by the culture
of the time.
COOMBS: Historically, medicine
in general and also psychiatry
have looked at themselves
as immune to the impact
of society and culture,
as if, that it would be
unbiased, right?
And totally just trying
to be scientific.
But you see
from the very beginning
ways that people try to make
sense of what they're seeing
that are completely shaped
and informed
by the ways in which the world
is biased.
NARRATOR:
One enduring bias embodied by
an ancient Greek diagnosis
targeted women
who behaved too emotionally.
SCULL: Hysteria is a diagnosis
that doesn't exist anymore.
It derives from the Greek word
for a womb.
There was a sense that the womb
wasn't fixed in place,
it could move about,
and part of the mischief it
created was upset in the body
and in the brain
and in the behavior of women.
NARRATOR: Even late into
the 20th century,
when the female anatomy
was better understood,
doctors continued to diagnose
women with hysteria.
RAGAB: The term hysteria has
expanded and shrank depending on
society and depending on
where women are.
In many cases, women simply
voicing their opinion,
participating in society,
or offending a prominent male
in their household
would be branded
as mentally ill.
♪
NARRATOR: The beliefs of the day
often shape the understanding
of mental illness.
WAILOO: In societies where
authority was organized
around religion,
it was common sense
that mental illness was either
divinely inspired or the product
of devilish intent.
NARRATOR: In the fourth century,
the rapid rise of Christianity
forged an enduring framework
that would shape how society
sees the mentally ill
to this day.
Early proselytizers
quoted the Old Testament,
warning non-believers,
"The Lord shall smite thee
with madness."
ALLEN FRANCES: One of the
problems
for the mentally ill
that came with Christianity
was that mental illness
was related to the morality
and the worthwhileness
and the sinfulness of the person
who was suffering.
So if life was a battle
between God and the devil,
the mentally ill were seen
as pawns of the devil.
NARRATOR:
When it came to treatment,
humoral techniques competed
with religious ritual.
GEORGE MAKARI: You would vet
these people, triage them,
like in an E.R.,
and try to figure out whether,
let's say, a delusion
was due to a supernatural spirit
that had invaded their soul
or a disruption of their body.
It was a critical
fork in the road,
because if it was a disruption
of their body,
you were going to send them
to the humoral doctors,
who would bleed,
who would do their thing.
If it was a possession
of the soul,
you needed to really be careful
with this person,
'cause the power of a witch
and of being possessed,
they can possess others.
FRANCES:
And so they were shunned,
and even worse,
they were often punished.
Sometimes with the best of
intentions exorcisms,
but exorcisms that might result
in death.
♪
SUSANNAH CAHALAN:
Anyone that doesn't fit into
the kind of archetype of what
a woman is supposed to be
is obviously ill
or sick/a witch.
That is a direct reflection of
the culture that it came from.
So psychiatry is a science
that grapples constantly
with cultural norms,
because it's really deciding
what's outside the kind of
spectrum of normal behavior
and what is inside it.
The question of what these
behavioral problems mean
has persisted, right?
The, "Why this person?"
"Why me?"
"There must be some meaning
associated
with this affliction."
So even though
our religious and social
and scientific authority
has shifted over time,
there is still this notion,
this quest for meaning.
♪
(indistinct chatter)
CECILIA McGOUGH:
If I lived in a different time,
I could have very easily
have been labeled possessed.
It could have cost my life.
When I was very young,
maybe five,
I remember seeing
shadowy figures.
I got very confused
and scared about what it was.
♪
I grew up in
a very religious community,
so I was embarrassed
about these hallucinations,
because I started thinking
that maybe this is a punishment,
maybe I did something wrong.
♪
NARRATOR: Cecilia McGough
turned away from religion
and towards science for answers
to the unknown.
McGOUGH: I loved school.
It was an escape for me.
And I became quite the nerd.
NARRATOR: When she was 17,
Cecilia fell in love
with astrophysics
and helped discover a type
of collapsed star
called a pulsar.
♪
McGOUGH:
That was an amazing opportunity,
but this was the same time
that my hallucinations
were becoming much more
prevalent.
(static hissing)
I started hearing
staticky whispers
and struggling with
scattered thoughts.
Up to, like, the moment,
I was, like, "Cecilia,
"it just might come up on the
screen as, like, you know,
"like, nothing's there, you
know, or, oh, there's a lot of
"RFI there, you know,
it must have been
some wacky radio signal,"
you know?
These symptoms progressed.
And then, I watched the older
adaptation
of Stephen King's "IT."
It really resonated with me,
because the kids
were seeing something
that the adults weren't.
And I started seeing,
like, these shadowy figures
very similar to the clown.
I think, like, something with my
consciousness sort of, like,
latched on to that figure,
and it's still a hallucination
that I struggle with 24/7,
even to this day.
♪
I kept these hallucinations
very much a secret.
♪
I was hoping that maybe if I
moved away, things will change.
But it was quite the opposite.
♪
In college, I tried to go to
different mental health clubs,
but no one was really talking
about hallucinations.
So it in a way
even stigmatized it more,
because I felt like if I can't
even open up about this
in a mental health space,
then, like,
is there something
that wrong with me?
♪
It was just a very dark time
in my life.
I wasn't just losing my future,
but I was also losing my mind,
and I didn't know if I wanted
to live like that.
♪
I thought it would be better
to just sort of end things.
♪
And I tried to take my own life.
♪
NARRATOR: A combination
of the Greek words
"split" and "mind,"
schizophrenia
is used today to describe
Cecilia's hallucinations
and scattered thoughts.
While this diagnosis only dates
to the early 20th century,
individuals have experienced
Cecilia's constellation
of symptoms
across time and culture.
This is the case for other
mysterious disorders, as well.
♪
In the 16th century,
St. Ignatius Loyola,
founder of the Jesuit order,
blamed himself for his
obsessive behaviors he called
"scruples" or "doubts"
about his faith in God.
Today, psychiatrists still use
the word "scrupulous"
to describe certain types
of obsessive behaviors.
And for many, the legacy of
self-blame persists.
FUCHS: I was diagnosed with OCD
when I was in sixth grade.
My family, they support me
all the way.
But I hid my OCD, 'cause
I was scared of getting judged.
I didn't accept it, and I was,
like, "That's not who I am.
I don't want people to know,
that that's who I am."
I came out to the public in 2015
at the Olympic trials,
because I knew that I was going
to be around, like,
my team members 24/7
and rooming with them.
So, I knew I wasn't going to be
able to hide it from them.
♪
(groans)
Okay, you know what?
That's not going to work.
I forgot I was out of
plastic bags, but I got an idea.
See, you wanna
When I'm out of something
and I need to do something,
I can figure out a way
to get around it.
(sniffs)
This thing in the middle,
the top of it is contaminated
to me,
because it doesn't really
get washed,
so I always have to cover that,
'cause it'd be impossible
to take that out
without my clothes touching it.
NARRATOR:
Obsessive-compulsive disorder
is characterized
by anxiety,
repetitive unwanted thoughts,
and compulsive behaviors.
ANGELA SMITH:
What we look at to determine
if something meets
the threshold of OCD
is the frequency and intensity
and level of distress
that it causes.
(Fuchs sighs)
So this happens with this, um,
washing machine.
My arm touched the side, so now
I gotta go wash it off.
SMITH: With Ginny,
her symptoms right now are at
a severe level, in that the
compulsions take up
several hours a day.
FUCHS: I'm so focused on
getting that clean feeling
of what it is at the moment,
I'm not realizing the mess
I'm creating around me.
The tip of this
just actually touched that,
which is contaminated to me,
so
I can't use, like,
the squirter thing.
I just have to take this off.
I could spend almost $500 a week
on just supplies.
And I go through soap a lot.
When I moved to the
Olympic Training Center,
so these past four years,
I've relapsed really bad.
It has hit me very hard,
to the point to where I feel
no control over it.
Coronavirus has not helped.
It's kind of made it worse.
I've my anxiety level is
(sighs)
From a scale from one to ten,
it's just,
I wake up with an eight and
I can't get it down to a one.
(sighs): Okay.
It's the only thing in my life
that is really, like
Almost, like, a good way
to describe it,
like, possesses me
It's kind of scary.
(humorless chuckle,
inhaling deeply)
♪
Don't
Hold on, I gotta concentrate.
Okay.
♪
(shudders)
Hate these washing machines.
So I bring myself down
a lot, like,
"I'm never going to be able
"to have a normal life,
"I'm never gonna be able
to own a house,
and I'm never gonna be able
to have kids."
And it's so distressful.
It takes so much energy.
I do that every day,
three to four times a day.
These items right here,
I have to rewash them because
it touched the in,
the rim of the washing machine
that I feel is contaminated.
But my therapist
tries to get me out of that
negative loop,
so I don't go down that hole.
♪
So, we're kind of manipulating
my mind, in a way.
♪
NARRATOR: Today,
therapy is a common intervention
used to "manipulate" the mind.
But the modern concept
of the mind
is only a few hundred years old.
In the 18th century
Known as "the Age of Reason"
people looked beyond religion
for clues into the mysteries
of mental illness.
England's King George III
ruled a global empire.
But when he was 50 years old,
he was racked with convulsions
and delusions,
and began speaking incessantly
until he foamed at the mouth.
MAKARI:
When King George III became ill
and started to spout nonsense,
it was exceedingly distressing
because he was supposed to be
close to God.
Initially, the doctors around
him
tried the usual
humoral remedies.
They bled him, they blistered
him, and it didn't work.
♪
MAKARI:
Everyone by this point knows,
you call in the humoral doctors,
you probably should get ready
for the funeral.
'Cause they're gonna kill you.
If you're not going to die
on your own,
they'll bleed you to death.
But King George's wife
took a chance.
She called in a doctor
named Francis Willis, who was,
you know,
rather obscure country doctor,
but he had adopted the methods
that had started
with John Locke.
John Locke is the first person
who says,
"There's a thing called a mind."
NARRATOR: Locke,
a philosopher and physician,
defined the mind as the source
of consciousness and identity,
and claimed it was part of
the natural
not supernatural world.
MAKARI: And because it's
a natural thing, it can be ill.
And this, he says,
is a kind of illness
that only the mind can have,
mental illness has nothing
to do with a soul.
We need to treat it.
You gotta attack
these incorrect ideas.
You've got to refute them.
And Francis Willis
has the gall to do this
to the king.
NARRATOR: Willis took Locke's
ideas and attempted
to manipulate the mind of King
George with physical force.
But a letter from the queen's
attendant reveals
this new therapy
was not so different
from the spiritual exorcisms
of the past.
SCULL: "The unhappy patient
was no longer treated
"as a human being.
"He was sometimes
chained to a stake.
"He was frequently beaten
and starved, and at best,
was kept in subjection by
menacing and violent language."
You know, as we've seen,
exorcism involved,
through some metaphysical means,
driving out the devil.
This is a more physical attempt
to force the patient back into
the world as it is,
not into the phantasmagorical
world that he is trapped in.
♪
MAKARI: Francis Willis printed
a coin that said,
"The king is restored."
And on the back, he might as
well have put, like,
"Francis Willis call me,"
because the coin said,
"This is the guy who did it."
Now, all throughout Europe,
there was this almost panic.
The English know how to treat
mental illness.
They can cure it.
This was, in a way,
the biggest moment
for the emergence
of a mental kind of medicine.
♪
NARRATOR: King George relapsed
12 years later,
but Europe embraced this
new kind of "mental medicine"
and its physical interventions.
(machine ratcheting)
The Industrial Revolution
was in full swing,
and every facet of society
turned to mechanization.
Following the trend, physicians
even invented machines
to cure madness.
♪
SCULL:
One is the swinging chair.
The patient was strapped
into the chair,
and started to spin faster
and faster and faster.
People vomited, they voided
their bowels and their bladders.
Their hair stood on end.
They lost consciousness
in the end.
There were all kinds of devices
like this.
♪
(water splashing)
CAHALAN: It's this approach
to trying to make something
in the mind a physical force.
Because if it's just kind of
metaphysical,
if it's just in the mind,
how do you fix that?
So by making it
a part of the body,
it kind of galvanized medicine
to try to treat it
in many misdirected ways.
(Lorina Gutierrez speaking
indistinctly, dog barking)
LIEBERMAN: Right now, there is
no objective biologic test
that can be used for
mental disorders.
We'd like to have them.
We desperately seek them.
It's the Holy Grail.
(Lorina speaking indistinctly)
NARRATOR: Even today,
many cases confound
both doctors and patients,
and people still search
the mind, the body,
and even the soul for answers.
LORINA: You know what I mean.
(Stephen Gutierrez murmurs)
LORINA: I'm talking about you,
I'm talking about you you.
STEPHEN: I don't know what
you're talking about.
I was working nights.
Lorina called me and
said she wanted me to come home
because she didn't feel good.
(Lorina speaking indistinctly,
dog barking)
STEPHEN:
By the time I got home,
she was not making any sense
at all.
Making up her own words.
(Lorina panicking)
STEPHEN: She kept saying the
word "fire" a lot.
(Lorina panicking,
speaking indistinctly)
STEPHEN: Religion is a big part
of our life.
So even though it might sound
crazy to a lot of people,
I thought,
"Could my wife be possessed?"
It did cross my mind.
We have holy water in our house.
I splashed her, it got her
pretty good in the face,
but nothing happened.
So I called up her doctor.
MARCUS HIGI: In Lorina's case,
you're left with, "Okay,
this has got to be psychiatric
and psychological."
That was the conclusion
that I came to.
A lot of the things
that started to come up
appeared to coincide with an
anniversary
of her mother's death and
an extremely difficult childhood
with a long history
of multiple episodes of abuse.
So it seemed like the
perfect storm
of a lot
of psychological issues.
NARRATOR: Lorina was admitted to
a psychiatric hospital.
But after nearly a week
on medications,
she showed no response.
STEPHEN: They did tell me
one day,
"We don't think this
is something psychiatric."
They said, "We think
it's something medical.
We need to send her back
to the hospital."
So they start over.
They were just trying everything
they can.
They came back and said,
"Look, we see something,
like a mass,
on one of her ovaries."
And they said,
"We found antibodies.
"In our lifetime,
we would never think
we would ever see any of this."
♪
NARRATOR: A team of specialists
uncovered evidence
of a rare autoimmune disease
attacking her brain
called anti-NMDA
receptor encephalitis.
For her, triggered by an immune
response to an ovarian tumor.
HIGI: What appeared to be a
psychotic break
was really just a symptom of a
storm of hormones
and chemicals that just
essentially
made her brain on fire.
NARRATOR: The disease was
virtually unknown
until journalist
Susannah Cahalan
brought it
to the world's attention.
CAHALAN:
I was the 217th person
to be diagnosed with this ever
in the history of the world
But I remember feeling so
ashamed about the psychosis,
about the hallucinations.
First was misdiagnosed as
bipolar disorder,
and then was misdiagnosed
as schizoaffective disorder.
And as I became more
and more psychotic,
I became a difficult patient
is what I was called.
There was a hopelessness.
But when I was diagnosed with
autoimmune encephalitis,
there was a shift.
You could recover from this
illness.
Whereas the implication with a
serious mental illness
is that it's something that you
have for the rest of your life.
LORINA: Please tell me I'm not
on fire.
STEPHEN: No, you're not.
Please tell me I'm not on fire.
STEPHEN:
You don't remember that one?
LORINA: This disease just took
over my mind,
heart, body, soul everything.
It took probably about five
months of me being home
for me to even really know
I was here in my house.
It's just very scary.
But who knows how many
individuals have ended up in the
psychiatric ward
being labeled with schizophrenia
or anxiety
or bipolar or what have you,
when there could be more of a
underlining medical issue?
You just never know.
♪
NARRATOR:
Lorina's case sheds light
on how biology and
mental illness are intertwined.
Was she suffering from
a physical or mental disorder?
Is there even a difference?
This question
has long puzzled science.
In the late 1800s,
a biological breakthrough
raised hopes
researchers were close
to finding
the root of all mental illness.
Advances in dissection revealed
the brain contained cells
called neurons.
And scientists discovered
different regions
controlled different behaviors,
like speech, movement,
and sight.
Would they find the source
of madness next?
This was the era of the asylum.
Hundreds were built to treat
and house the insane.
When patients died,
their bodies were often sold
to researchers.
They probed these corpses
and zeroed in on
a mental illness afflicting
about one in four
asylum patients:
general paralysis of the insane.
SCULL: This came with both
neurological symptoms
and psychiatric symptoms,
which were often
quite subtle at first:
difficulty articulating words,
shuffling gait.
You at the same time developed
these extraordinary
psychiatric symptoms.
You often believed
you were Jesus or Napoleon
or Mary, Mother of God.
And as this progressed, you
became increasingly paralyzed
and eventually you usually
choked to death.
Some psychiatrists thought that
general paralysis of the insane
was the end state
of all forms of madness.
NARRATOR: But then doctors
noticed a surprising connection.
Dissections revealed
that in many patients previously
treated for syphilis,
a common sexually transmitted
disease,
the infection had migrated
to their brains.
SCULL: It creates a sense that
biology may be a way forward.
If a quarter of all madmen
were really the result
of infectious illness,
what about the rest of them?
NARRATOR: Soon, advances
in imaging techniques
unlocked the details of single
neurons, and for the first time,
scientists found physical
evidence of diseases
like Alzheimer's
and Parkinson's.
CAHALAN:
But this idea that we
were going to make
this major breakthrough
in understanding all of madness
through biology,
through pathology,
um, that didn't come
to fruition.
♪
NARRATOR: Today,
ever more sophisticated tools
provide new clues.
Gene sequencing
may one day reveal
the genetic origins of
these diseases.
MRIs and PET scans offer insight
into how disorders
like schizophrenia
impact different regions
of the brain.
But there are still many
unknowns.
COOMBS: With schizophrenia,
not unlike any other diagnosis,
we know that there
are multiple factors,
but we don't know exactly,
you know,
which factors are playing out
more in which person.
How much of it
is, you know,
a biological component,
how much of it is social,
how much is psychological,
how much of it relates to trauma
and all different kinds
of aspects, is the question.
FRANCES:
So many genes are involved.
For schizophrenia, 150,
interacting in permutations that
are probably in the billions.
There's never
any specific genetic pattern
that explains a particular
clinical presentation.
We know more than we ever have,
but there's still a lot
that's not known.
And so that's a big reason
why the stigma persists.
♪
McGOUGH: I didn't talk about my
hallucinations at all.
After my first suicide attempt,
I didn't
feel comfortable.
It took me eight months after
that to finally get treatment.
I've had three near-attempts
since then.
NARRATOR:
Even after her diagnosis,
Cecilia tried to hide her
symptoms, but events intervened.
(sirens)
McGOUGH:
My second psych ward stay,
I had to open up afterwards
because the police
were involved.
They patted me down in front
of my roommates
and I had to convince
them not to put handcuffs on me.
I wasn't at all refusing to go.
I have no history of violence.
(sirens)
I believe I was gone
for ten days,
and when I came back,
people knew something was up,
and I had to set
the story straight.
So I opened up through
a social media post.
And that's when I started
realizing
that, you know,
this is something
that needs to be talked
about more.
So I'm Cecilia McGough,
I'm the blogger for
the "I Am Not a Monster
Schizophrenia Project."
I have a real problem
of getting trapped,
trapped in my bedroom, because
my hallucinations are the worst
when I wake up.
I'm doing this live stream right
now because it's important
that I do these live streams,
even when I'm,
when I'm struggling.
LIEBERMAN: There's extensive
data which shows that
if you're treated for an acute
episode of schizophrenia,
particularly early
or at the beginning
of your course of illness,
your response to treatment
is very good.
NARRATOR:
But if left untreated,
studies suggest schizophrenia
gets worse over time.
Cecilia didn't start therapy
or medication
until 15 years after
her first hallucinations.
McGOUGH:
This is my first video
since coming back from
my sixth psych ward stay.
NARRATOR: And like many living
with schizophrenia,
she's tried a variety of drugs
and therapeutic approaches.
Sometimes I feel
like it's a choice
for me to take my medicine,
go to sleep, be a good patient,
or stay up and do work,
because my medicine
makes me go to sleep.
LIEBERMAN: 80%-plus people will
have
a very significant response to
anti-psychotic drug treatment.
The thing is, is sustaining
that.
I tried different medications.
Some of them would make the
hallucinations worse.
COOMBS: With schizophrenia,
we believe that there's
a certain biological component,
but it's not the full story.
When I see those giant spiders,
that usually happens during
the medicine changes.
COOMBS: So what that means is
that, when we look at treatment,
we have to combine different
interventions
that target different types
of challenges.
♪
NARRATOR:
More than a century ago,
one doctor recognized
this complexity
and realized biology might
not have all the answers.
In the late 1800s, Sigmund Freud
was a frustrated neurologist
hoping to discover
the biological mechanisms
of thought and feeling.
MAKARI: The motor neuron had
been found,
the sensory neuron had been
found.
He thought for sure there's
gonna be a will neuron
and a memory neuron
and a thought neuron.
And he scribbled out
this thing called
"The Project for
a Scientific Psychology."
And then he looked at it
and he said, "This is a,
this kind of a madness, this is
all BS I'm making this up."
So Sigmund Freud is at the end
of his academic tether
when he gets this grant to go
to Paris and study with Charcot.
NARRATOR: When Freud met him in
1885, Jean-Martin Charcot
was the world's most prominent
neurologist.
At the Salpêtrière Hospital
in Paris,
he was trying to unravel
one of psychiatry's oldest
and most vexing diagnoses.
HARRINGTON: This was a hospital
for a lot of indigent, sick
women.
A group of those women had been
diagnosed with hysteria.
They suffered from
motor problems, paralyses,
and most dramatically, fall into
states of convulsion,
like someone with epilepsy.
MAKARI: Charcot, he thought
"You know, there's something
to this illness.
"I bet you
it's a neurologic illness
and it has discrete
neurologic stages."
He then tried to sort out
what those stages were.
NARRATOR: Charcot decided to use
a technique popular at the time:
hypnosis.
A trance-like state
was induced in patients
to control their minds
and bodies.
HARRINGTON: Hypnosis drew from
the exorcism rituals.
Exorcists often required
the demon to obey commands.
"Make this person go rigid!"
And the person would go rigid.
"Okay, now, demon,
now that you know
that I control you, begone!"
So hypnotists kind of
do a little bit of that, too.
Charcot uses hypnosis
to create on command
the various symptoms of hysteria
that he believes occur
naturally.
He can call them out on command,
and then he can photograph them,
or then he can demonstrate them.
MAKARI: Everyone wants to come
and see this.
And Freud goes there
and he's utterly blown away
by this stuff.
He writes to his fiancée,
"My brain is sated as after an
evening of theater.
No other human being has ever
affected me in the same way."
But that theater was not
all real.
The patients were figuring out
what the doctors wanted them
to do.
These apparently
spontaneous pictures
took two, three, four,
five minutes
to produce, and so
these figures had
to somehow learn
to hold these poses.
It was suggestion,
a bath of suggestion,
where what the doctors wanted,
the patients gave them.
And soon it seemed like that
was just the truth.
♪
NARRATOR: The medical
establishment dismissed
Charcot's work as unscientific.
MAKARI: And Freud goes back to
Vienna
just as Charcot's reputation
starts to really plunge.
And he comes out of it
with a new synthesis.
NARRATOR:
The notion that doctors can
tap into hidden parts
of a patient's mind
sparked an insight in Freud.
At the time,
society was starting
to embrace the concept
that humans and animals alike
possess innate instincts.
Charles Darwin had recently
introduced
the revolutionary idea that
evolution shapes
not just humans'
physical characteristics,
but their behavior.
FRANCES: Darwin said that we
have inborn tendencies
that developed during the
evolution
of our species, that
our behavior is just as much
a function of evolution
as is our body.
That was the home run.
♪
Freud applied
this Darwinian thinking
to clinical situations
by saying we had inborn
instincts
that were not always available
to consciousness.
The treatment is really
basically getting the person
to understand what was
previously unconscious
and to try to change
those patterns
through that understanding.
MAKARI: He said, "Whatever the
brain has to do with that,
"someday we'll find out.
"I'm just going to say that's
a black box
and I'm gonna track these things
psychologically."
And that's psychoanalysis.
NARRATOR: Psychoanalysis relies
on dream interpretation
and stream-of-consciousness
exploration
to resolve what Freud calls
neurosis,
the distressing conflict
between the conscious
and unconscious mind.
Finally,
after centuries
wrestling with the question,
"Is mental illness
an evil infestation
or a biological disorder?",
Freud argues it's part
of the human condition.
But how society applies
his ideas
changes as culture changes.
COOMBS:
We know for a fact
that when we're walking
and living our lives,
that there are all kinds of
behaviors and actions
that we do that are not within
our conscious awareness,
we just do them.
So why wouldn't that be the case
when it comes to unconscious
feelings, motivations?
So for me, sort of the lessons
and teaching of Freud
as it relates to some of that
is helpful.
Other things, not so much.
MAN (in film): Tommy wouldn't be
behaving as he is
if he weren't seriously upset
by something that we don't
understand at the moment
and that he's not aware
of himself.
NARRATOR: In the mid 20th
century, American psychiatrists
took Freud's ideas about
the importance
of early life experience
to the extreme.
After centuries of searching,
they claimed to have finally
found
the source of mental illness:
bad mothers.
WOMAN (in film):
You know it's the mother
who is responsible
for the child's character.
HARRINGTON: This does lead to a
kind of project
to identify the range
of ways that
mothers can harm their
kids' emotional development.
MAN (in film): She inflicts on
both her husband
and son the kind of punishment
she had.
- Poor child.
- And poor man.
HARRINGTON: It has a kind of
quasi-medical
sort of spirit to it,
because certain kinds of bad
mothering
lead directly to certain kinds
of messed-up kids.
MAN (in film): There's an angry,
frustrated woman.
HARRINGTON: There was a mother
that was blamed
for driving her children
into states of schizophrenia,
the "schizophrenogenic" mother.
There was a lot of controversy
over what
was exactly wrong with her.
But there was clarity
that there must be something
wrong with her,
because her children
were so sick.
MAN (in film):
He is placed on a couch
and urged to let his mind
roam freely.
NARRATOR: Through the lens of
this conservative era,
Freud's ideas were widely
adopted, but distorted.
PSYCHIATRIST: Now, tell me about
your mother.
NARRATOR: Psychiatrists saw the
need for new approaches
and built off Freud's use of
talk therapy.
FRANCES: Starting in the '50s
and '60s, there became
the addition of different
therapies
that focused less on unconscious
motivation
and more on the current
behaviors,
thoughts, and feelings,
with the idea that you might
have a quicker
and more efficient way
of promoting change.
SMITH: You are going to be
doing a cleaning, and we want
to try to achieve
not clean enough.
- Okay.
- Go.
NARRATOR:
To manage her OCD symptoms,
Ginny relies on one of these
different approaches,
known as
cognitive behavioral therapy,
or CBT.
SMITH: Not clean enough
NARRATOR:
CBT combines talk therapy
with a theory pre-dating Freud:
John Locke's notion
that it's possible
to identify problems
and manipulate the mind.
COOMBS: Cognitive behavioral
therapy is shown
to be really helpful
in how people build up
and bolster tools for themselves
to be able to, you know,
ask themselves and
challenge some
of their automatic thoughts.
NARRATOR: Ginny uses a form of
CBT called exposure therapy.
SMITH: Very different than lying
on a couch
talking about your mother.
That is just fine,
and it's relevant,
but the focus of exposure
therapy is to be in contact
with the thing that
you've been avoiding.
It's a very active kind
of treatment.
♪
NARRATOR:
Ginny's exposures include
using a single toothbrush
for two minutes
and touching dirty surfaces
she'd usually avoid.
SMITH: She's been in treatment
now with me somewhat on and off
over a year and a half.
And she, she is still in need
of treatment.
- I just feel weird.
- Mm-hmm.
NARRATOR:
Like many,
Ginny continues to search
for effective treatments.
SMITH: Sometimes it's a matter
of,
is medication being taken
consistently?
Sometimes the answer
has been no.
But I always hold on to hope
that things can be different
and we'll keep on working
for that.
It's a feeling, I don't know
how to handle this feeling.
Like, I feel like it's never
gonna go away
When I'm having a bad time,
I will go and do therapy with my
therapist every day.
Therapy for mental health
disorders, it's out of network,
so my insurance
doesn't pay much of it.
So that adds up.
If I resist those thoughts
sometimes,
it's, like, sometimes I get all
these other thoughts
that overwhelm my brain
that I, um
that I can't, like
that I feel stuck, like
I feel like I would just call my
coach
and say, like, "I can't
go to the gym."
♪
Well, I think society doesn't
help people
with mental health as much
as, like, physical problems,
because a lot of people
still don't understand it.
The United States Olympic
Committee,
they're willing to help me,
because they want to see me
succeed and win a gold medal.
So I'm lucky with that,
but most people don't get that.
Most of my therapists
that I've had
have been when I've been
in a psych ward.
I went to a therapist once.
But unfortunately, and this is
the case for a lot of people,
I couldn't afford to have
a therapist
and a psychiatrist
and support myself.
It is frustrating that sometimes
you have to make that choice
on what, what can you afford for
your mental health.
NARRATOR:
After centuries,
mental illness is still shrouded
in stigma and mystery.
Like millions,
Cecilia and Ginny
live with disorders
that are challenging to treat,
and managing difficult symptoms
dominates daily life.
I sometimes actually
take pictures of little spiders
with my phone, because I've
realized
that if I take a picture,
I don't hallucinate it on the
NARRATOR: Cecilia's social media
presence took off
I think that says "hello from
Spain."
NARRATOR: attracting
thousands around the world
living with schizophrenia.
WOMAN: Hey, Mr. Honey, don't
you drive too fast for me ♪
Turn the radio down
So you can hear me
NARRATOR: Cecilia left her
studies in astrophysics
and started the organization
Students With Psychosis.
It's a supportive community
that pushes back
against centuries of stigma.
MAN: We're starting a big
movement here tonight,
and, you know,
what we really want
to do is change policies
in the future.
(song continues)
McGOUGH: I think there can be
some parallels
between the discovery of pulsars
and also people realizing
that schizophrenia
is a medical condition.
When pulsars were first
discovered,
people were initially scared.
It was thought that they
were aliens.
But they realized that
pulsars can be used as, like,
these lighthouses in space,
a way to triangulate location.
It just shows how something
can be less scary
when we know more about it.
And I think the same can be
said about schizophrenia.
A lot of times, people
will look at me in fear after
I tell them
what I hallucinate,
but really, we all see,
hear, and feel things
that aren't there
when we're dreaming.
As much as I loved the research
I did with pulsars
I freaking love pulsars
I shifted gears
because I feel like I can
make more of an impact
or making this world better.
It helped make me feel less
alone.
When I look up at the sky,
there's still that hope.
WOMAN: So I can fly high
♪
NARRATOR: Only a few days after
Cecilia's event,
the COVID pandemic shut down
New York City and the world,
raising urgent new questions
about mental illness
and how society will respond.
WAILOO:
COVID-19 is a great revealer.
There is a sad and tragic
opportunity we have
to take stock
of what kind of vulnerabilities
exist
in our society and try to remedy
them.
At the same time,
looking back at history,
you wonder whether, you know,
Americans have the steel
to address the kinds of problems
that are being revealed
in our time.
♪
ANNOUNCER: Next, on "Mysteries
of Mental Illness"
CAHALAN: What is abnormal,
what's normal behavior?
What's illness?
RONALD BAYER:
The boundary is very fluid.
COOMBS: In the 1800s,
drapetomania was described
as an illness that led enslaved
people to seek freedom.
WAILOO: Societies decide
the lines of deviance.
YAMAMOTO:
I was not like everybody else,
so I thought
of course I was sick.
WALROND: In my 20s, I began
to experience depression.
You suffer in silence,
because, as a Black man,
there's not a desire
for one more label.
MAN (in film): One out of three
of you will turn queer.
MAN (in film):
Judgments have changed!
BAYER: People began to say,
"We're not sick
and you are oppressing us."
YAMAMOTO:
If I can survive this,
I'm going to be living the life
that I've always wanted to live.
ANNOUNCER: To order "Mysteries
of Mental Illness" on DVD,
visit ShopPBS
or call 1-800-PLAY-PBS.
This series is also available
on Amazon Prime Video.
♪
For more about "Mysteries of
Mental Illness,"
visit pbs.org/
mysteriesofmentalillness.
♪
♪