If you are one of us who still love the sounds of The Beach Boys, you might want to catch the movie, “Love and Mercy.” The story of Brian Wilson, co-founder and brilliant arranger, composer and vocalist of the group, is a lesson in the perfect storm of a mental health misdiagnosis.
Diagnosis is at best an assessment for the purpose of treatment. If the diagnosis is incorrect or carelessly made, the treatment may make the symptoms worse instead of better. Brian, who later was correctly diagnosed as having schizoaffective disorder, was at first evaluated to be a person with paranoid schizophrenia. True, auditory hallucinations are a symptom of schizophrenia, but they may also accompany bipolar disorder, schizoaffective disorder, and even clinical depression. The movie actually uses sound techniques to simulate the experience of having auditory hallucination or “hearing voices.”
Differential diagnosis is the process of teasing out symptoms of overlapping diagnoses—sort of like identifying what does not belong in the diagnosis. Schizophrenia can have features of paranoia and hallucination, but is a thought disorder and presents as disorganized thinking and cognitive deficits. Schizoaffective disorder is characterized less by cognitive deficit and more by mood disorder, while it also may have features of paranoia and hallucination. The use of recreational drugs or alcohol only complicate the process of diagnosis. Sometimes medications which work and those that don’t become a part of the answer to correct diagnosis.
Brian’s symptoms of psychosis (delusions and hallucinations) and mood disturbances appeared both at the same time and intermittently. As with bipolar disorder, there were times of deep and debilitating depression as well as manic episodes. The lack of respectful and considerate treatment by his caregiver must have seemed “deserved” or normal to a person who experienced abusive treatment throughout childhood. The lack of competent treatment nearly cost him his life.
The good news is that those who truly loved Brian Wilson did not give up on him and continued to help find an answer. Brian survived his misdiagnosis and today is once again a practicing artist as he lives with a very real disability. “Love and Mercy” is an apt title for a process that seeks to build mental health and wellness.