Malady of the Mind

Schizophrenia and the Path to Prevention

By: Jeffrey A. Lieberman

Narrated by: Jacques Roy

“The most important book about schizophrenia in decades, and perhaps ever…a total game-changer.” —Sylvia Nasar, author of A Beautiful Mind

A comprehensive, deeply researched, and highly readable portrait of schizophrenia—its history, its various manifestations, and how today’s treatments have promising and often lifesaving potential.

This “incredibly captivating” (Siddhartha Mukherjee, author of The Emperor of All Maladies) portrait of schizophrenia, the most malignant and mysterious mental illness, by renowned psychiatrist Jeffrey Lieberman, interweaves cultural and scientific history with dramatic patient profiles and clinical experiences to impart a revolutionary message of hope. For the first time in history, we can effectively treat schizophrenia, limiting its disabling effects—and we’re on the verge of being able to prevent the disease’s onset entirely.

Drawing on his four-decade career, Dr. Jeffrey Lieberman expertly illuminates the past, present, and future of this historically dreaded and devastating illness. Interweaving history, science, and policy with personal anecdotes and clinical cases, Malady of the Mind is a rich, illuminating experience written in accessible, fluid prose. From Dr. Lieberman’s vantage point at the pinnacle of academic psychiatry, informed by extensive research experience and clinical care of thousands of patients, he explains how the complexity of the brain, the checkered history of psychiatric medicine, and centuries of stigma combined with misguided legislation and health care policies have impeded scientific advances and clinical progress. Despite this, there is reason for optimism: by offering evidence-based treatments that combine medication with psychosocial services and principles learned from the recovery movement, doctors can now effectively treat schizophrenia by diagnosing patients at a very early stage, achieving a mutually respectful therapeutic alliance, and preventing relapse, thus limiting the progression of the illness. Even more promising, decades of work on diagnosis, detection, and early intervention have pushed scientific progress to the cusp of prevention—meaning that in the near future, doctors may be able to prevent the onset of this disorder.

A must-read for those interested in medical history, psychology, and those whose lives have been affected by schizophrenia, this “penetrating, important” (Andrew Solomon, author of Noonday Demon) work offers a comprehensive scientific portrait, crucial insights, sound advice for families and friends, and most importantly, hope for those sufferers now and future generations.

Hope for an insidious disease

Very informative book with an offering of hope for treating an insidious disease and having a decent outcome.

All about schizophrenia

I loved listening to the book although some was difficult to hear as a mother of a person with schizophrenia. At the end is this story that God says This is Hell and the person sees people with long spoons, like as long as your arms, trying to feed themselves while there’s food all around. Then God says this is heaven, and the person sees all the people feeding each other with their long spoons and food all around. And that’s the dilemma of schizophrenia in our society. Anyway I will listen to it again because it’s a lot to process and take in. Dr L. points out how much $ goes into finding cure for cancer, how fast we found meds for HIV, and Covid 19, but for schizophrenia there doesn’t seem like society is prioritizing it as much. Somehow we need to get larger society to care more and prioritize finding a cure for schizophrenia. Also society doesn’t understand schizophrenia or people with schizophrenia- even many in the medical field, and stigma just means avoidance and closing one’s mind to finding solutions or resources for it besides jail, and prison.

Great

I loved that 7.5 of the 17.5 hrs were about treatment and prevention and how he mentions that there are a lot of effective treatment options currently available that need to be more incorporated. The science about the disease was very interesting. In some ways it felt like different books because some of it is written in his capacity as a (compassionate) psychiatrist about his patients, some of it technical about the developments in the treatment of schizophrenia, and some of it touching on some of the politics that could help incorporate current solutions more successfully. Interesting that he said in Europe more schizophrenics are prescribed Clozaril - the best of the anti-psychotics for schizophrenia treatment - but that unfortunately in the US it is only 5% (though maybe 40% could benefit from it, he said); an easy place to improve the US treatment of schizophrenia. I personally take clozapine/Clozaril now but wish I was put on it sooner because it works so much better than any of my previous anti-psychotics. Also interesting to hear about the social support structures that can successfully contribute in the treatment of schizophrenia (like clubhouses) - some of them challenging for some people, like stable housing and an outside person dedicated to your treatment. My parents have been able to effectively help me in this way. I personally am a well-treated mild-moderate schizophrenic who still has a rich life but I also have most of the support and even early treatment that he talks about as contributing factors to health. (And I take my meds religiously, finally and luckily under an incredibly talented and caring psychiatrist). I liked this book greatly. The reader was wonderful too. I really recommend buying this book.

Great insight

This book gave me a great idea of what people with Schizophrenia go through. It gave stories of people that have been diagnosed with it. Also stories of how they were treated back in the day. It gave me details of research that has gone on trying to come up with a reason that it only happens to certain people and the medications that have been used throughout the years.

An impressive career and detailed overview of schizophrenia

The author’s weighty experience gives a lot to chew on. Read or listen to this if you want to know the takeaways from decades of first-hand experience treating and researching schizophrenia in an era of new advancements. Also if you are interested in what work needs done to better serve people now.