Scientifically, I’d say the genetics is telling us schizophrenia is very closely tied to H. sapiens cognition, such that many different combinations of events can nudge a highly optimized system from state 1 toward state 2. And that makes it more important than ever to focus on the *what to do to help people suffering from schizophrenia.*

See my posts on the missed opportunity here for journalists and how framing schizophrenia as a scientific problem can go awry.

More intuitively, ask yourself what would happen if Jenny McCarthy’s son were to develop a condition that could be mistaken for schizophrenia.

I think people are generally locked into the wrong model of what a disease is. The traditional, scientific model is that a disease is caused by something going wrong, such as a bad gene or a bad protein. This model is very good when it works. It defines diseases by causes, and, when there is a clear cause, especially a genetic cause, it seems very clean.

But I think another category of disease is better defined by a state than a cause. Examples of defective states are epilepsy or cardiac arrhythmias. A state is a system property that, in healthy individuals, is hard to get into. Once in a state, it may be hard to get out of. A person suffering from a state disorder has a low barrier to defective-state entry; importantly, there may be many routes to defective state entry, so discovering a single route may account for very little of the population variance.

In this way of thinking, the frustration in not finding simple genetic or cellular causes of schizophrenia (and other psychiatric disorders) suggests that these diseases may be state defects rather than defects based on singular cellular mechanisms.