In Hidden Valley Roads, Family Travel Helps Transform Psychiatric Science

There are still many questions about schizophrenia—what it is, what is the cause, and how to treat it.

One family has helped researchers advance their efforts to find answers to these questions.

Galvins looked like an American model of baby boomers. Twelve children with a military father and a strict and religious mother raised in Colorado in the 1960s. However, over the years, six boys in the family have been diagnosed with schizophrenia.

Writer Robert Colker, best-selling writer Lost Girls, The story of the Garvin family, and how their journey is changing the science surrounding mental illness in a new book, Hidden Valley Roads: In the Heart of the American Family.

Interview highlights

Looks like a perfect family

Well, apparently Donald [the oldest son born in 1945] It was perfect. He was a perfect son in the eyes of his parents. He made no mistake. He was a high school football star and a wrestling star. He dated the general’s daughter at the Air Force Academy. He really seemed to have it all together. But he knew that something was wrong even in his teens. He had a barrier between himself and others. And when he went to college, it got worse. And, as we now know, schizophrenia often manifests in late adolescence. By the age of 20, I was doing impulsive things at school, such as encountering a bonfire. However, an incident with a cat occurred later. He went to college health services once, biting his cat’s hand, but did not explain how he got it. A year later, he came back and said that this time he killed the cat slowly and painfully. But as he says, according to hospital notes, he seemed emotionally confused. He seemed upset, as if he did not even know why he did it. And this was a real excuse to send him into the mental health system for the first time. But not the last.

How six brothers presented schizophrenia

Well, one of the challenges as a reporter was not to make mental illness uniform … In fact, these siblings are all different and represent their illness in different ways. Donald said he was really unsteady and very procrastinated at a young age, very kind and kind in his 70s, but still quite delusional. He believes he is a descendant of the octopus. Matthew is tired. But in medicine he In fact, it is much more functional than his other brothers. Peter is a talented musician and he loves the whole family very much. Then, the other three psychiatric brothers who died were all different—Joseph saw an empty vision as the Chinese emperor told him. Jim did a lot of self-harm because he was so paranoid and upset, and he was also abusive and severely abusive against his young brother, especially a girl. … The most disastrous story of all is Brian, who seemed to be nowhere in 1973, killed his girlfriend, and committed suicide with a murder suicide that his family tried to cancel as an accident. But in fact, he was prescribed an antipsychotic shortly before. So he was also schizophrenic.

Controversy over nature versus nurturing

Well, in the early stages of psychiatry, most people who had named schizophrenia, whether it was a precursor to dementia or schizophrenia, had some physical qualities And believed that it was hereditary. However, Sigmund Freud did not agree with this. He mainly focused on how it was not inherited in a genetic sense, but in terms of childhood trauma, and how childhood experiences affected the unconscious mind. I really believed in And the debate on this nature and upbringing continued for a while.

And indeed, the caregiver psychoanalyst, through the 20th century, at least in the United States, I never promised you a rose garden —People with schizophrenia live in a world where the therapists must penetrate, suggesting that they had to break down barriers and bring them back to our world. And with the right kind of treatment, the problem is solved and one may come back into reality. And this completely ignored the genetic aspects of it.

Now we live in a world where everything seems to be about genetics, but schizophrenia and other complex diseases are not only about genetics, but about the genes that are affected or affected. Believe that there are so, go back to the discussion of parenting by environment. Perhaps, whether hallucinogenic or bacterial, they may be vulnerable or susceptible to developing schizophrenia activated by something in the environment. Everyone has a theory, but it’s a nature-fostering argument that couldn’t really leave us.

Changes in the definition of schizophrenia

The definition of schizophrenia varies from generation to generation. With each edition of DSM [Diagnostic and Statistical Manual of Mental Disorders]. Well, it is always known to be a syndrome, not a disease. It’s not like the flu that you can identify what it is in terms of its chemistry. Schizophrenia is a set of symptoms that are truly defined and treated based on their symptoms. As a result, the DSM editions and the Bible for Psychiatrists often changed the definition of schizophrenia and adapted it to the treatment style at the time.

And people were blaming schizophrenic mothers and fathers in their 50s. As such, all symptom collections were arranged based on that idea. Later, by the 1980s, the definition of schizophrenia was officially changed, mostly adapted to new treatment styles with psychotropic drugs such as tolazine and clozapine. These drugs at the time are considered almost cures. But, of course, it can help in many cases, but we know that we are actually treating the condition and not actually solving it.

Important work of a doctor in the 1980s

Doctor [Lynn] DeLisi was a pioneer at the time, one of the top researchers at the National Institute of Mental Health, and was fascinated by the idea that studying a family with a high incidence of schizophrenia would allow them to: . Find some kind of genetic silver bullet in it. This will help you understand how the state of the general public is shaped. At the time, she was not taken seriously. Because in the 80s, before everyone sequenced the human genome, they thought that schizophrenia was too complex and a genetic disease to even be able to do that. They thought it was like Alzheimer’s disease or cancer. How one family can have a key

But she continued to collect the largest collection of what she called a multiple family. And Galvin was one of its first families—and they were the largest families. And through many twists and turns through the study of those families, a sequenced human genome, she understands how a family like Galvins understands the condition and how it is formed Can be shown positively. …

[DeLisi’s] This is undoubtedly a belief that the environment has nothing to do with it, and her belief goes to Mimi Garbin, mother, the mother of a family that has really been blamed by many psychiatrists. It was brought as great relief. State year. And she pinned all our hopes to Dr. DeLisi and other researchers to really prove this is genetic. What they found was, in fact, genetic mutations that might be endemic to this family, but are so essential to brain function that they may help to understand how schizophrenia works was. And that’s how families like the Galvin family can help us move forward. We can see them and their specific genetic variants that may be defective. And while the mutation may not exist elsewhere, it helps us understand the disease and how it affects others. And there are models for this in other diseases. And if anyone knows or finds the right mutation and can treat it with a drug, that drug may help others.

Schizophrenia in young adulthood

In the eighties, the new wisdom about schizophrenia was that it was a developmental disorder. In other words, falling down at the age of 20 or 21 doesn’t mean you’re suddenly stung by an insect. It was schizophrenia. That meant there was a vulnerability, something that gave special sensitivity in their genetic makeup that they had before they were born-before they could get rid of certain stimuli Regardless of whether it is or the difficulty of developing the brain-as we now know, the final stage of brain development is puberty. So, in fact, the blueprint for their genetic code was like giving them a disadvantage from the start. Some people are lucky and do not take a mental illness break. Other vulnerable people experience some trauma and other irritations, and then suddenly have mental illness.

About the spectrum of mental illness

Peter Galvin moved his diagnosis from schizophrenia to bipolar disorder, and again and again. He shows a really good gray area. However, in fact, in more respects, there is now more genetic research each month, many psychiatric disorders are in the spectrum, especially bipolar disorder and schizophrenia have many duplications in it The spectrum that seems to be—and so may autism. It is really attractive to see it. It is also interesting to know that the spectrum of mental illnesses exists for those who do not consider themselves mental illnesses. According to a study of people who reported hearing but never considered a mental illness, a large number, a large percentage, probably 5, and probably 7%. So this spectrum may be even more advanced than we thought. …

This is one of the most amazing and promising elements of Hidden Valley Road, a researcher named Robert Friedman who has been studying families since the 1980s. He has identified one particular gene. This is also not a silver bullet and not a smoking gun gene, but one of the genes that may be linked to brain functions associated with schizophrenia. And he understands that the gene is very important not only for brain development but also for brain development in the uterus. Even before you are born, your body plans to build and develop your brain over the years. And his hypothesis is: What if the gene was fortified in the womb with some nutritional supplement?

And he arrived at Colin. And indeed, the FDA has approved this and recommends that pregnant women safely consume dietary supplements needed for brain health. But in fact, what it is is something that could potentially make you less susceptible to acute mental illness. Currently, I do not know if this is true. I don’t know if it helps. But if you do, you may know in a few years.

About Galvins story reporting

My friend and Lindsay Galbin introduced me. Lindsey is the youngest of 12 years old. He knew them for years. And two sisters, ten brothers and two sisters, two sisters, Margaret and Lindsay, and families have been talking for years about trying to get their family stories out to the world. Was. First of all, they knew how unique a family was. But there were also many mysteries that they were trying to solve themselves about their families, the secrets of many families that no one was talking about. And finally, they decided I needed an outsider, an independent journalist who could tell the story everywhere, their reporter, and told me about them.

I was initially skeptical because these were very personal concerns, medical information about people, and family members thought they might be sensitive to privacy laws and such. But in fact, for a year, we talked with all living members of the Galvin family. They were ready. They really believed that their stories had something that could be comfortable for others suffering. And i really want to believe Hidden Valley Road Offer it to people …

Regardless of mental illness, these are difficult times. I think this is an example of a family that actually experienced two, three, or four different fears at once, not just one, and came out on the other side. That is not to be introverted when the worst of life happens, to reach out to each other, to understand the value of family and the value of not locking yourself into potential. I really believe in this story there is a lot of hope and inspiration that people can get rid of it regardless of the problem of mental illness.

Copyright NPR 2020.