Schizophrenia is a mental illness that can
incapacitate and even kill a person. Schizophrenia is not the same as 'split
personality' or 'multiple personality' disorder. Instead, it refers to
disruption of the usual balance of emotions and thought process.
About 2.4 million schizophrenics live in America
estimates the National Institute of Mental Health. Approximately 1% of the
entire population of the world is schizophrenic.
Schizophrenia results in hallucinations,
delusions and disordered thinking and behavior. Schizophrenics withdraw from
both people and activities around them. Instead, they seem to retreat to an
inner world marked by psychosis.
Causes of Schizophrenia
Although the exact cause of schizophrenia is not
clearly established, there could be a combination of factors that can differ
from person to person. Some well known causes include genetics, changes in the
brain chemistry, brain damage before or during birth, stress, family problems,
childhood deprivation and substance misuse, which is known as drug induced
psychosis. Although some may be born with a genetic predisposition toward
schizophrenia, stress and life experiences can trigger the onset of symptoms.
Signs and symptoms of Schizophrenia
About one in hundred are diagnosed with schizophrenia and two to four
people per thousand are schizophrenic worldwide. Symptoms of schizophrenia can
begin at any age although it is most likely to develop between the ages 20 and
30. Schizophrenia affects young men and women equally although young men tend
to get diagnosed earlier than women. The most prominent symptoms of
- Delusions such as belief that there is a
conspiracy hatched against him/her
- Disordered thoughts
- Hallucinations, that is seeing or hearing especially
voices that does not exist
- Incoherent speech
- Lack of emotions
- Angry outbursts
- Catatonic behavior
- A persistent feeling of being watched over
- Social isolation
- Clumsy and uncoordinated movements
Whereas schizophrenia can range from mild to
severe; there are people who may be able to go about their daily life
reasonably well while others may require specialized intensive treatment.
Over a period of time it would become difficult
to function in daily life with schizophrenia. Relationships could get troubled
due to inability to read social cues and other's emotions.
Acute and chronic schizophrenia
Acute schizophrenia is the one that is most
common. It occurs in a young adult who has been previously healthy and who
exhibits increasingly odd behavior over a short span of time. Symptoms of acute
Irrational beliefs or disordered thoughts
Lack of insight and illogical and incoherent
Delusions of persecution
Flat mood and mood disturbances and swings
including depression, anxiety, irritability and euphoria
Inappropriate emotional responses, for example,
laughing at sad news.
Schizophrenics generally are aware of the time
and place they are in but sometimes they may become confused due to disordered
thoughts. They could lack insight into their condition and it would become
difficult to organize them.
Schizophrenics suffer a delusion that they are
under control of another influence. They feel that thoughts are being put into
or taken out of their mind. Unfortunately, a schizophrenic never knows he/she
is experiencing such symptoms of illness.
Chronic schizophrenics exhibit certain negative symptoms including:
- Social withdrawal
- Underactivity and slowness
- Lack of interests and conversation
- Odd behavior
- Neglect of appearance and
It is not necessary that all chronic
schizophrenics should experience these negative symptoms. As such chronic
schizophrenia is a longer term state and it is characterized by lack of drive,
underactivity and social withdrawal
Chronic schizophrenics may do nothing for long
periods of time, or engage in purposeless activity repeatedly. Their self
neglect is quite marked. Hallucinations and delusions are common in acute
Even extensive research has not been able to
clearly reveal if schizophrenia can be hereditary as the causes still remain
generally unknown. Schizophrenia is caused by a combination of both genetic and
social factors and much depends on the individual's circumstances. While
genetic makeup can put a patient at a higher risk, a stressful life can trigger
possible symptoms of the illness.
Although there is 'no gene for schizophrenia,' a
family history of the illness can increase the risk of being affected.
Schizophrenia is seen to run in families and it is established that
the risk rises to 3 % if a grandparent had the
the risk is as high as 10 % if one parent was
affected by the illness
the risk rises to 40 % if both the parents had
Types of schizophrenia
Schizophrenia types depend largely on the
specific symptoms a person experiences. Since the symptoms are bound to change
over time, it is possible to have more than one type of schizophrenia in a
Paranoid schizophrenia is the most common form of the illness and the primary
symptoms include grandiose delusions and hallucinations. Disorderly thought,
disorganized behavior and affective flattening are some of the prominent
symptoms. Auditory hallucinations of hearing voices and a strong belief that
others are deliberately cheating, harassing, poisoning, spying or plotting
against them indicate paranoid schizophrenia.
Disorganized schizophrenia results in unusual thought processes. Garbled speech,
illogical thoughts, 'thought blocking,' where a person stops abruptly in the
middle of a thought and unintelligible words or 'neologisms,' are symptoms of
Catatonic schizophrenia can be clumsy and uncoordinated behavior and involuntary
movements and unusual mannerisms. Repetitive motions, which could be catatonic
in extreme cases, may result. Catatonia as such, is a state of immobility and
unresponsiveness which is very rare these days.
Residual schizophrenia seems to occur in those with long term schizophrenia. These
patients exude negative symptoms such as flat effect, with immobile facial
expressions, lack of pleasure in life, disability to any planned activity and
infrequent talk even when forced to interact. They lack any positive symptoms
and neglect basic hygiene and need help in performing everyday life activities
Undifferentiated schizophrenia is when the patient exhibits symptoms not consistent with any
other form of the illness.
Treatment for schizophrenia
Schizophrenia is usually treated
by a professional psychiatrist and a team consisting of psychologist, social
worker and psychiatric nurse.
Medications are considered the cornerstone in the treatment of
schizophrenia. But some medications for schizophrenia could have serious and
rare side effects. A medication regimen that would ideally suit the patient
with fewer side effects has to be chalked out.
Anti psychotic mediations are
normally prescribed to treat schizophrenia. These can control the
neurotransmitters in the brain. Anti psychotic medications are of two main
- Conventional or typical anti psychotics
- New generation, atypical anti psychotics
The conventional anti psychotics have remained
effective traditionally in managing positive symptoms of schizophrenia. They
could have potentially severe neurological side effects. The newer atypical
antipsychotics are effective in managing both positive and negative symptoms.
But these pose a risk of metabolic side effects like weight gain, diabetes and
Possible side effects of antipsychotic medications:
Increase in risk of diabetes
High blood pressure
Changes in white blood cell count
Serious health problems in older adults
Some antipsychotic medications can pose
dangerous interactions with other substances as well.
Incase a medication does not work well for a
patient and he/she has intolerable side effects, the treating doctor recommends
combining and switching of different medications and sometimes adjusts dosage.
The danger here is that if one stops taking medications, the relapse of
psychotic symptoms could occur. Antipsychotic medications needs to be tapered
off and cannot be stopped abruptly.
Psychosocial treatments: Psychotherapy and psychosocial treatments are important in
treatment of schizophrenia in addition to the medications. These treatments
include in their purview:
Individual therapy provided by a skilled mental health provider.
Family therapy provides education and support to the families of the patient. This
way the family members can understand the symptoms better and recognize
stressful situations which may cause relapse. The family can also communicate
better with the patient and help reduce the distress.
- Above all, rehabilitation to live independently is the key of recovery from schizophrenia. The
schizophrenic should learn skills as good hygiene, cooking and better
communication. There are communities that help schizophrenic with jobs, housing
and self help during times of crisis.
Treatment for schizophrenia is not without its
challenges. As such, it is difficult for schizophrenic to stick to their
treatment plans. They may assume that medications is not necessary or forget to
take the medications or attend therapy sessions.
Many schizophrenics smoke and they may require an
additional dosage of medication as nicotine interferes with medications.
Alcohol and drug abuse can worsen schizophrenia symptoms. A positive family
intervention should help maintain periods without illness. It can also help
with social skills and psychological therapy allowing schizophrenics to lead
productive and enjoyable lives.