I believe Mahiru has Schizophrenia
(Go to third paragraph if you want to skip my prefaces and meandering. I also put a fairly simple to understand DSM-5 criteria screenshot from one of my textbooks for schizophrenia near the bottom)
Admin Saturn here post Mahiru drop, I’m sure others will have either similar or very contrasting thoughts on this but I thought I’d offer my own perspective on it as a psych major and a person with a family member who has schizophrenia. She definitely shows a lot of symptoms of schizophrenia which of course doesn’t necessarily mean this is what they’re intending to portray with her, nor a good portrayal, but I want to put my thoughts out here.
I also want to say that I’m most familiar with schizophrenia and this could very easily fall into a different psychotic disorder I’m less familiar with so I’ll be doing some research into those to either rule out other possibilities or hone in more on a potential schizophrenia portrayal.
Starting with the most basic, she’s near the typical age of onset for schizophrenia in women which is mid 20s to early 30s. (although of course theres a very broad range)
Going on to criteria A. To start there are three ‘main criteria’ that are often the most telling for people with schizophrenia. These include 1. delusions, 2. hallucinations, and 3. disorganized speech. I would say mahiru definitely meets delusions and hallucinations based on this MV.
While auditory hallucinations are the most common, and having fully formed and incredibly all encompassing visual hallucinations like the ones depicted in her MV are very uncommon, milgram depicts very specific and intriguing cases. The fact that all the prisoners hear our voices also makes it difficult to be able to tell if she might experience auditory hallucinations as well, but it’s something I’ll be looking out for.
To say more on delusions (and keep in mind I’m reporting all this in a very simplified version sans context because theres a lot about delusions within psychotic disorders. And also this is just with just a quick refresher from a previous textbook) there are a few kinds. Mahiru would be expressing erotomanic type where you believe a person is madly in love with you and you two were meant to be together. This is most often experienced in relation to celebrities but again, milgram tries to take looks at the most ‘intriguing’ cases.
The other criteria are 4. grossly disorganized or catatonic behavior and 5. negative symptoms. Schizophrenia can be thought of as having negative and positive symptoms. Positive symptoms are things like hallucinations and delusions that add a nonreal experience where negative symptoms reduce a typical experience/self expression. (again, simplified) So some negative symptoms a person could experience would be reduced affect or a lack of pleasure from everyday activities. I don’t see her having any reduced affect but I could definitely see her having grossly disorganized behavior.
Grossly disorganized behavior includes not understanding you have a problem (specifically in a lacking insight way), another thing is cognitive slippage where a person will jump from topic to topic or talk illogically. While we haven’t seen her have these symptoms recently, the deterioration of her notebook entries could be an attempt to show the audience this.
A person must have at least 2 of these 5 symptoms.
She also def meets criteria B (worsened hygiene at the very least which doesn’t even bring in how much these actions likely impacted the other aspects of her life)
I can’t say for sure with C, D, or E, however F I can say has been met.
Something important to note is that it’s hard to tell if Mahiru would meet the criteria of experiencing this for the past 6 months. We don’t know how long she was holding him captive (although I think from the wear it looks like he experienced it was longer than the few days expressed in her journal) but it’s still difficult to know. If she hasn’t, it would be important to look into schizophreniform which is a shorter version of it and brief psychotic disorder which is an even shorter version. These can have a better long term prognosis.
In regards to outcomes that people with schizophrenia can experience long term with treatment vary. Unfortunately, many people never make a full recovery and continue to experience symptoms, especially those who never receive treatment. Schizophrenia is typically considered a chronic disorder. They typically benefit most from a structured inpatient facility with good care and this is a disorder where med compliance is one of the number 1 things that can impact recovery. However, that definitely doesn’t mean they can’t. With med compliance, a good support system as well as coping skills and frequent checkups symptoms can severely lessen to almost disappear. Especially with schizophreniform and brief psychotic disorder, there are a lot of cases where a person can experience one case of it and never have these symptoms again (although it is also a very big risk factor for a later schizophrenia diagnosis)
Another thing to consider going forward in regards to being able to ask her questions would be asking about childhood and family history. Schizophrenia is highly hereditary and there are also some early flags in childhood that include atypical beliefs or some of the negative symptoms.
From a personal standpoint, I would also say that my family member expresses a lot of floaty whimsical type ideas. Not quite in the Mahiru love way but it has similar vibes? I don’t quite know how to describe it because it’s such a specific mannerism but it’s just another coincidence I thought I would add.
Theres always the availability heuristic and I know a lot about schizophrenia and it’s something I think about a lot more than the average person. However, I do feel that she meets a lot of criteria and I’ll definitely be looking for more signs.
