Gendering psychosis: the illness of Zelda Fitzgerald

Abstract

Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance.

Stratification by Sex and Hormone Level When Contrasting Men and Women in Schizophrenia Trials Will Improve Personalized Treatment

“…The timing of onset of diagnosable illness in women is considered late by male standards, and the discontinuities in the course of illness (many well periods interspersed with psychotic episodes) are more characteristic of women than of men, perhaps due to hormone fluctuation. So are the association of flare-ups with immune and hormonal changes, and the relative responsiveness to treatment [ 121 ].…”

Metodologia para estimativa de demanda em uma rede cicloviária baseada no conceito de pontos de interesse

“…She was hospitalized for the first time with psychiatric issues at the age of 30. The course of her illness until her death at the age of 48 was marked by surreal beliefs, transient auditory hallucinations and occasional acts of violence, usually directed at herself [13]. After her first hospitalization in 1930, diagnosed with Schizophrenia, Zelda stopped practicing ballet, one of her passions.…”

Targeting Gender and Age in First-Episode Psychosis Services: A Commentary on Ferrara and Srihari

“…These women may have children living at home, or they may be grieving for babies who have been aborted or adopted or are currently in foster care. The joys, responsibilities, and burdens of both child and elder care, which are all more prevalent among women than among men (6), are unlikely to be a major focus of first-episode intervention programs that serve patients who are still in their early twenties.…”

“…Women are stigmatized for other reasons, notably with respect to motherhood. Families and care providers often feel, justifiably or not, that women with a diagnosis of psychosis will not be good mothers and should not have children (6). Another form of stigma, diagnostic overshadowing, that is, health providers' attribution of all medical symptoms to psychosis, applies to men and women alike (6).…”