Schizophrenia
People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn, and could appear to have lost touch with reality. This lifelong disease can’t be cured but can be controlled with proper treatment.
Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia involves a psychosis, a type of mental illness in which a person can’t tell what’s real from what’s imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.
How severe schizophrenia is varies from person to person. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively normal lives in between. Still others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.
What Are the Early Symptoms of Schizophrenia?
The condition usually shows its first signs in men in their late teens or early 20s. It mostly affects women in their early 20s and 30s. The period when symptoms first start and before full psychosis is called the prodromal period. It can last days, weeks, or even years. It can be hard to spot because there’s usually no specific trigger. You might only notice subtle behavioral changes, especially in teens. This includes:
- A change in grades
- Social withdrawal
- Trouble concentrating
- Temper flares
- Difficulty sleeping
Positive Symptoms of Schizophrenia
In this case, the word positive doesn’t mean good. It refers to added thoughts or actions that aren’t based in reality. They’re sometimes called psychotic symptoms and can include:
- Delusions: These are false, mixed, and sometimes strange beliefs that aren’t based in reality and that the person refuses to give up, even when shown the facts. For example, a person with delusions may believe that people can hear their thoughts, that they are God or the devil, or that people are putting thoughts into their head or plotting against them.
- Hallucinations: These involve sensations that aren't real. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person's behavior, insult them, or give commands. Less common types include seeing things that aren't there, smelling strange odors, having a funny taste in your mouth, and feeling sensations on your skin even though nothing is touching your body.
- Catatonia: In this condition, the person may stop speaking, and their body may be fixed in a single position for a very long time.
Disorganized Symptoms of Schizophrenia
These are positive symptoms that show that the person can’t think clearly or respond as expected. Examples include:
- Talking in sentences that don’t make sense or using nonsense words, making it difficult for the person to communicate or hold a conversation
- Shifting quickly from one thought to the next without obvious or logical connections between them
- Moving slowly
- Being unable to make decisions
- Writing excessively but without meaning
- Forgetting or losing things
- Repeating movements or gestures, like pacing or walking in circles
- Having problems making sense of everyday sights, sounds, and feelings
Cognitive Symptoms of Schizophrenia
The person will have trouble:
- Understanding information and using it to make decisions (a doctor might call this poor executive functioning)
- Focusing or paying attention
- Using their information immediately after learning it (this is called working memory)
- Recognizing that they have any of these problems
Negative Symptoms of Schizophrenia
The word "negative" here doesn’t mean "bad." It notes the absence of normal behaviors in people with schizophrenia. Negative symptoms of schizophrenia include:
- Lack of emotion or a limited range of emotions
- Withdrawal from family, friends, and social activities
- Less energy
- Speaking less
- Lack of motivation
- Loss of pleasure or interest in life
- Poor hygiene and grooming habits
What Causes Schizophrenia?
The exact cause of schizophrenia isn’t known. But like cancer and diabetes, schizophrenia is a real illness with a biological basis. Researchers have uncovered a number of things that appear to make someone more likely to get schizophrenia, including:
- Genetics (heredity): Schizophrenia can run in families, which means a greater likelihood to have schizophrenia may be passed on from parents to their children.
- Brain chemistry and circuits: People with schizophrenia may not be able to regulate brain chemicals called neurotransmitters that control certain pathways, or "circuits," of nerve cells that affect thinking and behavior.
- Brain abnormality: Research has found abnormal brain structure in people with schizophrenia. But this doesn’t apply to all people with schizophrenia. It can affect people without the disease.
- Environment: Things like viral infections, exposure to toxins like marijuana, or highly stressful situations may trigger schizophrenia in people whose genes make them more likely to get the disorder. Schizophrenia more often surfaces when the body is having hormonal and physical changes, like those that happen during the teen and young adult years.
The goal of schizophrenia treatment is to ease the symptoms and to cut the chances of a relapse, or return of symptoms. Treatment for schizophrenia may include: Medications, Coordinated specialty care, Psychosocial therapy, Hospitalization…
Psychosocial therapy:
While medication may help relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, social, and occupational problems that go with the illness. Through therapy, patients also can learn to manage their symptoms, identify early warning signs of relapse, and come up with a relapse prevention plan. Psychosocial therapies include:
- Rehabilitation, which focuses on social skills and job training to help people with schizophrenia function in the community and live as independently as possible
- Cognitive remediation, which involves learning techniques to make up for problems with information processing. It often uses drills, coaching, and computer-based exercises to strengthen mental skills that involve attention, memory, planning, and organization.
- Individual psychotherapy, which can help the person better understand his illness, and learn coping and problem-solving skills
- Family therapy, which can help families deal with a loved one who has schizophrenia, enabling them to better help their loved one
- Group therapy/support groups, which can provide continuing mutual support
There’s no known way to prevent schizophrenia. But early diagnosis and treatment can help avoid or ease frequent relapses and hospitalizations, and help cut the disruption to the person's life, family, and relationships