The movie, A Beautiful Mind, offers a fascinating account of the life of John Nash, a mathematical genius and a Nobel Prize-winning economist. It depicts Nash’s battle with paranoid schizophrenia, a type of mental illness. John shows many of the classic negative and positive symptoms of schizophrenia, including delusions, hallucinations, poor interpersonal skills, and marked fear of persecution (Taufiq and Mega 56). This paper seeks to evaluate Nash’s presenting symptoms and diagnosis according to the DSM-5 provisions. The movie’s depiction of living with schizophrenia closely resembles a schizophrenic patient’s actual life because it demonstrates both classic positive and negative symptoms of the disease.
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Nash’s Presenting Problem
As portrayed in the movie, John Nash presents symptoms suggesting an underlying mental illness. He demonstrates flat affect, with an inability to make meaningful social connections with other campus members. Moreover, he shows marked delusions, where he thinks of himself as an American codebreaker working for the Department of Defense during the Cold war with Russia. During the episode where Nash delivers a lecture about his mathematical research, Nash misconstrues the men who came to take him to a psychiatric hospital as Soviet Union spies (Taufiq and Mega 58). Additionally, he shows vivid, complex visual hallucinations, which obstruct his ability to distinguish between real and unreal objects. Despite his ability to invent and solve novel mathematical concepts, Nash’s series of erratic behavior points to a deeply embedded mental health problem.
Formal Symptoms Observed in the Movie
A Beautiful Mind portrays a behavioral pattern in John Nash, which deviates from the accepted regular conduct code. He has delusions about Parcher, a United States Department of Defense agent who recruits him to execute a highly classified assignment. The task involves scrutinizing magazines and newspapers for hidden patterns to impede a Soviet Union plot. However, he becomes obsessed with this work in a way that shows disorganized thinking and reduced cognitive function. Besides being arrogant to his colleagues at Princeton, his interactions with others remain socially off-putting. Furthermore, he demonstrates grandiosity when he dismisses other graduates’ work as unoriginal and instead claims his ideas as superior.
Diagnosis and Congruence with DSM-5 Provisions
The conglomeration of symptoms that John Nash presents closely links to a schizoaffective mental disorder. The combination of vivid visual hallucinations, persecutory delusions, and disorganized behavior comprises the positive symptoms of schizophrenia. Likewise, he exhibits a series of schizophrenia-defining negative symptoms, such as reduced emotional expression, and asociality. On the other hand, the DSM-5 diagnostic criteria for schizophrenia defines a cluster of presentations in several steps. Notably, one must experience one month at least two hallucinations, delusions, disorganized speech, negative symptoms, and catatonia (McCutcheon et al. 202). Moreover, one must experience a significantly reduced functioning level in such significant areas as work and interpersonal relations. Most of these DSM-5 requirements for diagnosis are met, hence are congruent with the movie’s depiction of Nash.
While no cure for schizophrenia exists currently, psychological counseling and medications allow patients diagnosed with the illness to lead regular lives. However, without a proper treatment modality, the overall outlook remains poor. Typically, about half of those diagnosed with schizophrenia fully recover and resume their everyday lives after ten years since the first diagnosis (McCutcheon et al. 202). On the contrary, about a quarter improve but remain dependent on a strong support network. An unfortunate ten percent usually end their lives by committing suicide. Generally, schizophrenia with an acute and later onset and preponderantly presented with positive symptoms have a desirable prognosis (Kendler 1085). Other positive prognostication factors include good premorbid work and social history, and early treatment.
A combination of genetics, altered neurochemistry, brain structure, and environmental conditions are implicated in the etiology of schizophrenia. Certain gene combinations have been suggested to increase the likelihood of developing the disease, but no single gene defect has been isolated (Kendler 1085). In addition, environmental factors, such as poverty, intrauterine nutritional deficiencies and infections, and highly stressful situations, are known risk factors. Similarly, frontal lobe abnormalities and reduced volume of the limbic structures, such as the amygdala and hippocampus, are key neuro-structural determinants for schizophrenia development (McCutcheon et al. 202). Furthermore, neurotransmitter alternations, such as dopaminergic and serotonergic hyperactivity, can cause psychotic symptoms.
Movie Treatment Methods vs. Current Management Modalities
At the hospital, Nash undergoes a series of treatments to manage his debilitating illness. The psychiatrist prescribes insulin shock therapy numerous times a week as the basal mode of treatment. However, this form of treatment did not prove useful for managing his symptoms. Thus, mood stabilizers’ introduction proved a better alternative to shock therapy despite their numerous adverse effects. Currently, schizophrenia is treated pharmacologically with both typical and atypical antipsychotics. The former include haloperidol and chlorpromazine, while the latter include olanzapine, and aripiprazole (Kendler 1085). Simultaneously, psychosocial treatment approaches, such as cognitive-behavioral therapy (CBT) and assertive community management, are adopted.
A Beautiful Mind is a fascinating movie, which depicts living with paranoid schizophrenia through the life of John Nash. He displays negative symptoms of schizophrenia, such as blunted affect and asociality at the Princeton University graduate school of mathematics. Later on, he progresses to show the classic positive symptoms of schizophrenia, including persecutory delusions, visual hallucinations, and disorganized behavior. The mode of treatment for the illness prescribed in the movie differs significantly from current management standards. In place of insulin shock therapy, novel pharmacological agents and psychotherapy are preferred.
Kendler, Kenneth. “Phenomenology of Schizophrenia and the representativeness of modern diagnostic criteria.” JAMA Psychiatry, vol. 73, no. 10, 2016, pp. 1082-1092.
McCutcheon, Robert, et al. “Schizophrenia—an Overview.” JAMA Psychiatry, vol. 77, no. 2, 2020, pp. 201-210.
Taufiq, Taufiq, and Mega Harwati Nungki Wiranita. “Psychoanalysis in the Movie entitled “A Beautiful Mind” By Ron Howard.” Terob vol. 9, no. 2, 2018, pp. 56-63.