The movie, “A Beautiful Mind”, was based on a true-life story of a genius mathematician who suffered from a severe mental illness which was schizophrenia throughout his lifetime. In the movie, John Nash shows the multiple symptoms of schizophrenia include hallucinations and delusions. John has advanced intelligence in math that he was accepted, and a got a scholarship to Princeton University and graduated with a Ph.D. in Math. In 1947, he won the Nobel Prize. John is a mid-aged Causation male.
He is married and has a baby boy. John started experiencing his mental illness after he had been admitted to the graduate school in Princeton. He is intelligent but awkward socially. He often withdrew from peers and was isolated that he most likely spent his time working on discovering equations in mathematics when he was at Princeton. The first hallucination occurred while he was at Princeton which he met his roommate, Charles who was just a hallucination created by his mind due to his schizophrenia.
Charles became his best friend and occasionally appeared in his life through his mind. Five years later, John taught at MIT and helped the government to descript numbers of codes that were sent by Russia. The second hallucination developed along with the delusion when John was working as a secret code breaker. He met the government spy, William Parcher, and agreed to work for him. William always praised and appreciated John’s special ability for breaking codes. John also believed that he was the middle of the War and had a special job from the government as a code breaker.
In his delusion, his job was collecting codes from magazines and newspapers and obsessively looking for hidden messages on magazines and newspapers.
While John taught at MIT, he fell in love with a young woman, Alicia who will become his wife. The third hallucination developed when John had a stressful time making an important life decision which is to ask Alicia to marry him. In his hallucination, Merced, Charles’s niece appeared and supported him emotionally. John continues to struggle with hallucinations and delusions after he got married to Alicia. He was unable to function adequately at home and work, as well as interpersonal relationships due to delusions. He was always busy collecting and analyzing codes from papers. Alicia started to notice John’s unusual behavior and ended up calling a psychiatric hospital. When John was sent to the hospital, he believed the Russians had taken him due to his mental illness.
Alicia found out that John has schizophrenia and he is dealing with severe hallucinations as well as delusions and need to be treated. John denied his mental disorder and believed everything was true until he got treatment with electroshocks and medicines. John relapsed one year after being released from the hospital due to stopping taking the medicines. He stopped taking the medicines because it interfered with his memory and intellectual capacity as well as interpersonal relationships with his wife and family. Since then, he had started to have hallucinations again. He found the small house for his secret job and started working on finding codes from magazines and newspapers and believed that everything was real. Overall, delusions made him difficult to take care of his family that he almost killed his baby son and hurt his wife.
Alicia called the psychiatric hospital again when she found out the small house where was filled up with all kinds of papers for decoding articles and left him alone. Finally, he realized that he had hallucinations and delusions, and everything was unreal. Full mental Status Examination Appearance and Behavior John looked at his age and dressed appropriately and was well-groomed. He looks nervous with inconsistent eye contact, gestures, as well as facial expressions. Speech and thought process John often speaks loud, fast, and clear. His speech is coherent and monotonous. He is obsessed with mathematics and calculation. He is logical and intelligent.
His thought process is coherent and goal-directed. However, he has a looseness of associations between reality and imagination. Mood and Affect John is often anxious and easily gets distracted, agitated, and frustrated. His has blunted and flat affect. His mood is congruent. Thought content John is currently experiencing auditory and visual hallucinations from three people; Charles was thought to be his roommate and best friend in college, Charles’ niece Merced, and William Parcher who is a spy. He also experienced various paranoid delusions about the role of a code breaker for the U.S. government and Russia.
He has no signs of suicidal thoughts, ideation or self-harming. Cognition John’s memory is intact. He has excellent memory and functioning, as well as advanced knowledge in math. He is alerted and oriented to person, place, and time. Insight/Judgment John has impaired insight and judgment due to his mental illness. He almost killed his baby son and hurt his wife due to the mental illness. Mini-mental Status exam: John has no cognitive impairment with a scoring of 30. DSM-5 Diagnosis John meets the diagnostic criteria for DSM-5 which is Schizophrenia. He shows at least two symptoms on DSM-5 psychological diagnostic criteria including hallucinations and delusions for a long time of the period. His mental illness which is Schizophrenia increases impairment in functions in occupation and interpersonal relations. In fact, he was unable to maintain the interpersonal relationship with his wife and to function as a father that he put his son in danger and almost killed him.
John’s score of the Global Assessment of Functions Scale (GAF) is between 30 to 40 and his mind and behaviors are constantly influenced by hallucinations and delusions. Overall, John has difficulty in social and occupational functioning, as well as maintaining interpersonal relationships due to the severe symptoms of schizophrenia. A Preliminary intervention Plan Medication Antipsychotic medications will reduce John’s symptoms of schizophrenia and allow him to function efficiently and effectively on a daily basis. He will keep taking antipsychotic medication daily to relieve the psychotic symptoms including hallucinations and delusions. He will also take antidepressants and anti-anxiety medications to manage the symptoms that come with the mental disorder.
Cognitive Behavior Therapy CBT will help John to increase healthier and accurate thought processes and patterns. Throughout the therapy sessions, John will be able to determine the perception of reality and the symptoms of mental illness. He will benefit from CBT that he can learn and develop the skills of coping, problem-solving, and self-management of the illness. Moreover, CBT will reduce his psychotic symptoms, as well as mood-related symptoms such as depression and anxiety as result. John will get the CBT treatment 2 x a week for 6 months. As a result, CBT will help him to improve his abilities on social functions and social cognition.