There’s a big difference between tabling a discussion and bringing people to the table to have discussions. Gail Simmons, cookbook author and longtime judge on Bravo’s Top Chef TV series, wants the latter to happen much more often when it comes to mental health issues. And she knows quite a lot about bringing people together to a table since cooking and meals can be central in doing so. She also has something that’s been very personal about a family member that she wants to bring to the table.
“I’ve always had a passion for bringing people to the table,” Simmons told me.”My life’s work has been about cooking and feeding people and sharing a love of food and connection through food.” And then she spoke of a mental health condition that is often very misunderstood and that her older brother, Alan, who died in 2018, had battled. “Schizophrenia is a topic that is very personal to me because I had a brother who lived with the condition,” she added. “And for World Mental Health Day [which was on October 18], it felt like the right time to be able to sort of open up the floor to talk about it a little more.” It’s also motivated her to partner with Bristol Myers Squibb for the COBENFY Connections campaign. Cobenfy is manufactured by BMS and, as you’ll see later, is one of the different medications that can be used to treat schizophrenia in adults.
There Are Many Misconceptions About Schizophrenia
If you were to ask Joe or Josephine Public what schizophrenia is, you’d probably get wide range of misses, such as misperceptions, misunderstandings and mistaken ideas. Patricia Ares-Romero, MD, who is president for the Dade County Medical Association, serves on the board of The National Alliance on Mental Illness and treats many patients with severe mental illness identified three common misconceptions, starting with, “Schizophrenia is not multiple personality disorder. A lot of people think schizophrenics, it’s like they have all these personalities. That’s not the case.”
Ares-Romero continued with what she considered to be the number two misconception: “that people with schizophrenia are violent,” whereas “schizophrenics are usually the victims of violence” instead. The last of the three listed by Ares-Romero was, “People think that living with schizophrenia, you can’t have a normal life. And the truth is that although it’s a complex diagnoses, if you have the right connections, the right support and the right treatment, you can have a really meaningful life.”
What Is Schizophrenia
So what then is schizophrenia? Simmons described schizophrenia as “a pervasive, disabling mental health condition that changes how you act, how you feel, and it can disrupt and make even sometimes the easiest daily tasks really, really difficult.” People with schizophrenia can suffer from hallucinations, which is when they see or hear things that aren’t there in reality, have delusions, when they firmly believe and strongly insist on things that aren’t true, and even at times completely lose touch with reality. Schizophrenia can lead to all sort of complications, ranging from anxiety and depression to misuse of alcohol and other substances to aggressive behavior to thoughts and attempts of suicide.
The World Health Organization indicates that around 23 million people worldwide suffer from schizophrenia, which comes out to about one in 345 people one in 233 adults. It’s still not clear what causes schizophrenia. Studies have found changes in neurotransmitter levels and the brain structures of those with schizophrenia. There are questions as to what combination of genetics and the environment may play a role too. But a lot more research is needed to better understand the origins of this condition. One thing clear, though, those with schizophrenia need proper treatment for the rest of their lives.
Diagnosis And Treatment Of Schizophrenia Can Be Delayed
The general lack of awareness about schizophrenia can make this challenging diagnosis even more challenging to diagnose. People often do not know what to look for and can as a result miss earlier signs. “My brother was diagnosed when he was in his mid 20s, I was in my late teens,” recalled Simmons. “Sure, it’s easy in hindsight to see things that we now kind of identify. But really, it wasn’t something that would have ever been obvious until it was something that was really dominating his life.”
The behavior changes and other symptoms early on can be subtle. Moreover, since delusions and hallucinations can be part of it, a person experiencing may not recognize symptoms even after they’ve gotten more severe. In fact, he or she may continue to deny that something is wrong. As a result, people suffering from schizophrenia can go untreated for a long time, like many, many years.
Even after it becomes more apparent that help is needed, the lack of awareness about schizophrenia in society can make it more challenging to find the right doctors and treatment. “I think about my parents and how incredible and dedicated they were at every turn to finding him the right treatment,” said Simmons. “And to sort of keep our family grounded.”
Early And Comprehensive Treatment Of Schizophrenia Is Important
The delays in diagnosis and getting treatment clearly are not good because you don’t want people suffering for so long and having their family members and other close ones not knowing what’s going on and confused. Earlier treatment can also lead to better control of symptoms and improving the longer-term prognosis.
Medications are the mainstays of treatment. There are so-called first-generation antipsychotic medications that were more limited by side effects such as tardive dyskinesia, which I have written about before in Forbes. These include: chlorpromazine, fluphenazine, haloperidol (otherwise known as Haldol) and perphenazine (known as Trilafon). The second-generation antipsychotics tend to have fewer side effects and include aripiprazole (Abilify), asenapine (Saphris), brexpiprazole (Rexulti), cariprazine (Vraylar), clozapine (Clozaril), iloperidone (Fanapt), lumateperone (Caplyta), lurasidone (Latuda), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), ziprasidone (Geodon) and xanomeline and trospium chloride (Cobenfy).
Psychotherapy and other types of therapy can help people with managing their symptoms and interactions with others. Family therapy can be important as well. “It changed our dynamics a lot,” Simmons explained. “In a way, I felt like I lost I lost my brother. But we had to find a new language to speak together, a new way to connect, because the ways that we used to as children didn’t necessarily work anymore.”
This brings us back to the whole table discussion thing, which was not tabled. “So much of what we did when I look back to was about the table,” Simmons said. “It was about coming together, about normalizing our family experience and sharing moments together in, maybe we had to alter them a little bit, but in ways that he could participate.”
So Simmons’ experience and now her opening up about her brother does provide a lot of food for thought. “That gave me a lot of empathy for people who do struggle with mental health conditions,” she said. “I made me realize that you can’t ever give up, that there are so many paths to finding the right treatment for you.” Simmons also talked about “changing the narrative about schizophrenia and about the importance of connection and support.” She recently finished filming the 23rd season of Top Chef and will be serving up her third book towards the end of next year. She also hopes that sharing her, her brother’s and her family’s journey will serve to help many others and bring discussions about schizophrenia and other mental health conditions more out into the open on the table.
