Nancy Andreasen is a world-renowned psychiatrist, whose ground-breaking work with schizophrenia earned her the National Medal of Science in 2000, one of only a dozen such awards ever given.
Her best-selling book, “The Broken Brain: The Biological Revolution in Psychiatry,” was nominated for The National Book Award.
Iowa Public Televison visited with the University of Iowa professor in January of 2002 to discuss her work with schizophrenia, the disease that afflicts one in every 100 Americans; the career change that led her from a professorship in English to a Ph.D. in psychiatry; and her appearance in the PBS series, “The Secret Life of the Brain.”
The magical thing about photography is, every time the lens opens, a little bit of history is recorded. Today’s historian is Jon Van Allen, nephew of physicist James Van Allen, discoverer of the radiation belts that also bear his name. Jon’s subject? Dr. Nancy Andreasen, the University of Iowa psychiatrist who won the 2000 National Medal of Science, the same award the elder Van Allen won for his research into outer space. Andreasen’s work, though, focuses on inner space - the workings of the human mind.
Nancy Andreasen: “We have tools that permit us to get inside the brain and measure its structure and its function. What we know now compared with what we knew ten years ago is astonishing. We’ve learned huge amounts and that’s one of the reasons we have hope we have now the means to begin to unlock the secrets of the mind and the brain.”
Andreasen was awarded the National Medal of Science for her groundbreaking work with schizophrenia, a mental illness that afflicts one percent of the population with delusions, hallucinations and social withdrawal. Her use of cutting edge imaging techniques has led to a new understanding of the disease.
Nancy Andreasen: “It’s important to understand what’s going on in the brain behind the clinical symptoms. It’s important to begin to think of defining schizophrenia in terms of much more basic mechanisms that involve changes in the circuits in the brain.
“People who have this illness had an intact mind at one point and then it’s as if it’s a panel of glass and somebody just took a hammer and the pieces have begun to fall apart.”
By comparing the neural activity in the brains of schizophrenia patients with that of non-sufferers, andreasen and her associates interpret the differences.
What they’ve learned is that schizophrenia is a disease characterized by miscommunication between several regions of the brain – a wiring problem that leads to the fragmentation of both the brain’s functions and the patients’ lives.
Nancy Andreasen: “We visualize changes in patterns of blood flow when the mind performs a task. For example, right now I’m talking and while I’m talking it’s totally predictable I’m going to be using speech, language areas here in my left hemisphere that are used for speech.
“I’ll be using motor parts of my brain because I’m moving my lips, but I’m also using areas in the front of my brain called the frontal cortex because I’m planning the speech. And I’m going back to word treasures in my temporal lobes and picking out words that have meaning in order to perform this very complex thing that we human beings do which is talk to each other in a complicated language.
“So we can visualize in healthy, normal people the circuits that are used for a talk and then we can compare that with people who have schizophrenia.”
The brains of schizophrenia sufferers stumble at these seemingly routine functions. In some, this neural disconnect causes hallucinations, both visual and auditory. Other patients become paranoid, shrinking from a world they feel is out to get them. Many withdraw, both from themselves and from society.
Nancy Andreasen: “People with schizophrenia proceed from that onset on into a lonely existence where they have a sense that they’ve lost themselves; they’ve lost their opportunity to go to school, to learn, to have a job, to have friends. It’s a very tragic illness.”
One of the mysteries researchers are trying to unravel is why schizophrenia typically strikes in late adolescence and early adulthood, a time of dramatic changes for us all.
Nancy Andreasen: “Many of us think that schizophrenia is an adolescent or young adult neural developmental disorder or a disorder in how the brain develops during that time period.
“The brain of a 16-year-old is really quite immature compared to that of a 30 or 40-year-old. It’s also being bombarded by hormones. Testosterone and estrogen probably play a major role in causing the brains of some people to develop wrong and develop into a pattern that produces schizophrenia.”
The path Andreasen took to psychiatry was anything but traditional. Shortly after earning a Ph.D. in Renaissance Literature, she joined the faculty at the University of Iowa as an Assistant Professor of English.
But the birth of her first child came with complications; a serious infection Andreasen looks back on as a life changing event. The experience left her with a great admiration for the medical profession and questions about her career choice.
Nancy Andreasen: “I got my first book accepted for publication about six months after Susan was born and I was still in my early 20’s which should have been a tremendous coup.
“Instead of being elated, you know, I just imagined that book sitting on dusty shelves and never being read and so basically I said, if I took the same amount of energy that went into writing that book and used it to tackle a problem in medicine, like postpartum hemorrhaging or infection or whatever, you know, I might change a lot of lives in a way that I’m never going to change lives writing books or even being an English professor no matter how good I am.”
Within 9 months of her daughter’s birth, a new career germinated. The year was 1966, and the prospect of a woman attending medical school was not met with overwhelming acceptance.
Nancy Andreasen: “My parents really wanted me to marry a rich man and be a member of the Junior League. They were disappointed when I got a Ph.D. and they were kind of appalled when I said I thought I’d go to medical school.
“The medical school here wasn’t real enthusiastic about admitting me, either, because they’d never had a married woman with a kid. So getting in as a woman in itself was difficult. Yeah, in that era it was an uphill struggle.”
These days, Andreasen and her colleagues are in a struggle to unravel perhaps the most formidable and misunderstood of mental illnesses. The rigors of their research, though, pale in comparison to the every day struggles patients and their families endure.
But Andreasen says the U of I research, coupled with new medicines and supported by type of increased public awareness a national medal of science brings are what make her optimistic.
Nancy Andreasen: “The great rewards are often some of the smallest things. They’re having people come up and hug me and cry and thank me because they’ve read one of my books or they’ve seen a tape or they’ve heard about my research or whatever.
“The fact that what I do gives people hope in what is sometimes a very hopeless situation, I think those are probably the biggest rewards.”