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Note: I realize this is speculation and that it is highly inappropriate to diagnose a mental illness based on media reports. But since many are doing this already and they are causing harm with poor speculation (for example, to children with Asperger's), I feel compelled to speak up based on my understanding of mental health issues.  

The shooting of 20 children is incomprehensible. Why would anyone do this?

I am not an expert on mental health, but I have some familiarity and training and there is only one answer that makes any sense (if you can call it sense): the shooter did not believe he was shooting children - instead he was shooting "bad" guys in some parallel universe he has been constructing in his mind the past few years.

We don't talk about mental health much in this country and, when we do, it is a confusing mess of a discussion that tends to get things very wrong. For example, there is nothing in Asperger's that could lead to this result. Children and adults with asperger's struggle to interpret the emotions and motivations of others - but this is the only thing different about them. They would be horrified by the concept of shooting a child.

Only a mental health issue that involves an alternate reality and psychotic break could explain this result. Add to this the fact that it is a bright young man of 20 who has struggled to transition to the "real world" after school (is not working, lives at home, is a loner) and the highly probable diagnosis is schizophrenia.

Unfortunately, schizophrenia takes some of our brightest into a mental abyss and most do not come back. I am not sure that this is what happened with Adam Lanza but it fits. Follow me below for more.

If you have seen the movie A Beautiful Mind, you have seen a good depiction of schizophrenia as John Nash, a brilliant economist, struggles with an alternate reality where his longtime college friend was completely imaginary. Nash couldn't tell what was real and what was an invention of his mind. Eventually, he learned to deal with the condition and had a successful career as a professor, so the movie had a happy ending. The reality of schizophrenia, however, is that John Nash is one of the few who was able to rejoin reality. Most stay in their alternate worlds and are unable to rejoin society as "normal" people.

The heartbreaking thing about schizophrenia is that it usually strikes young adults as they are graduating from high school and going to college. I mention college because most children with schizophrenia are intelligent and have done well in school. But then something goes wrong in the period from 17-22 and they are unable to cope with reality. They start hearing and seeing things that are not real and they invent alternate worlds in their minds to live in. The result is that they are unable to hold real jobs, appear strange to friends and family, and end up alone with their thoughts in their alternate reality.

For most people with schizophrenia, there is no danger to society. They do not take up guns and shoot people. Instead, after drifting in and out of jobs and relationships, they quietly become homeless. In other words, the chronic homeless have many who suffer from schizophrenia. In popular culture, it is common to hear jokes about people yelling at inanimate objects. But this is not really a joke because this person believes they are having a conversation with someone.

This illness raises many questions: don't they know it is not real? why don't they stop listening to the voices like John Nash did? I don't know the answers to this as I do not work with schizophrenics regularly. But I suspect most do know something is off but struggle to do anything about it as their mind is clouded on the issue of what is real. Also, if you are paranoid about the world being run by robots or aliens and then everyone starts telling you to ignore this - you might just believe it was the robots trying to convince you they are not real.

For me, this issue has a personal connection because just this week one of my students appears to just have gone into the abyss. He is a bright young kid who had been sharing his ideas for a business he wants to start. At first, he was rational but a bit dreamy. But as time went on, the ideas were grander and hard to believe were real. Then he showed me his secret document that pulls it all together. What I can only call a "manifesto" was a document full of magical thinking that pulled together ideas from many sources into a jumbled mess that he clearly thinks outlines the solution to the universe. When I did not "get it", he was a bit disappointed, but refused to engage in dialogue as to the meaning of any of the parts or how the logic did not make sense. Instead, in his mind it was apparently perfect how it all fit and he did not recognize the concept of questioning something so brilliant. So he just looked at me like I was crazy when I didn't understand. This may not be schizophrenia but it fits the typical picture - bright young adult who devolves into an alternate universe instead of going out into the real world in the usual way (get an entry level job, work your way up, etc.)

Bringing it back to Adam Lanza, we know very little at this point. But I have noted the following from media reports:

20 years old

Living at home with no discernable employment

Strange behavior (a bit different, troubled, loner, etc.)

Brother has not spoken with him since 2010 (estranged)

Bright student in high school

Unfortunately, this all fits the typical pattern of schizophrenia as this appears to be a young man who struggled making the transition from high school to the real world as a young adult.

Considering now the shooting of 20 children. Such a horrifying act is beyond what any other criminals have done. Most multiple shootings are to get back at someone - they have a motive however twisted it might be. But there is no motive for shooting innocent young children. This does not fit with our common conception of what "evil" people do and this makes it impossible to understand.

To me, this only makes sense as a tragic case of schizophrenia - where a young adult devolves into an alternate reality. Unfortunately, mental health issues are heavily stigmatized and it is difficult for a young adult to admit they have a problem in their lucid moments. I imagine Adam struggled with this illness for years as he was sliding away from reality. After the fact, it seems clear what happened, but this is a slow ride down and maybe the family did not realize the severity. Adam likely hid his delusions and creeping alternate reality from everyone. But it must have come out eventually as his first victim was his mother which suggests a confrontation gone wrong. And something as traumatic as shooting your own mother can easily set off a psychotic break where you are "all in" on your alternate reality. If the school and everyone in the school were (for some unknowable reason) the evil ones in Adam's reality, then there is logic to trying to take out as many as he could in a final stand. He likely did not see them as children - maybe they were killer robots or some other type of creature. In essence, once he committed an act as horrible as killing his mother, this triggered a psychotic break where he was "all in" on his fantasy world with him against them in a battle Adam did not expect to survive.

I apologize if the speculation has offended anyone. I just don't like to see all the "evil" talk like this was the devil at work. There is unfortunately a simple explanation for what happened - there are people with serious mental illnesses among us and they should be given help (and not given access to guns). Hopefully this diary will help to dispel some of the confusion about the different types of mental illness. Depression or mania or Asperger's can't explain purposely shooting small children; the only mental illness that can is a psychotic break with reality which means schizophrenia.

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Comment Preferences

    •  second that (5+ / 0-)

      Diarist, do yourself a favour and delete this.

      All things in the sky are pure to those who have no telescopes. – Charles Fort

      by subtropolis on Sat Dec 15, 2012 at 12:03:15 PM PST

      [ Parent ]

      •  nope (1+ / 0-)
        Recommended by:
        rwgate

        This is an excellent diary.

        We consume the carcasses of creatures of like appetites, passions and organs with our own, and fill the slaughterhouses daily with screams of pain and fear. Robert Louis Stevenson

        by Christin on Sat Dec 15, 2012 at 03:32:34 PM PST

        [ Parent ]

      •  Seriously! It's hugely insulting to the mentally (2+ / 0-)
        Recommended by:
        Timaeus, sboucher

        ill, who are no more likely to be violent than the general population. Yes, there are schizophrenics who commit violent crimes. There are many more with personality disorders who commit violent crimes. You really need some evidence to conclude that a schizophrenic diagnosis is warranted. As of now, the police are saying they have evidence for a motive, which schizophrenics generally do not have.

        •  It's not about being insulting (0+ / 0-)

          to the mentally ill.  The diarist is simply saying that this in not Aspergers, and I certainly concur.  I am close friends with a woman who is definitely schizophrenic, bi-polar.  She has times of extreme depression, crying, and then in an instant the tears stop and she appears absolutely normal.  An hour later, she is just like the man described by the diarist who has grand plans, which nobody else understands.

          She is not violent.  She has been diagnosed by psychiatrists as schizophrenic, but she recently decided that that carried too negative an image.  Now she insists that she has Aspergers, which is actually a form of autism.

          We don't know at this time what drove Adam Lanza to kill his mother and 26 other people.  But, as the diarist stated, schizophrenia is certainly a possibility.  Just as certain is that someschizophrenics are violent.  However, I have never heard of an Asperger's sufferer facing the same demons.

          "There are times when even normal men must spit in their hands, hoist the black flag, and begin slitting throats." - H.L. Mencken

          by rwgate on Sat Dec 15, 2012 at 05:39:54 PM PST

          [ Parent ]

    •  Hard to get around (4+ / 0-)
      Recommended by:
      second gen, atana, plumbobb, sboucher
      1. I know that what I am doing is a bad idea. I know that so well, that I put it in boldface.
      2. But lots of other people do it too, so here goes:
      •  True. Diarist doesn't seem to understand (0+ / 0-)

        that writing a diary

        "based on my understanding of mental health issues"
        has resulted in showing how badly the diarist understands mental health issues. This is a worthless piece that only adds to the swirl of misinformation.

        I'll be the first to bell the cat -- HR for a diary that is admitted on your part to be a bad idea; not removing diary despite requests; your doubling-down by adding that first paragraph; full of misinformation based on diarist's opinion, not knowledge of, the subject.

        It's not just a zip code, it's an attitude.

        by sboucher on Sat Dec 15, 2012 at 08:28:22 PM PST

        [ Parent ]

    •  Diarist recognizes it is irresponsible. (3+ / 0-)
      Recommended by:
      atana, plumbobb, sboucher

      Does so anyway.

      Doubles down in it. It is irresponsible to diagnose ouija board board, which is what has been done. And it is irresponsible to hare off about schizophrenia when it is only a tiny fraction of schizophrenics who ever represent a danger, WHEN we don't even know that the shooter was schizophrenic.

      Lois more like a narcissistic diarist to me; 'I have something to say about something, and you need to hear me. Even though I know it is really irresponsible to bring it up....'

      (Note for the irony impaired; yes, suggesting the diarist suffers from narcissism is an example of nearly evidenceless diagnosis from afar.)

      "Be just and good." John Adams to Thomas Jefferson

      by ogre on Sat Dec 15, 2012 at 12:07:32 PM PST

      [ Parent ]

      •  If the instant media diagnosis of Asperger's (0+ / 0-)

        is wrong, isn't that a matter we should take some interest in, those of us that are either aware of the nature of Asperger's or schizophrenia up close?

        I, too, think this will be something on the schizophrenia spectrum.  The diagnoses of Asperger's make no sense.

  •  I suggest deleting this diary. (5+ / 0-)

    Schizophrenia is rarely associated with violence.

    There is no evidence of schizophrenia.

    And mass murderers absolutely don't need to be living in a delusion.

    Maybe he was just plain evil, or possessed by Satan, or on meth.  Nobody knows.  At least not at this point.

    •  Aspies are not delusional. (0+ / 0-)

      Some delusional disorder seems to make more sense.  Yup, maybe meth; that would work too.  But the current snap diagnosis of the media seems way off.

    •  Possessed by Satan? and you want to (0+ / 0-)

      be taken seriously?
      I agree with your point that most mentally ill people are not violent.
      However, some are.

      You can't make this stuff up.

      by David54 on Sat Dec 15, 2012 at 05:00:26 PM PST

      [ Parent ]

      •  Wow. You're not winning an IQ contest here. (0+ / 0-)

        Read again.

        The point, which was clear, is that the diary's conclusion is just as irrational as that, or at least as that could be considered by many.

        FWIW, as a religious Catholic, I believe that people sometimes do actually get possessed by Satan, and there is very good evidence for that.  Look up Malachi Martin's book Hostage to the Devil.  But I was not advancing that belief in my comment.

        •  I'm sorry. I will tell you up front that I'm not (0+ / 0-)

          big on "supernatural concepts" . If God exists I don't see any evidence he's superstitious. I don't think he wants us to be.
          I don't think this community should tear itself apart because of someone's madness or horrific behavior.
          I think there's also a sociological component that's somewhat separate from psychiatry even though it may have its roots in socio-biology and brain chemistry. I'm not up to speed on the most recent research on the subject.
          That is "sociopathology". This person may have been a "sociopath".
          I do know that psychology has been advanced by the advancement of sociology. The "psyche" is a social institution of the brain. Language itself is a social function and the internal dialogue we have is a function of our relation with society. It's a chicken and egg, thing, but the fact is "society" itself came before the "individual" (psyche) and identity and language evolved as our social relations evolved.

          That's what I believe. I'm not an expert on it. In another comment I suggested the diarist rewrite the diary, such that his speculation became less of a "diagnosis".
          I think it will take a Capote/Bugliosi level of reportage on what happened in this person's life to illuminate it sufficiently as well as years of study and possibly a molecular level of autopsy.

          However, I don't want to toss this person's life into the dustbin of history rubberstamped with the "evil" label, and not because I feel sorry for him, (I do) and not because I want to make excuses for him (I don't). It seems to me that that would also be tossing away the lives of his victims as meaningless as well.
          That seems like a "Forget about it, Jake...it's Chinatown". response to this tragedy.  

          You can't make this stuff up.

          by David54 on Sun Dec 16, 2012 at 06:13:21 AM PST

          [ Parent ]

  •  So the answer to poor speculation re: Aspergers (4+ / 0-)
    Recommended by:
    Timaeus, Garrett, FG, skohayes

    is poor speculation re: schizophrenia?

  •  I'm having the same thought, that this (6+ / 0-)

    is probably schizophrenia or schizoaffective.  This is atypical behavior for Asperger's, which is a syndrome that is too widely diagnosed because of some recent fads in that direction.

    I'm bipolar I (vanilla manic-depression).  I live with and care for (to an extent) a brother who has schizo-affective disorder, a type of bipolar disorder which can at times resemble schizophrenia.  I'm used to having to talk him down from his delusions, many of which he won't give up even during the best of times.  I sometimes worry that he's where I may be headed someday.

    So... to all the people complaining, what's the point of raising this issue?  I'll offer one: trying to be more accurate, on a day when all the news are (including right now on MSNBC while I type this) linking this incident to the shooter's alleged Asperger's.  It isn't just that this may do a disservice to the reputation of those who have Asperger's.  It just seems very unlikely to be Asperger's based on what I know of it and schizophrenia; it seems to be a snap assessment of people ignorant of the characteristic of these things; and the questionable nature of it also seems to be characteristic of all the other jump-the-gun bullshit items that have come out since yesterday, like the mom being a teacher and the shooter being somebody else...  

    It's also important because if this does turn out to be some kind of schizophrenia (his face has that look, but that means little, I suppose), then better to focus on that and how and why schizophrenics aren't getting better treatment in many cases (there are good medications out there for it.)  It also lets us raise the question of what the fuck his mother was doing teaching him how to shoot weapons like the bushmaster at shooting ranges, as has been alleged on the news today.  

    I'd really like to know a lot more about the mother and her relationship with this kid.  It sounds like it might have been very messed up.

    So cut the diarist some slack.  He may or may not have asked the question eloquently, but it's an important matter.

    •  agreed (2+ / 0-)
      Recommended by:
      Dumbo, David54

      And even liberals on daily Koswould rather live In a black and white world of calling him evil, a monster, a sociopath that hated children....rather then understand mental illness.
      Too much to think about there.
      And yes schizophrenia is an alternate universe where Andrea Yates thought she was saving her children from
       Satan by drowning them.
      The idiots on the Texas jury said that was bullshit and sent her to jail.
      Thank god compassion and sanity prevailed.

      We consume the carcasses of creatures of like appetites, passions and organs with our own, and fill the slaughterhouses daily with screams of pain and fear. Robert Louis Stevenson

      by Christin on Sat Dec 15, 2012 at 03:31:21 PM PST

      [ Parent ]

      •  What a bunch of crap. (1+ / 0-)
        Recommended by:
        sboucher

        You have no idea about any of this.

        •  you (0+ / 0-)

          Can get lost and  stay the eff away from me creep. This is your last warning.

          We consume the carcasses of creatures of like appetites, passions and organs with our own, and fill the slaughterhouses daily with screams of pain and fear. Robert Louis Stevenson

          by Christin on Sat Dec 15, 2012 at 08:46:12 PM PST

          [ Parent ]

          •  Last warning before what? (0+ / 0-)

            What an unhinged comment.  You made a comment.  I criticized it, without any personal malice.  That's what we do here.

            It remains true that your comment was full of crap.  It's perfectly acceptable to say that here.

            Especially when abundantly true.

            Sorry to receive personal insults like this ("creep") from you.  I used to think you were a friend, and have supported you hundreds of times.

            Shame on you for being so hypersensitive and small.

    •  I don't know what the diagnosis will be, (0+ / 0-)

      (post-mortem) but I'm tired of the useless "evil" term. I think the diarist may be close to the truth, but premature.
      He should consider re-writing the diary. I appreciate what you're adding with your experience.
      I've had a lifetime of experience with someone who's now diagnosed with schizo-affective bi-polar disorder.
      She's carries a potential of psychosis but never would hurt a fly.
      Most mentally ill people are not violent. This should be repeated over and over during this period of coping with this event.

      You can't make this stuff up.

      by David54 on Sat Dec 15, 2012 at 04:57:10 PM PST

      [ Parent ]

      •  Just for the record, (0+ / 0-)

        Asperger's is not a mental illness.  That's very important.  It's a syndrome, a personality type.  It's not curable.  Schizophrenia, however, they have lots of pills for.  Thus there's a big difference between suggesting a killer was schizophrenic and suggesting that a killer was an Asperger's.  

        •  It's a neurological condition (1+ / 0-)
          Recommended by:
          Timaeus

          that may be hereditary, or, as recent new suggests, because of the age of the parents. My sister's son has Asperger's so I'm very familiar with the topic. He has been treated all his life by psychiatrists, which would indicate that in addition to being neurological, it has psychiatric issues that must be dealt with as well.

          I also have a disease that runs strongly in my father's side of the family: chronic, debilitating depression (with a couple of side orders). I've been treated by psychiatrists most of my life, even though we know it's an inherited (neurological) condition.

          It's not just a zip code, it's an attitude.

          by sboucher on Sat Dec 15, 2012 at 06:14:05 PM PST

          [ Parent ]

          •  Autism, including Asperger's, is definitely (1+ / 0-)
            Recommended by:
            sboucher

            considered to be a mental disorder that requires psychiatric attention.

            It's not a condition associated with violence or delusions.

            Incidentally, the American Psychiatric Association has removed Asperger's as a diagnosis from the fifth edition of the canonical Diagnostic and Statistical Manual (DSM5).  They now lump all versions of autism together as "autism spectrum disorder."

            FWIW.

            I don't think this killer was Asperger's nor schizophrenic.

            I think he was a mass murderer.  No psychiatric label (or excuse) is necessary.

            •  We're on the same page, (1+ / 0-)
              Recommended by:
              Timaeus

              I was trying to explain that while it is a neurological disorder, it is also a mental disorder. Like I said, my nephew has undergone treatment his entire life.

              I think he was a mass murderer.  No psychiatric label (or excuse) is necessary.
              This is what I've been screaming at everyone who won't listen. Thanks for summing it up so succinctly.

              btw you have a new follower :)

              It's not just a zip code, it's an attitude.

              by sboucher on Sat Dec 15, 2012 at 08:34:45 PM PST

              [ Parent ]

  •  I had the same thoughts as expressed in your Diary (0+ / 0-)

    I've known a fair number of "Asperger's" (not sure that it made it into the updated DSM ( Diagnostic and Statistical Manual of Mental Disorders) and the actions of the shooter was not connected with anything I know about or have seen with this disease.  Asperger's is now very often simply described for anyone who is deemed "weird" or badly "introverted".
    Schizophrenia is a complex disease (or more appropriately, a complex of complex diseases) and contrary to what one of the comments above stated, schizophrenics have been associated with violent acts done because they were told to do so by "the voices".  
    At this point, however, it is as irresponsible to make a diagnosis in the MSM based on the little we know, as it was to give out the name of the shooter's brother as the culprit -- I have less problem with a speculative diary on DKos.  Schizophrenia, nevertheless, certainly sounds more plausible to me than Asperger's, but as I said - it is far too early to make any diagnosis...

    •  Nonsense. (1+ / 0-)
      Recommended by:
      sboucher

      The risk of violence for schizophrenics is very small.

      See, e.g., http://www.nimh.nih.gov/... from the National Institutes of Mental Health.

      Or just google "schizophrenia violence."

      Some of the comments in this thread, and the diary, are completely full of crap.

      I'll stake my entire reputation on this site on the claim that this particular mass murderer was not schizophrenic.

      Moreover, I doubt if he had any diagnosable mental illness at all.  I think he was an asshole who knew exactly what he was doing.

      Have you seen his evident 4chan posts?

      •  Links? n/t (0+ / 0-)

        It's not just a zip code, it's an attitude.

        by sboucher on Sat Dec 15, 2012 at 06:04:43 PM PST

        [ Parent ]

        •  I'm sorry, I've been reading on this all day (1+ / 0-)
          Recommended by:
          sboucher

          and don't remember how to retrieve that.

          I'll bet a search on "Lanza 4chan" would work.

          Somebody who seems to be him posted on odious 4chan that he planned to commit suicide on Friday, in Connecticut, and it would be a big news item.  He also posted a picture of the two dead Columbine killers.

          No idea whether this was done by the killer, but my impression was that it probably was.

  •  Take it down. (1+ / 0-)
    Recommended by:
    Timaeus

    As other posters have said, this diary is irresponsible and insulting, and not based in reality.

    It's not just a zip code, it's an attitude.

    by sboucher on Sat Dec 15, 2012 at 06:18:11 PM PST

  •  I'm sorry, but I don't see (0+ / 0-)

    being 20 years old as indicative of mental illness.

    Yet you list Lanza's age as if it were.

    Your list is this:

    - - -

    20 years old

    Living at home with no discernable employment

    Strange behavior (a bit different, troubled, loner, etc.)

    Brother has not spoken with him since 2010 (estranged)

    Bright student in high school

    - - -

    Anybody who doesn't die before his or her 20th birthday becomes 20 years old.  Growing up does not equal mental illness.

    Any number of people live at home with no discernible employment in a nation whose corporate executives outsource their jobs to other countries.  

    Any number of people are estranged from members of their family.  Having a psychosocial support system is likely better than not having one, but it is not statistically possible in all cases.  

    Any number of high schoolers are "bright students."  Being bright does not preclude a DSM diagnosis.  

  •  iloperiodone (0+ / 0-)

    Reports surfaced this morning that Adam Lanza was being treated with Fanapt (iloperiodone) aka Zomaril, an atypical antipsychotic used in the treament of schizophrenia.  His uncle was the source of the reports.

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