What is Schizophrenia? Symptoms, Causes, Treatment, and Facts
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. The person finds it difficult to tell the difference between real and imagined experiences, to think logically, to express feelings, or to behave appropriately. Schizophrenia is a mental illness that usually strikes in late adolescence or early adulthood, but can strike at any time in life.
People with schizophrenia may hear internal voices not heard by others or may see things that are not really there. These experiences can seem threatening and can make them fearful and withdrawn. They also may have trouble organizing their thoughts and expressing themselves. Their speech and behavior can be so disorganized that they may seem frightening to others.
Schizophrenia is one of the most misunderstood mental illnesses. Contrary to popular belief, it does not involve a "Jekyll-and-Hyde" type of split personality. Instead, it means that all the attributes that go into the makeup of the human personality - logical thinking, feelings and expression, perception, and relating to others - become separated from one another.
Schizophrenia affects about one percent of the world's population and is found all over the world, in all ethnic and social groups.
People with schizophrenia often have difficulty functioning in society, at work, and in school. The illness can be taxing on both the individuals who are affected and on their families.
But the symptoms of schizophrenia vary widely from one person to another. In some people, the dissociated feelings caused by the illness are a constant part of life. In others, the symptoms will come and go.
People with schizophrenia do not always act abnormally. They may appear perfectly responsible and in control, even when experiencing hallucinations or delusions.
General signs are delusional thoughts, bizarre thoughts and beliefs, hallucinations, hearing voices, paranoia, depression , delusions of the grandeur.
The main symptoms of schizophrenia include:
- Thought disorder: Thoughts and speech can be very jumbled, jumping from one topic to another without any obvious link. It can be very difficult to talk with a person who has schizophrenia.
- Delusions: These are false beliefs of being persecuted, or of guilt, or of being very powerful. Some people may think they are being controlled by others, or that they have special powers. Some feel so afraid of others that they withdraw or hide to keep themselves feeling safe.
- Hallucinations: This most commonly involves hearing voices which the person thinks are criticizing them or telling them what to do. Some people have hallucinations affecting what they see or feel or smell. To the person having the hallucination, these seem real.
- Bizarre behavior: This can be expressed in many different ways. In short, the individual behaves in ways that seem inappropriate or strange to other people.
- Disorganized speech: The individual speaks in ways that are hard to understand. For instance, sentences might not make sense, or topic of conversation changes with little or no connection between sentences. Sometimes speech is completely incomprehensible.
- "Negative symptoms": This includes lack of motivation or interest, diminished cognitive functioning, and decreased emotional expression. Individuals may lose interest in attending to their own personal hygiene, have little interest in interacting with others, and rarely seem to feel or express strong emotions.
Other symptoms of schizophrenia include:
- Loss of drive: The person doesn't feel able to do the normal tasks of living, including washing, cooking, or changing clothes. This is because of the illness, not because the person is lazy.
- Changes in the way they show emotions: They may not show happiness or sadness when it seems those feelings fit a situation.
- Social withdrawal: This may be due to fear that someone will harm them, or fear that they will not be able to interact well with others because they have lost social skills.
- Lack of insight: Because delusions and hallucinations seem so real, people with schizophrenia can be unaware that they are ill. This, plus the side effects of medication may mean they refuse to take medication.
- Thinking difficulties: Their concentration, memory, ability to plan and organize may be affected, making it harder to work things out, communicate and complete tasks.
In addition to these above symptoms, people with schizophrenia suffer a decline in their level of functioning; for instance, they may not be able to work at a job that requires the same level of skill or concentration as the job they held before they became ill required, or they may lose all ability to withstand the pressures of the working world. They may show a decline in their ability to attend to household chores or all the demands of raising their children, and/or they may not be able to have a full social life anymore.
Sometimes schizophrenia is a chronic condition, and the individual afflicted is constantly experiencing hallucinations or other symptoms of the disorder. Other people have periods of time when they are relatively symptom-free but have periods of more acute psychosis. Every individual is different, and every person with schizophrenia experiences the disease in a different way.
Genes and environment: Scientists have long known that schizophrenia runs in families. The illness occurs in 1 percent of the general population, but it occurs in 10 percent of people who have a first-degree relative with the disorder, such as a parent, brother, or sister. People who have second-degree relatives (aunts, uncles, grandparents, or cousins) with the disease also develop schizophrenia more often than the general population. The risk is highest for an identical twin of a person with schizophrenia. He or she has a 40 to 65 percent chance of developing the disorder.
Different brain chemistry and structure. Scientists think that an imbalance in the complex, interrelated chemical reactions of the brain involving the neurotransmitters dopamine and glutamate, and possibly others, plays a role in schizophrenia. Neurotransmitters are substances that allow brain cells to communicate with each other. Scientists are learning more about brain chemistry and its link to schizophrenia.
Schizophrenia cannot be cured, but the symptoms can be reduced significantly with treatment. Treatment with medication will usually reduce the psychotic symptoms. Just as different people with schizophrenia can experience different symptoms, the effective treatment for each person is different. Each individual's treatment program can include one or more of the following:
- Medication: Finding the right medication can be difficult, and a trial-and-error process may have to occur. It is important to be open with the psychiatrist, reporting what symptoms and side-effects are occurring, so the doctor can help to find the best medication to meet individual needs of each patient. It is also important to learn the contraindications of certain medications, such as the effects of alcohol or sunlight on the effectiveness of the medication.
- Education: The person with schizophrenia and his or her family members can benefit from learning all they can about the disorder, including how to diminish stress and conflict, which can sometimes help spark a relapse. It is also important to learn what resources are available in the community for treating mental illnesses.
- Individual, group, and family therapy: This can help with problems that arise day to day, as well as setting realistic goals and defining strategies for reaching those goals.
- Hospitalization: This is required during some acute phases of the illness or sometimes in order to make changes in medication in a well-controlled, monitored environment.
- Support groups: These can be very important for those with schizophrenia and for their family members and friends. See below for a list of support groups.
- Residential, day-treatment, and vocational programs: These programs can help the person with schizophrenia reach his or her highest potential and greatest level of independence. Staff in these programs become well-acquainted with their clients and can help find living arrangements, work, and recreational activities that are well-suited to each client's needs.
Not all people diagnosed with schizophrenia have hallucinations and hear voices. Many people with schizophrenia have jobs and family's, but they still require medication.
Facts About Schizophrenia
- Schizophrenia affects an estimated one percent of the world's population.
- Symptoms usually appear between the ages of 15 and 35.
- Schizophrenia affects males and females equally, although symptoms often appear earlier in males.
- In the U.S., about 2.5 million people have this illness.
- About 80 percent of people with schizophrenia can live either full, productive lives or relatively independent lives with treatment.
- The other 20 percent of sufferers will require long-term, structured care.
- People with schizophrenia have a higher rate of suicide than the general population. Approximately 10 percent of people with schizophrenia (especially younger adult males) commit suicide.
- Schizophrenia accounts for about 40 percent of all long-term hospitalization.
- Schizophrenia can run in families. The risk for inheriting schizophrenia is 10 percent in those who have an immediate family member with the illness, and 40 percent if the illness affect both parents or an identical twin.
- Heredity does not explain all cases, however. About 60 percent of people with schizophrenia have no close relatives with the illness.
- Early treatment of schizophrenia and newer treatment options may control the illness in up to 85 percent of individuals.
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