Can a diagnosis of schizophrenia lure a man to his death?

The mother of Josh Marks, the promising TV chef who killed himself last Friday within 24 hours of receiving the diagnosis, said it had the effect of plunging her son into deep dejection.

Which begs the question: If the word’s a suicidal tipping point–and one in ten succeed–why not chuck it?

Is it time to consign schizophrenia to the dustbin of medical terms? Hasn’t the popular culture killed it off by now? Isn’t it doing more harm than good?

While the 26 year-old Josh Marks had been troubled since his arrest in 2012, a time coinciding with the expiration of his fifteen minutes of fame on Gordon Ramsey’s MasterChef television show, the seven foot, two-inch chef made a fast decision to take his own life as soon as his diagnosis was upgraded from manic depressive disorder, the condition that most often precedes full-blown schizophrenia.

The theory that he’d cracked under the pressure of fame is far-fetched, or at least only part of the story. A more likely explanation is that it was his neurobiological destiny to be taken by hallucination as his brain reached maturity.

My guess is that the diagnosis was delivered with a minimum of subtlety.

At the time of his 2012 arrest he claimed that he was God and that Ramsey, the blustery British TV personality, had possessed his body. The police subdued the “gentle giant” with batons and pepper spray at the time, and placed him on a 5150 psychiatric hold like Hollywood star Amanda Bynes.

His mother said that the determination of schizophrenia was the proximate cause of his suicide: “He couldn’t bear the thought of another diagnosis,” Paulette Mitchell told the Chicago Tribune. “He was just coming to accept the diagnosis of bipolar.”

After picking him up from his treatment program on Thursday, his mother noticed he was upset. She was worried enough to stay with him through the night. On Friday she took a call from her brother saying that Marks was skulking down an alley with a gun.

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It’s not the fault of the medical establishment that schizophrenia has a bad name. It’s had a public relations problem since Hitchcock’s Psycho gave the world Norman Bates more than 50 years ago.

Yet health care providers have a responsibility to be more sensitive these days, given the status that the “schizo” has acquired in a society that mostly reserves scorn for him.

If you’re having a bad day, a diagnosis of schizophrenia is not likely to improve it. And doesn’t the Hippocratic Oath pledge doctors to first do no harm?

Several suggestions have been made to replace it, the leading candidate being salience syndrome, which better describes the shifting internal turmoil of having to process disturbing stimuli such as auditory, visual and tactile hallucinations.

Those with schizophrenia almost unanimously support making the change, the most often cited reason being the protection from stigmatization. But they also fear that salience syndrome may assume negative connotations one day too.

The problem, of course, is that bad medical terms have a way of digging in, as schizophrenia has been doing since it was coined in 1911 by Eugen Bleuler to replace then unsatisfactory term dementia praecox.

Much has been made of the confusion schizophrenia–Greek for split mind–causes with multiple personality syndrome, a condition so rare that many doubt it exists.

Others insist on always drawing the distinction between having schizophrenia (good) and being schizophrenic (bad).

To me the term is so fraught with negative connotations that I prefer schizo, if only in the ironic way that a black man might prefer the n-word. Because the s-word mocks the clinical term for perpetuating the stereotype.

Diagnosis Treated, Symptoms Ignored

Worse than the semantic debate is the treatment one receives when hearing voices. After you check the box on the one-page nurse’s admissions sheet that states “is hearing voices,” that is likely to be the last time anyone shows any interest at all in voices that never leave you be.

What’s classically known as audition (an experience one in ten people polled report having) is still shamed in all but the most progressive psychiatrist circles.

While “not colluding with delusions” is an official medical protocol that has been understood to mean not providing additional evidence to support delusional beliefs like CIA brain chips, telepathy and spirit possession, as a practical matter it means not talking about voices with people who desperately need to do so.

Individuals could easily be informed that there’s nothing unusual about hearing voices, that it’s a very real human experience, that individuals have always heard them—including such luminaries as Socrates, Jesus, Joan of Arc, Carl Jung, Mahatma Gandhi, and Brian Wilson of the Beach Boys.

That’s positive change, and also a “bridge to normal living” for those with schizophrenia. Because to be fair, we all hear voices. Whether they come to us in the first person (for most) or the second or third person (for others) is the distinction that matters.