Schizophrenia: Definition, Symptoms, Causes
Schizophrenia that alters how a person thinks, feels and acts. They have had a hard time determining the difference between real and what is imaginary. They can also be unresponsive or withdrawn. It is difficult to establish relationships in the world both personal and professional. (Haycoco, 2009) It is not a split or multiple personality disorder. Most people with schizophrenia are non-violent and usually, do not pose a danger to other people. (Mental Health America, 2013)
They may come up with a person that they really love, hate, or have a different opinion about. In their mind, they may have no connection with reality. They live in their own world. People with schizophrenia are seen with different moods. The disease affects individuals with different backgrounds and every person unique. Studies have shown that the younger the patient the more severe the effects. The condition worsens with age. In the beginning, people appear slightly eccentric, reclusive, irate, and emotionally upset. Their appearance becomes untidy, say weird things, and life becomes indifferent. (Wilkenson, 2014) People with schizophrenia require lifelong treatment. Getting symptoms under control will help improve quality of life. (Mayo Clinic Healthy Living, 1998-2018) The cause of schizophrenia is unclear. Many theories include heredity, abnormal brain chemistry, viral infections, and immune disorders to name a few. Scientist agree that some disorders run in families and that people may inherit or develop the disease over time. It may appear dormant in the body until the body undergoes hormonal or physical changes. These changes usually occur during puberty or stressful situations. (Mental Health America, 2013) There can be individuals who have it, but no one else in their family has it. There also may be people with multiple family members that have been diagnosed with schizophrenia but do not develop it themselves. Scientists understand that many different genes can increase the risk but are unable to identify a specific gene that causes the disorder by itself. (National Institute of Mental Health, 2016)
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How it works
Chemical imbalances of dopamine, glutamate, and serotonin can affect the way a brain reacts to stimuli. This may explain how schizophrenic people can become overwhelmed by bright lights and loud music. (Mental Health America, 2013) The signs are different for everyone. Some may develop slowly over years or appear shortly. Symptoms of schizophrenia start between ages 16 and 30. (National Institute of Mental Health, 2016) It affects perception. The person may hear or see something that isn’t there. Have a feeling of being watched. Have an odd way of speaking or writing, A person may experience false beliefs, anger, confusion, hallucinations, auditory or sensory thus decreasing social interaction. (Mental Health America, 2013) Schizophrenia affects men and women equally but has an earlier onset in men. Men experience symptoms in their early 20s and women are in their 20s and early 30s. They are also more likely to die at a younger age due to comorbidities like diabetes and heart disease. (American Psychiatric Association, 2018) Paranoia is a common symptom. No one symptom indicates a diagnosis of schizophrenia. Hallucinations and delusions are some of the most common symptoms. (Torrey, 2013)
The American Psychiatric Association describes 3 categories of symptoms: positive, negative, and cognitive. Positive symptoms are described as existent or present to only the person. They appear out of touch with reality. They include delusions, hallucinations, strange or distorted, larger than life ideas, behaviors or perceptions. Behavioral changes: withdrawal from society, suspicion, hostile temper, withdrawn gaze, lack of expression, Lack of personal hygiene, cleanliness, unnecessary expression of joy or pain. Lack of concentration, depression, forgetfulness, insomnia. (Haycoco, 2009) (National Institute of Mental Health, 2016) Delusions are found in 90% of all cases. Delusions are beliefs which are held against all odds. Delusions of persecution are cases where the patient believes someone is out to get them. Delusions of control make the patient think they are controlled by a third party. Delusions of reference are where a person believes that a movie or television program is speaking directly to them. Delusions of grandeur are when they believe like, Joan of Arc has blessed them with special powers. (Wilkenson, 2014) Hallucinations are when a voice, vision, or sensation is believed to be real, but only exists in their mind. They may involve all the senses or just one. They may hear voices talking to them or see someone sitting with them. In more severe cases they might even feel it.
Auditory hallucinations occur due to the misinterpretation in the patient’s own mind. They have so many disorganized thoughts they think they are having a conversation with another person. (Wilkenson, 2014) Negative symptoms are represented as diminished or missing traits. They can be a disruption to normal behaviors and emotions. They include blank expressions, no eye contact, no motivation or zeal. A person can be monotone and aware of the surrounding environment. (Haycoco, 2009) (National Institute of Mental Health, 2016) Cognitive symptoms can be subtle or severe, the patient may even have changes in their memory. Symptoms include poor ability to understand information and use it to make decisions, trouble focusing, problems with the ability to use information immediately after learning it. (National Institute of Mental Health, 2016) Symptoms are teenagers are like adults but can be more difficult to recognize. The symptoms are very similar to behaviors that are typical teenage development. Some examples are; withdrawal from friends, drop in school performance, difficulty sleeping, depressed mood, and lack of motivation. Teens are less likely to have delusions, and more likely to hallucinate. (Mayo Clinic Healthy Living, 1998-2018)
The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) defines and classifies mental disorders in order to improve diagnoses, treatment, and research. According to DSM-5 criteria am person must show symptoms associated with schizophrenia, delusions, hallucinations, etc. for at least one month of supervised observation to be diagnosed with a mental disorder. If the disorder has been present for more than a month, and less than six months, the patient will be treated for schizophrenia. Disturbances lasting for less than a month are considered brief psychotic disorders. (American Psychiatric Association, 2018)
DSM-5 have defined 5 subtypes of schizophrenia in the United States. Paranoid type feels hallucinations and delusions but does not have disorganized behavior. Disorganized type has a flat affect and thought behaviors are observed. Undifferentiated type has psychotic symptoms but paranoia, and disorganized thought are not observed. Residual type has positive symptoms and not sever in nature. Catatonic type can be immobile or active, agitated without cause. (Wilkenson, 2014) Currently, there is no cure for schizophrenia, but people can lead productive and fulfilling lives with treatment. Some forms of treatment include medication and rehabilitation programs. Rehabilitation can someone recover confidence and teach skills to help them live a productive, independent life. (Mental Health America, 2013) Individuals with schizophrenia lack awareness that their difficulties maybe from a mental disorder. Many times, the family and friends are left to convince the individual to seek professional help. (Mayo Clinic Healthy Living, 1998-2018)
- Case management: helps with access to financial services, treatment, and additional resources.
- Psychosocial Rehab: helps with regaining employment, cooking, cleaning, socializing, and stress management skills.
- Self-help groups: support and information for people with serious mental illness provided by an individual with personal experience.
- Drop-in center: places where people can socialize, receive informal support as needed.
- Housing: can range from moral support to 24 hours supervised living.
- Employment: assistance in finding employment or help with gaining skills to re-enter the workforce.
- Therapy: “”talk””, individual, group, and family. They can help members have a better understanding of the illness and share their apprehensions.
- Crisis: 24-hour hotlines, after hours counseling, behavioral center placement, and planned hospitalizations. (Mental Health America, 2013)
Medications are also used to help with symptoms of schizophrenia. They can reduce chemical imbalances. There are two major types of antipsychotic medication: Typical medications help with “”positive”” symptoms. Atypical medications help with “”positive and negative”” symptoms. TypicalAtypical Chlorpromazine (Thorazine)Fluphenazine (Proxlixin) Aripiprazole (Abilify, Aristada)Lurasidone (Latuda) Haloperidol (Haldol)Thioridazine (Mellaril)Asenapine (Saphris)Olanzapine (Zyprexa) Mesoridazine (Serentil)Thiothixene (Navane)Brexpiprazole (Rexulti)Paliperidone (Invega) Perphenazine (Trilafon)Trifluoperazine (Stelazine)Cariprazine (Vraylar)Quetiapine (Seroquel) Clozapine (Clozaril, FazoClo, Versacloz)Risperidone (Risperdal) Iloperidone (Fanapt)Ziprasidone (Geodon) (Mental Health America, 2013)
Another category is known as “”miscellaneous antipsychotic agents.”” These medications are used to treat agitation in schizophrenic people. One such example is Loxapine (Adasuve, Loxitane). As with most medications, side effects are common with all of these medications. They can range from mild such as dry mouth, blurred vision, constipation, drowsiness, and dizziness to more severe side effects such as trouble with muscle control, pacing, tremors, and facial tics. (Mental Health America, 2013) Coordinated specialty care integrates medication, psychosocial therapies, case management, family involvement, supported education, and employment services. All of these are intended to reduce symptoms and improve quality of life. The National Institute of Mental Health, Recovery After an Initial Schizophrenic Episode (RAISE) research project seeks to change the course and projection of schizophrenia to treatment in the earliest stages. (National Institute of Mental Health, 2016)
Clinical trials look at new ways to prevent, detect, or treat schizophrenia and other conditions. Treatments can be new medications, surgical procedures, devices, or new ways of using existing treatments. The goal of the treatment is to determine if the new tests or treatments work and if they are safe. (National Institute of Mental Health, 2016) If left untreated, there can be severe problems that can affect every aspect of a person’s life. Complications include suicide thoughts or attempts, self-injury, anxiety, obsessive-compulsive disorder, depression, drug or alcohol abuse, inability to hold a job or go to school, legal, financial, health, and medical problems. (Mayo Clinic Healthy Living, 1998-2018) Schizophrenia causes people to suffer from other disorders such as obesity, sedentary life, smoking, drug, and alcohol abuse. These additional factors can cause physical, mental, and psychological disabilities. People can live and function as long as the conditions are managed. Many people have fought this disorder and lived successful lives.
- Dr. John Forbes Nash Jr. one the Noble Prize for economics suffered from schizophrenia. His life was the inspiration for the movie, A Beautiful Mind.
- Peter Green, one of the founding members of Fleetwood Mac suffered from schizophrenia. He spent tie in and out of hospitals, but he managed to control his disorder over time.
- Lionel Aldridge, a two-time super bowl champion, from the Green Bay Packers developed schizophrenia after he retired.
- Brian Wilson, a Beach Boys, and Grammy-winning singer developed schizophrenia The list goes on and on, but all these people overcame this obstacle and lived their lives to the fullest. (Wilkenson, 2014)