Understanding Schizophrenia: Fake Signer at Mandela Memorial Claims Mental Illness

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From left: U.S. President Barack Obama and Thamsanqa Jantjie during Obama's speech at the Nelson Mandela Memorial at FBN Stadium, Johannesburg, on Dec. 10, 2013.

Could schizophrenia explain Thamsanqa Jantjie’s bizarre behavior?

“I don’t remember any of this at all,” Jantjie told the Associated Press when a reporter showed him video footage of him signing at the Mandela memorial service on Dec. 10.

Jantjie was on stage for more than three hours, ostensibly interpreting speeches made by dignitaries, including President Obama, in sign language for the deaf community. Except that his sign language was incomprehensible to them; during the service, they took to Twitter, describing what they saw as gibberish and accusing him of “flapping his arms about” and being an “embarrassment.” Deaf actress Marlee Matlin, told CNN, “It was almost like he was doing baseball signs.”

Defending himself to the press on Thursday, Jantjie says he suffers from schizophrenia, but stands by his sign language credentials. Although he did not recall the Mandela memorial, he said to CNN, “It has been many years I have been doing this job. My portfolio shows that I have been a champion of what I have been doing.”

Jantjie claimed he was experiencing a psychotic episode during the service; he told the Star, a Johannesburg newspaper, that he “lost concentration, started hearing voices and hallucinating.” The voices drowned out what he was supposed to be interpreting, so he said he did the best he could. He mentioned to other reporters that he saw angels enter the stadium as he was standing on the stage.

Still, realizing that he had a responsibility and that he was surrounded by armed men who were part of the security details of the dignitaries attending, Jantjie told the Star that “I tried to control myself and not show the world what was going on. I am very, very sorry, it’s the situation I found myself in.”

Is such rational thought – about needing to control and cope with a psychotic episode, possible? Elyn Saks, professor of law, psychology and psychiatry and the behavioral sciences at University of Southern California, says yes. Saks, herself a schizophrenic, chronicled her own experiences in managing her illness while a law student and a tenured professor in her memoir, “The Center Cannot Hold: My Journey Through Madness.” “Can people like me function? The answer is yes,” she says. “I have been able to function through episodes without people knowing.”

How successful schizophrenic patients are in accomplishing this depends on the types of symptoms they experience and how well they are treated, with medications, psychotherapy or a combination of both. While each case can vary, there are five hallmark symptoms that mental health experts generally recognize as signs of schizophrenia – delusions, hallucinations, disordered thoughts, disorganized or bizarre behavior, and negative symptoms.

Delusions can include beliefs that people or organizations are conspiring against and targeting the patient, making them the victim of persecution. Hallucinations, such as the ones Jantjie claims to have seen or heard, include hearing voices and seeing nonexistent visions; these can become dangerous if they command the patient to execute certain actions, such as harming others or themselves. Bizarre behavior, such as attempting to wear food as clothing, or other irrational acts, can also be a sign of schizophrenia. And in some patients, severe deficits in motivation, speech or thoughts can also occur – “everything seems to slow down, and go blank in some way,” says Dr. Ann Shinn, instructor in psychiatry at Harvard Medical School and McLean Hospital.

Some schizophrenics also exhibit thought disorders, in the form of garbled speech or nonsensical speech that may lack syntax or structure. Whether Jantjie manifested this symptom with his nonsensical signing isn’t clear.

In order to be diagnosed with schizophrenia, the most recent manual of psychiatric disorders says at least two of the five symptoms above have to be present, as well as impairment in the patient’s ability to function independently.

To live with their mental illness, most patients need antipsychotic medications, some form of talk therapy, or a combination of both. For Saks, medications and therapy five days a week keeps her psychotic thoughts to a minimum. “In law school, when I was on and off my meds, I would say 30% of my waking thoughts were psychotic – I would have delusional ideas, like I had killed hundreds or thousands, or that a nuclear explosion would go off in my brain,” she says. “Now I would say 2% of them are.”

Jantijie told the AP that he was being treated for his mental illness, and that he was due for a checkup on the day of the memorial.

His actions, regardless of their cause, have upset both the deaf and mental illness communities. Deaf individuals have demanded to know why Jantjie was allowed to continue signing throughout the more than three hour service – most sign language professionals change interpreters every 20 minutes to avoid fatigue — after many pointed out that there were problems with his interpretations. And for the mentally ill, such coverage of his failings only increases the stigma that schizophrenia patients already face as being unable to function as productive members of society.

“In the past, if you were diagnosed with schizophrenia you were told to downgrade your expectations of what you would accomplish in life,” says Shinn. “We are trying to change the way people think about that, and to give people a chance to accomplish their life goals. Not everyone is going to be able to do that, but for the people who can, let’s give them a chance.”

Saks is an example of someone who took that opportunity, but she is concerned that media coverage of the negative consequences of schizophrenia may bias the public against providing more of these chances. “To the extent that people come forward, and talk about their stories and experiences with schizophrenia, it reduces the stigma,” she says. “Seeing people do well does that. [Jantjie] is an example of someone who didn’t do as well, so it can cut the other way, to increase stigma and make things worse. But the fact that this guy didn’t do well doesn’t mean we shouldn’t hire sign language interpreters who have schizophrenia. It just means that we want to make sure they are okay, and getting the care they need.”