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Learn to Understand Schizophrenia
Schizophrenia
is one of the most debilitating mental illnesses known.
It is characterized
by impaired or disrupted thinking, delusions and hallucinations.
People with schizophrenia also experience psychotic episodes
during which they are unable to determine what is real and
what is unreal. These symptoms can vary in severity from
one person to another and often interfere with a person’s
ability to carry out normal daily activities such as office,
school or house work.
It is estimated that four million Americans are at risk
of developing this disorder and that approximately 1.5 percent
of our population are already affected by it. While the disease
typically strikes during adolescence or early adulthood,
it can also begin in later years. Schizophrenia affects men
and women equally.
What Does Schizophrenia Mean?
The word schizophrenia comes from Greek terms meaning “splitting
of the mind.” This Greek derivation is probably what
has caused the term to be inappropriately used over the years
to describe people with multiple personality disorder. People
with schizophrenia, however, do not have more than one distinct
personality; instead they have distortions in their perceptions,
feelings, and relationships with the world around them.
What are the Causes of Schizophrenia?
Research shows that schizophrenia is a medical or biological
disease like diabetes, multiple sclerosis or cancer. Like
cancer, schizophrenia is thought to have more than one
cause and many theories exist about its origins. It appears
that genetic factors make a person more susceptible to
the illness, with environmental, biological and psychological
factors also potentially influencing its development.
Genetic Influences
A person who has a parent with schizophrenia has a 1 in 10 chance of developing
the illness, whereas the risk among the general population is 1 in 100. Many
scientists suspect that people inherit a susceptibility to schizophrenia,
but the reasons for this are still being explored.
Chemical Imbalances
It is likely that the disorder is associated with imbalances in the complex
interrelated chemical systems of the brain that control thought, mood and behavior.
Researchers indicate that a schizophrenic person’s brain may produce
too much dopamine, a neurotransmitter that carries messages or impulses between
nerve cells in the brain. The excess amount of this chemical may cause an “overload” effect
by creating too much stimuli for the brain to effectively process, thereby
creating confusion.
Physical Abnormalities
Research is being conducted to determine if the brain structures of those with
schizophrenia are different than those without it. The principle behind these
studies is that a physical abnormality in the brain may be causing the disease.
Biological Factors
Because schizophrenia most often strikes in the teen and young adult years
when the body’s chemical structure is undergoing dramatic changes, many
scientists suspect that the disease lies “dormant” during childhood
and emerges as the body undergoes changes during puberty. In this respect,
some scientists consider schizophrenia to be similar to autoimmune illnesses
like arthritis, which are caused by chemical changes in the body’s immune
system.
Some scientists also believe that schizophrenia can be caused
by a slow viral infection in a mother during pregnancy which
could infect her baby and produce pathological changes many
years after the birth.
Environmental Factors
Scientific research has not identified any life events that could be traumatic
or stressful enough to trigger the onslaught of schizophrenia. However, family
and social influences that cause distress or emotional strain may in some way
contribute to the development of the disorder in those individuals who are
already biologically vulnerable to it.
How is Schizophrenia Identified?
Although schizophrenia has a number of different characteristics,
the primary symptom is psychosis, which means people are
out of touch with reality, unable to separate real from
unreal experiences. Only a physician can diagnose a person
with schizophrenia. To meet the diagnostic criteria for
schizophrenia, a person must exhibit psychotic symptoms
for at least one week. Some individuals have only one episode
of psychotic symptoms, others have recurring episodes throughout
their lifetime.
The disease usually appears gradually with patients first
feeling tense, and developing an inability to concentrate
or sleep. They then begin to withdraw; their school or work
performance, general appearance and social relationships
slowly deteriorate. As the illness progresses, the symptoms
become more severe, causing individuals to experience disordered
thinking, delusions, hallucinations, and changes in behavior
and emotions.
For patients who do not recognize that they are ill, family
members or friends may need to take an active role in arranging
for a physical and psychiatric evaluation by a physician.
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The Symptoms of Schizophrenia
Disordered Thinking
Patients with disordered thinking may shift from one topic to another without
realizing it makes no logical sense. They may also substitute sounds or rhymes
for words, or make up their own words that have no meaning to others.
Delusions
These are false beliefs that have no basis in reality. People experiencing
delusions may believe that people are spying on or planning to hurt them. They
may also think they are someone else like Jesus, Napoleon or John F. Kennedy.
Hallucinations
The most common hallucination in people with schizophrenia is hearing “voices” that
say insulting things about them or give them commands to act in specific ways.
People suffering from schizophrenia can also experience visual hallucinations
through which they see nonexistent things, and tactile hallucinations in which
they experience burning or itching sensations.
Changes in Emotion and Behavior
People with schizophrenia may appear to have bland or flat emotions, and they
may react inappropriately to situations by talking or laughing to themselves.
They may also behave in ways that might seem strange by dressing in a bizarre
fashion or talking in an incoherent manner.
How is Schizophrenia Treated?
Generally, schizophrenia is treated through a combination
of medication and psychotherapy that is tailored to each
patient’s needs. A number of antipsychotic medications
or neuroleptics have been developed that help bring biochemical
imbalances closer to normal. These medications significantly
reduce agitation, confusion, delusions and distortions.
As with many medications, some side effects have been associated
with the use of antipsychotics. Short-term side effects
include drowsiness, restlessness, muscle spasms, dry mouth
or blurred vision. Some patients using antipsychotics over
an extended period of time may also develop tardive dyskinesia,
involuntary movements of the mouth, lips and other parts
of the body.
Clozapine, which is chemically different
than other drugs in this class, does not appear to cause
some of these troubling
side effects. Also, there are no reported cases of Clozapine
causing tardive dyskinesia. However, Clozapine has been associated,
although rarely, with seizures or agranulocytosis which is
a potentially fatal blood disease. Therefore, physicians
must carefully monitor patients’ white blood cell levels
and regulate Clozapine prescriptions to avoid any risks.
By controlling the psychotic symptoms, medications allow
people with schizophrenia to better participate and benefit
from other treatments. Psychotherapy offers understanding,
reassurance, insights, and suggestions for handling the emotional
aspects of the disorder. Family, group and individual therapy
and all very important parts of the treatment process.
What is the Outlook for People With Schizophrenia?
Although there is no known cure, the outlook for people with
schizophrenia has improved considerably over the past 25
years. Studies reveal that many schizophrenic patients
improve enough to lead independent, satisfying lives. In
fact, studies suggest that 25 percent achieve full recovery,
50 percent recover at least partially, and 25 percent require
long-term care.
How Can Family Members and Others Help People With Schizophrenia?
It is important for family and friends of people with schizophrenia
to understand the illness and support the patient’s
treatment. The following steps can help:
- Encourage the patient to accept
schizophrenia as a treatable illness.
- Support the patient
during periods when symptoms return or stress increases.
- Help
the patient structure his or her time and plan new undertakings.Offer
firm guidance during times when the patient may use poor
judgment.
- Serve as a source of information
for the therapists if new problems arise in the patient’s
life
- Recognize
that the patient’s intelligence is not
impaired, but his or her ability to tolerate stress is.
Do not place unrealistic expectations on the patient.
- Seek
help from advocacy groups such as the National Alliance
for the Mentally Ill or the National Mental Health
Association.
Learn More About Schizophrenia
The best way of coping with schizophrenia is through awareness
and education. Researchers continue to make advancements
in recognizing and treating this illness. By continuing
to reach out for information and assistance, you can help
those whose lives have been touched by schizophrenia continue
to improve.
Foundations Behavioral Health
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