Schizophrenia1 is a serious mental disorder that needs proper care and treatment. Unfortunately, in our society, such diseases are not taken seriously and people usually keep away from these patients.
This leads to the deterioration in the health of the patients. The stigma associated with mental illnesses2 like anxiety3, depression, schizophrenia, and others needs to be broken.
Get to know all about schizophrenia in this article in just 10 minutes.
1. Definition
More than a century ago schizophrenia was first identified. It is still now one of the most misunderstood and stigmatized illnesses.
This mental illness is considered a syndrome which means it may include several other related disorders that have similar symptoms but varying causes.
It affects the brain and leads to difficulty with thoughts, feelings, and behavior.
2. Schizophrenia Symptoms
Symptoms of schizophrenia vary from person to person. Schizophrenia affects different people in different ways.
Not every schizophrenic patient will have the exact same symptoms. Neither will they face psychotic symptoms at the same degree of intensity.
Symptoms of schizophrenia arenโt always visible and also they do not occur at a particular time or interval. The time these symptoms occur is known as โEpisodesโ.
2.1. There Are Three Types of Symptoms of Schizophrenia-
- Positive symptoms
- Negative symptoms
- Cognitive symptoms
2.2. The Initial Signs Can Be Easily Missed-
- Subtle personality change
- Irritability
- Unusual thoughts
During these symptoms people start experiencing hallucinations or delusional and confusing thoughts. These fall under the positive symptoms.
2.3. Other Symptoms of Schizophrenia Include-
- Reduced motivation
- The difference in the expression of emotion
- Difficulty in concentrating
- Remembering information
- Making decisions
All these are negative symptoms.
Then comes the cognitive symptoms which are in a way similar to that of Negative symptoms but not entirely.
It is very difficult for the patient as well the people around him/her when these โepisodesโ take place, but we need to keep in mind that they need our help more than we know.
2.4. Positive Symptoms
2.4.1. Jumbled Thought Process
This is almost like an internal battle. You feel at war with yourself. It almost feels like a gap in your thoughts.
2.4.2. Delusional Behavior
You always keep thinking that other people want to hurt you and that everyone wants to hurt you and that everyone hates you.
This also leads to oneโs thinking that they are someone very important. Patients also feel that others are controlling them.
2.4.3. Hallucinations
You start imagining the wildest things that probably wonโt make a lot of sense to other people.
2.5. Negative symptoms
- Lacking Motivation: Interest loss. This is also called Avolition.
- People lose interest in the things they used to love the most
- Loss of emotions like joy, sorrow etc.
- Feeling down and hopeless โ These are some symptoms that are often mistaken as depression or anxiety, but in reality, they are associated with schizophrenia.
- Alogia โ Losing control over speech. The train of thoughts in a personโs mind gets interrupted before he speaks it out thus resulting in the poverty of speech4. Generally, this is rather known as โbeing all over the placeโ. E.g.: โHow are you?โ Ans: Yes.
3. Phases of Schizophrenia
People with schizophrenia go through three major phases.
- Prodromal Phase: During this phase the patient starts cutting ties with everyone and everything they once held dear in their lives. They withdraw themselves from their daily activities. All these are often mistaken for other mental disorders like anxiety and depression.
- Active phase: During this phase the patient starts showing positive symptoms.
- Residual phase: After the active phase comes the residual phase where the patient exhibits the negative symptoms like losing interest, getting demotivated or going along with the symptoms of the prodromal phase all over again.
4. Causes
Although we still donโt know the exact cause of this mental disorder.
But there is a clue that the majority of the anti-psychotic drugs used in case of schizophrenia, block the dopamine receptor D25, which reduces dopamine levels in neurons. But again this is not a proven fact but only a hypothesis so thereโs nothing we can comment on it yet.
Other than this there are some other factors that might be held accountable for its triggers.
- Genes: Although there is no scientific proof or establishment of any theory yet but it is noticed that schizophrenia runs in the genes. A kid having schizophrenia in his/her background is more likely to develop it rather than a kid without a history of schizophrenia in his/her genes. This factor is supported by several studies. Although there is no proof of it yet, mental health professionals believe in this factor more.
- Disruption or Chemical Imbalance: Often some chemical imbalance in the brain can be the cause behind this. A link has been found between Serotonin and Dopamine to schizophrenia. Certain medications can help cure it if predicted in the early stages. All these are found to be triggering but they donโt have any established truth yet.
- Environmental Factors: Also, environmental factors, like early or prenatal exposure to infection. Also, a stressful environment is a trigger.
- ย Schizophrenia is often linked with autoimmune diseases.
- ย Finally, another important set of clues is that it is noticed that the occurrence of schizophrenia in men is slightly more than in women.
5. Cure and Diagnosis
People with schizophrenia, unlike people with other mental illnesses, frequently have their basic human rights violated by mental health issues. There is a need for expanded and faster community-based mental health treatment initiatives.
These initiatives begin with the creation of various high-quality community-based mental health services. Community mental health centers, day centers, assisted housing, outreach services for in-home support, and integration with primary healthcare and general hospital treatment are a few options for community-based mental health care.
Treatment is based on a schizophrenia diagnosis. Depending on the unique case, a combination of antipsychotic medications and other means of therapy might be used in conjunction for treating such mental health conditions
Also, it can be helped by setting clear goals, talking with others, knowing what is the right thing for you.
Also not taking medication and leaving therapy just because you think it is not important enough can cause hindrance to recovery.
6. A Case Study
Two of my very close friends happen to be schizophrenic and I got to know about their details.
One described it like โI have psychotic episodes a lot. I tend to believe that demons are out there and one day they will hunt me down and kill me. Right now I can rationally say that it was a part of an episode. But that thing โฆ When it happens it feels all so terrifying and real.โ
The other one went into a more detailed description of his schizophrenia. He described what he went through right from his childhood till now.
He had a history of:
(From when he was a child and some symptoms still present in adulthood)
- speech delay
- incredibly delusional personality and sensory perspective of himself and troubling changes in bizarre behaviors
- developmentally delayed chronological age
- developmentally delayed IQ
- late toilet training and problems with tying his shoes
- some symptoms related to dyslexia (he had trouble reading, but it slowly improved)
- some coordination problems (He doesnโt have coordination problems anymore)
- developmentally delayed social skills (used to have trouble understanding verbal and non-verbal social cues and had abnormal eye contact when he was a child and a young teenager and used to have blank facial expressions)
- used to not cry (when he needed something when he was a toddler)
- disorganized speech
- strange facial expressions
- self-abusive behaviors in frustration (such as head banging and hitting himself in the head for sensory needs or when routine changed and when he could not communicate correctly at that time) (From childhood to adulthood)
- had troubles when there was a change of environment
6.1. From Childhood to Adulthood
(ADHD was discovered when he was a young teenager and he is still taking medication for it. )
- unusually hyperactive
- trouble with focus
- spacing out
- drifting out
Descriptions of mental health problems that he suffers from time to time
- ย He sometimes exhibits milder forms of Schizotypal Personality Disorder symptoms from then and now, ever since I suffered from a mental health crisis in 2016.
- ย He developed Anxiety, Bipolar Disorder, and some form of Delusional Disorder (even though he only has a diagnosis of bipolar disorder and Catatonia) because he believed that the military was after him, that the aliens existed, etc. and some antisocial symptoms similar to antisocial personality disorderย is also recorded in his medical history.
- He lied, deceived others, was aggressive, had delusional racial thoughts about others (people of black color), and also had grandiose delusions as he also believed that he was a robot as well.
He has a history of:
- Mood swings
- Lying
- Deceiving
- History of stealing (was never in trouble with the police, his special needs teachers handled his misbehavior)
- Abnormal sense of empathy and remorse (used to have that problem but then he started to have empathy and remorse)
- Grandiose and paranoid delusions
- Running away
- Violent actions
But in spite of all these difficulties, both of them are undergoing therapy and taking psychotic drugs in the hope of living an independent life once again.
7. Words of Advice
7.1. For People with Schizophrenia
- Things are going to be hard. But eventually one day they will be okay. Forgive yourself.
- Donโt be ashamed of yourself. This is a serious mental illness and none of this is your fault.
- Even on those rainy days when the world seems to be covered in grey, do not lose hope; because there never has been a storm thatโs lasted forever. The sun is always present and it too will find its way back through the clouds. Do not give up. I promise there is a light at the end of this tunnel.
- The future is full of possibilities, your past does not define you. Donโt be hard on yourself thinking about the things that you have done due to this illness.
- Sometimes emotions arise without reasons or justification, there is no answer to why the pain is there. And that is okay. You are a human too.
7.2. For People Around the Patients
- Pay attention to these people. They are your friends and family and they need you more.
- Trauma responses can be hard to notice but you need to look for the red flags and take action accordingly.
- Donโt demonize and support them.
- Be understanding.
- Reach out to these people. Again, schizophrenia is not a shameful thing.
- Schizophrenia doesnโt make a person less worthy of love.
Take care of yourself and your near and dear ones!
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- Insel, Thomas R. โRethinking schizophrenia.โย Natureย 468.7321 (2010): 187-193. โฉ๏ธ
- Crisp, Arthur H., et al. โStigmatisation of people with mental illnesses.โย The British journal of psychiatryย 177.1 (2000): 4-7. โฉ๏ธ
- Klein, Donald F. โAnxiety reconceptualized.โย Anxiety: New research and changing conceptsย (1981): 235-263. โฉ๏ธ
- Ragin, Ann Barnett, Michael Pogue-Geile, and Thomas F. Oltmanns. โPoverty of speech in schizophrenia and depression during in-patient and post-hospital periods.โย The British Journal of Psychiatryย 154.1 (1989): 52-57. โฉ๏ธ
- Andersen, Peter H., et al. โDopamine receptor subtypes: beyond the D1/D2 classification.โย Trends in pharmacological sciencesย 11.6 (1990): 231-236. โฉ๏ธ
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