Schizophrenia: A Challenging Medical Illness
EmPower Research
November 08, 2007
By Prathima V
Schizophrenia is one of the most chronic and disabling of major mental illnesses. It is a highly complex condition, and scientists are not even sure if it is one disorder, or a range of disorders, with different causes. About one percent of the population develops schizophrenia during their lives. More than two million Americans suffer from the illness in a given year. Men and women are affected equally.
Schizophrenia is not, as is commonly thought, a split personality disorder. No other psychological disorder is as widely misunderstood as schizophrenia. People often equates schizophrenia with “split personality” or "multiple personality", which is a truly a myth. Although the word “schizo-phrenic” literally means "split mind", the term refers to the fragmentation or splitting up of normally integrated psychological functioning. A schizophrenic patient has only one personality, but his or her mental activity is often severely disorganized.
What is schizophrenia?
Schizophrenia is a psychiatric diagnosis that describes a mental illness characterized by impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking in the context of significant social or occupational dysfunction.
Onset of symptoms typically occurs in young adulthood; diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizophrenia exists. Patients with chronic schizophrenia often do not fully recover normal functioning and may require long-term treatment, generally including medication, to control the symptoms.
Schizophrenia can be confused with other mental disorders, such as manic-depression and with physical illnesses. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them.
Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely.
What causes schizophrenia?
There is no known single cause of schizophrenia. It appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals. No specific gene has yet been found; no biochemical defect has been proven responsible; and no specific stressful event seems sufficient, by itself, to produce schizophrenia. However, it is thought that a chemical imbalance in the neurotransmitters - substances that allow communication between nerve cells - is involved in the development of schizophrenia.
What are the symptoms?
Schizophrenia can cause a huge variety of symptoms, and a sufferer may exhibit very different behavior at different times. A person with schizophrenia may feel anxious and confused. A sufferer may seem distant, detached, or preoccupied. Sometimes they may sit motionless and silent for hours. Alternatively, a schizophrenic may move about constantly, always occupied, wide awake, vigilant, and alert. Prolonged extremes of depression and elation are not uncommon. Some people with schizophrenia experience hallucinations. The most common form of hallucination is the hearing of voices. People with schizophrenia also have delusions - false or irrational beliefs. People with schizophrenia also have trouble expressing their emotions. They may appear inconsistent, manic or emotionally stunted.
Symptoms of Schizophrenia
Hallucinations
Hallucinations are disturbances of perception that are common in people suffering from schizophrenia. Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient's activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly interpreted by the individual.
Delusions
Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's usual cultural concepts. Delusions may take on different themes. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling their behavior with magnetic waves; that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others.
Disordered Thinking
Schizophrenia often affects a person's ability to "think straight." Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed "thought disorder," can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.
Emotional Expression
People with schizophrenia often show "blunted" or "flat" affect. This refers to a severe reduction in emotional expressiveness. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, avoiding contact with others; and when forced to interact, he or she may have nothing to say, reflecting "impoverished thought." Motivation can be greatly decreased, as can interest in or enjoyment of life. These problems with emotional expression and motivation, which may be extremely troubling to family members and friends, are symptoms of schizophrenia – not character flaws or personal weaknesses.
Distorted Perceptions of Reality
People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.
Normal versus Abnormal
At times, normal individuals may feel, think, or act in ways that resemble schizophrenia. Normal people may sometimes be unable to "think straight." They may become extremely anxious, for example, when speaking in front of groups and may feel confused, be unable to pull their thoughts together, and forget what they had intended to say. This is not schizophrenia. At the same time, people with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal and be perfectly responsible, even while they experience hallucinations or delusions.
Are people with schizophrenia likely to be violent?
Although news and entertainment media tend to link mental illness and criminal violence, studies show that mentally ill people are no more prone to violence than the general public. Most schizophrenic individuals are not violent; more typically, they prefer to withdraw and be left alone. Some acutely disturbed patients may become physically violent, but such outbursts have become relatively infrequent following the introduction of more effective treatments.
How is schizophrenia treated?
Antipsychotic drugs - neuroleptics - are the best treatment now available. They do not cure schizophrenia but they have greatly improved the outlook for individual patients. These medications reduce the psychotic symptoms of schizophrenia, such as hallucinations and delusions, and usually allow the patient to function more effectively and appropriately.
Treatment of Schizophrenia
Since schizophrenia may not be a single condition and its causes are not yet known, current treatment methods are based on both clinical research and experience. These approaches are chosen on the basis of their ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return.
The following treatment approaches are used with schizophrenia, usually in combination, rather than separately:
Medication Treatment
Antipsychotic Medication List
Psychosocial Treatments
Rehabilitation
Individual Psychotherapy
Cognitive Behavioral Psychotherapy
Family Education
Self Help Groups
Community and Social Support
Medication for Schizophrenia: Some of the medications available for schizophrenia in the market are Abilify, Clozaril, Geodon, Haldol, Risperdal, Seroquel and Zyprexa.
Social Support for Individuals with Schizophrenia
A patient's support system may come from several sources, including the family, a professional residential or day program provider, shelter operators, friends or roommates, professional case managers, churches and synagogues, and others. Patients with schizophrenia may need help from people in their family or community in numerous situations. Often, a person with schizophrenia will resist treatment, believing that delusions or hallucinations are real and that psychiatric help is not required. At times, family or friends may need to take an active role in having them seen and evaluated by a professional.
The issue of civil rights enters into any attempts to provide treatment. Laws protecting patients from involuntary commitment have become very strict, and families and community organizations may be frustrated in their efforts to see that a severely mentally ill individual gets needed help. These laws vary from State to State; but generally, when people are dangerous to themselves or others due to a mental disorder, the police can assist in getting them an emergency psychiatric evaluation and, if necessary, hospitalization. In some places, staff from a local community mental health center can evaluate an individual's illness at home if he or she will not voluntarily go in for treatment. In addition to involvement in seeking help, family, friends, and peer groups can provide support and encourage the person with schizophrenia to regain his or her abilities. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be helpful and perhaps more effective in the long run than criticism. This advice applies to everyone who interacts with the person.
Schizophrenia is one of the most chronic and disabling of major mental illnesses. It is a highly complex condition, and scientists are not even sure if it is one disorder, or a range of disorders, with different causes. About one percent of the population develops schizophrenia during their lives. More than two million Americans suffer from the illness in a given year. Men and women are affected equally.
Schizophrenia is not, as is commonly thought, a split personality disorder. No other psychological disorder is as widely misunderstood as schizophrenia. People often equates schizophrenia with “split personality” or "multiple personality", which is a truly a myth. Although the word “schizo-phrenic” literally means "split mind", the term refers to the fragmentation or splitting up of normally integrated psychological functioning. A schizophrenic patient has only one personality, but his or her mental activity is often severely disorganized.
What is schizophrenia?
Schizophrenia is a psychiatric diagnosis that describes a mental illness characterized by impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking in the context of significant social or occupational dysfunction.
Onset of symptoms typically occurs in young adulthood; diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizophrenia exists. Patients with chronic schizophrenia often do not fully recover normal functioning and may require long-term treatment, generally including medication, to control the symptoms.
Schizophrenia can be confused with other mental disorders, such as manic-depression and with physical illnesses. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them.
Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely.
What causes schizophrenia?
There is no known single cause of schizophrenia. It appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals. No specific gene has yet been found; no biochemical defect has been proven responsible; and no specific stressful event seems sufficient, by itself, to produce schizophrenia. However, it is thought that a chemical imbalance in the neurotransmitters - substances that allow communication between nerve cells - is involved in the development of schizophrenia.
What are the symptoms?
Schizophrenia can cause a huge variety of symptoms, and a sufferer may exhibit very different behavior at different times. A person with schizophrenia may feel anxious and confused. A sufferer may seem distant, detached, or preoccupied. Sometimes they may sit motionless and silent for hours. Alternatively, a schizophrenic may move about constantly, always occupied, wide awake, vigilant, and alert. Prolonged extremes of depression and elation are not uncommon. Some people with schizophrenia experience hallucinations. The most common form of hallucination is the hearing of voices. People with schizophrenia also have delusions - false or irrational beliefs. People with schizophrenia also have trouble expressing their emotions. They may appear inconsistent, manic or emotionally stunted.
Symptoms of Schizophrenia
Hallucinations
Hallucinations are disturbances of perception that are common in people suffering from schizophrenia. Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient's activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly interpreted by the individual.
Delusions
Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's usual cultural concepts. Delusions may take on different themes. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling their behavior with magnetic waves; that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others.
Disordered Thinking
Schizophrenia often affects a person's ability to "think straight." Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed "thought disorder," can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.
Emotional Expression
People with schizophrenia often show "blunted" or "flat" affect. This refers to a severe reduction in emotional expressiveness. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, avoiding contact with others; and when forced to interact, he or she may have nothing to say, reflecting "impoverished thought." Motivation can be greatly decreased, as can interest in or enjoyment of life. These problems with emotional expression and motivation, which may be extremely troubling to family members and friends, are symptoms of schizophrenia – not character flaws or personal weaknesses.
Distorted Perceptions of Reality
People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.
Normal versus Abnormal
At times, normal individuals may feel, think, or act in ways that resemble schizophrenia. Normal people may sometimes be unable to "think straight." They may become extremely anxious, for example, when speaking in front of groups and may feel confused, be unable to pull their thoughts together, and forget what they had intended to say. This is not schizophrenia. At the same time, people with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal and be perfectly responsible, even while they experience hallucinations or delusions.
Are people with schizophrenia likely to be violent?
Although news and entertainment media tend to link mental illness and criminal violence, studies show that mentally ill people are no more prone to violence than the general public. Most schizophrenic individuals are not violent; more typically, they prefer to withdraw and be left alone. Some acutely disturbed patients may become physically violent, but such outbursts have become relatively infrequent following the introduction of more effective treatments.
How is schizophrenia treated?
Antipsychotic drugs - neuroleptics - are the best treatment now available. They do not cure schizophrenia but they have greatly improved the outlook for individual patients. These medications reduce the psychotic symptoms of schizophrenia, such as hallucinations and delusions, and usually allow the patient to function more effectively and appropriately.
Treatment of Schizophrenia
Since schizophrenia may not be a single condition and its causes are not yet known, current treatment methods are based on both clinical research and experience. These approaches are chosen on the basis of their ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return.
The following treatment approaches are used with schizophrenia, usually in combination, rather than separately:
Medication Treatment
Antipsychotic Medication List
Psychosocial Treatments
Rehabilitation
Individual Psychotherapy
Cognitive Behavioral Psychotherapy
Family Education
Self Help Groups
Community and Social Support
Medication for Schizophrenia: Some of the medications available for schizophrenia in the market are Abilify, Clozaril, Geodon, Haldol, Risperdal, Seroquel and Zyprexa.
Social Support for Individuals with Schizophrenia
A patient's support system may come from several sources, including the family, a professional residential or day program provider, shelter operators, friends or roommates, professional case managers, churches and synagogues, and others. Patients with schizophrenia may need help from people in their family or community in numerous situations. Often, a person with schizophrenia will resist treatment, believing that delusions or hallucinations are real and that psychiatric help is not required. At times, family or friends may need to take an active role in having them seen and evaluated by a professional.
The issue of civil rights enters into any attempts to provide treatment. Laws protecting patients from involuntary commitment have become very strict, and families and community organizations may be frustrated in their efforts to see that a severely mentally ill individual gets needed help. These laws vary from State to State; but generally, when people are dangerous to themselves or others due to a mental disorder, the police can assist in getting them an emergency psychiatric evaluation and, if necessary, hospitalization. In some places, staff from a local community mental health center can evaluate an individual's illness at home if he or she will not voluntarily go in for treatment. In addition to involvement in seeking help, family, friends, and peer groups can provide support and encourage the person with schizophrenia to regain his or her abilities. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be helpful and perhaps more effective in the long run than criticism. This advice applies to everyone who interacts with the person.
Print
Email
