What is Schizophrenia?

Schizophrenia is a chronic mental disease that drastically affects how a person thinks, feels, and behaves. People with schizophrenia often seem disconnected from reality, with a long list of symptoms that significantly change the lives of those it affects. Throughout history, society has held resentment for the mentally ill and discriminated against them in terrible ways. Following the classification of schizophrenia, the disease became gravely misunderstood by the public. Society harshly stigmatized people with schizophrenia because of the extensive list of debilitating symptoms.

Symptoms of schizophrenia generally fall into three categories: positive, negative, and cognitive. Positive symptoms are psychotic behaviors generally not seen in healthy individuals, which result in a disconnection from reality. These symptoms include hallucinations, delusions, dysfunctional thinking, and movement disorders. Hallucinations are sensory perceptions that occur without any cause and are experienced through the senses (sight, sound, taste, smell, touch). Auditory hallucinations are the most common, typically experienced as voices. Schizophrenic patients describe these voices as commentating on their behavior and intentions or as an imposing presence directing their actions. Most often, the voices are negative and critical. Unlike hallucinations, which trick the senses, delusions are fixed false beliefs that lead to misinterpretations of experiences and relationships. There are several types of delusions that share common themes, including persecutory, referential, somatic, religious, erotomanic, and grandiose delusions.

Persecutory delusions occur when the patient believes a person, group, or organization is mistreating or harming them, despite contradictory evidence. Referential delusions come from the belief that public communications contain special messages intended solely for the individual with schizophrenia. However, if the person realizes that their referential delusions may not be accurate, these notions are referred to as ideas of reference. Somatic delusions involve the patient's concern for their physical health when they diagnose themselves with medical conditions. Religious delusions involve the individual's belief that they have a unique relationship with God, comparable to biblical figures. Erotomanic delusions are false beliefs and unrequited feelings for relationships that likely don't exist. Lastly, grandiose delusions are the patient's belief that they hold a significant, powerful position in the world. Not all delusions fit into these categories, and often, they are a combination of two or more.

On the other hand, negative symptoms result from an absence of normal behavior and have a wide range of possibilities. The National Institute of Mental Health Measurement and Treatment Research to Improve Cognition in Schizophrenia consensus panel has recently defined five negative symptoms: blunted affect (diminished facial and emotional expression), alogia (decreased verbal output or verbal expressiveness), asociality (lack of involvement in social relationships), avolition (a reduction in interests, desires, goals, and self-initiated and purposeful acts), and anhedonia (inability to experience pleasure from positive stimuli) (Mitra 9). The most recent version of the DSM-5 characterizes the negative symptoms as restricted emotional expression and avolition, indicating a decrease in their motivation to engage in purposeful self-directed activities. While these negative symptoms may seem insignificant in comparison, they are the main reason why people with schizophrenia find it difficult to live normal lives.

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