Schizophrenia is a mental disorder that usually appears in late adolescence or at the beginning of adulthood and is characterized by delusions, hallucinations, and other cognitive difficulties; schizophrenia can often be a lifelong struggle.
While there is no cure for schizophrenia, research leads to new and safer treatments. Experts are also unraveling the causes of the disease by studying genetics, conducting behavioral analysis, and using advanced imaging to look at brain structure and function. These approaches hold the promise of new, more effective therapies.
What is schizophrenia?
Schizophrenia is a chronic brain disorder that affects approximately one percent of the population; when schizophrenia is active, symptoms can include delusions, hallucinations, trouble thinking and concentrating, and lack of motivation; however, when treated with these symptoms, most people will improve significantly over time.
It commonly strikes between the ages of 16 and 30. Men tend to show symptoms at a slightly younger generation than women; in many cases, the disorder develops so slowly that the individual does not know they have had it for many years. However, in other cases, it can strike suddenly and proliferate. Experts say, in terms of their studies, that schizophrenia is perhaps many diseases that pretend to be only one.
Some research suggests that schizophrenia may result from faulty neural development in the fetal brain, which later in life emerges as a full-blown illness.
People with this disorder may hear voices that do not exist, and they may even be convinced that others are reading their minds, controlling how they think, or plotting against them. This can severely and persistently distress patients, making them withdrawn and sometimes frantic.
Types of schizophrenia
It is the most common subtype of schizophrenia, mainly defined by the presence of auditory hallucinations or delusional thoughts “about the persecution or the conspiracy.”
In other words, you may think that you are being pursued a crime that you believe you committed, but those thoughts are not honest.
Paranoid schizophrenics are often diagnosed late in their illness because they often look normal to other people; only when you experience a major stressful event in your life that exposes your paranoid thoughts to your family will they get the attention of healthcare professionals. Mental. Read the full article here: Paranoid Schizophrenia.
The leading indicator of this type is a confused thought process; your ability to maintain logical thinking is significantly affected, such as jumping from one topic to another during a conversation, for example.
Another indicator is disorganized behavior, in which you may exhibit actions that are very out of place depending on the situation, such as wearing multiple layers of clothing on a hot day. Read more about Disorganized schizophrenia.
There are two types of catatonic behavior that define:
• Catatonic stupor: A dramatic reduction of inactivity to the point where all types of movement can stop; waxy flexibility can also develop. Someone places you in a particular position and is immobilized for a long time.
• Catatonic arousal: Characterized by hyperactivity and the presence of stereotypical behavior, a condition that creates repetitive but purposeless actions, it can also imitate what another person says (echolalia) or do (echopraxia). Full article: Catatonic schizophrenia.
It only refers to those who have had a history of schizophrenia before, and the severity of negative symptoms has been drastically reduced. You may still have positive signs, such as hallucinations or paranoia, but they appear less frequently; for being under this subtype, at least one negative symptom is still apparent. Your last attack of schizophrenia occurred at least a year ago.
Schizoaffective disorder is a mixture of schizophrenia and depression or bipolar disorder; schizophrenia is often challenging to diagnose because of the many symptoms that depression or bipolar disorder can cause.
Depression is marked by prolonged feelings of sadness and worthlessness and cognitive problems such as trouble concentrating and remembering details. On the other hand, bipolar disorder causes mood swings at one point – you can feel euphoric and suddenly feel low self-esteem, often to the point of sadness.
The cycle between high and low emotions can become so intense and frequent that they interfere with your daily life and affect your relationships and work or academic performance.
Symptoms of schizophrenia
Many people with schizophrenia have to depend on other people because they cannot keep a job or take care of themselves; many can also resist treatment, arguing that nothing is wrong with them.
Some patients may have apparent symptoms, but at other times, they may seem correct until they begin to explain what they are thinking. The effects of schizophrenia go far beyond the patient since families, friends, and society are also affected.
The symptoms and signs of schizophrenia will vary, depending on the individual.
They are classified into four categories:
- Positive symptoms: Also known as psychotic symptoms. For example, delusions and hallucinations.
- Negative symptoms refer to elements that are removed from the individual—for example, lack of facial expressions or lack of motivation.
- Cognitive symptoms: They affect the person’s thinking processes; they can be positive or negative symptoms; for example, poor concentration is a negative symptom.
- Emotional symptoms: These are generally negative symptoms, such as blunted emotions.
Below is a list of the main symptoms:
The patient displays false beliefs, which can take many forms, such as delusions of persecution or grandeur; they may feel that others are trying to control them remotely. Or, they may think that they have extraordinary powers and abilities.
Hearing voices is much more common than seeing, feeling, tasting, or smelling things that are not there, yet people with schizophrenia can experience a wide range of hallucinations.
The person may jump from one subject to another for no logical reason. The speaker may be challenging to follow or erratic.
Other symptoms can include:
Lack of motivation (abulia)
The patient loses his drive, and everyday actions are neglected, such as washing and cooking.
Poor expression of emotions
Responses to happy or sad occasions may be insufficient or inappropriate.
When a patient with schizophrenia withdraws socially, it is often because they believe that someone will harm them.
Ignorance of the disease
Because hallucinations and delusions seem so natural to patients, many of them may not believe that they are sick; they may refuse to take medication for fear of side effects or for fear that the drug is poison.
The patient’s ability to concentrate, remember things, plan and organize his life is affected, and communication becomes more difficult.
Causes of schizophrenia
Experts believe that several factors generally play a role in contributing to the onset of schizophrenia. Evidence suggests that genetic and environmental factors work together to cause schizophrenia, the condition has an inherited element, but ecological triggers also significantly influence it.
Below is a list of the factors believed to contribute to the onset of schizophrenia:
If there is no history of schizophrenia in a family, the chances of developing it are less than 1 percent; however, that risk increases to 10 percent if a parent is diagnosed.
Chemical imbalance in the brain
Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia, other neurotransmitters, such as serotonin, may also be affected.
There is no evidence to show or indicate that family relationships can cause schizophrenia; however, some patients with the disease believe that family stress triggers relapses.
Although there is no definitive proof, many suspected pre-birth trauma and viral infections can contribute to the development of the disease. Stressful experiences often precede the onset of schizophrenia. Before acute symptoms appear, people with schizophrenia routinely become moody, anxious, and unfocused. This can trigger relationship problems, divorce, and unemployment.
These factors are often blamed for the onset of the illness when it was the other way around: the disease caused the crisis. Therefore it is tough to know whether schizophrenia caused specific stresses or occurred due to them.
Marijuana and LSD are known to cause relapses in schizophrenia, and for people with a predisposition to a psychotic illness such as schizophrenia, cannabis use can trigger the first episode.
Some researchers believe that certain prescription medications, such as steroids and stimulants, can cause psychosis.
Risk factors for schizophrenia
Several factors contribute to and increase the risk of developing schizophrenia.
Genes and the environment
Scientists have long known that schizophrenia sometimes runs in families. However, many people suffer from this disorder and do not have a family member who has this problem. Conversely, many people with one or more family members with the disease do not develop it on their own.
Scientists believe and think that many different genes can increase the risk of schizophrenia and do it much faster, but that no single gene causes it by itself; it is not yet possible that genetic information is used to predict who will develop schizophrenia; they also think that interactions between genes and aspects of the environment of the individual are necessary for it to expand, environmental factors may involve:
- Exposure to viruses.
- Malnutrition before birth.
- Problems during birth.
- Psychosocial factors.
Chemistry and different brain structures
Scientists think from studies already done that an imbalance in complex, interrelated chemical reactions in the brain involving neurotransmitters like dopamine and glutamate and possibly others plays a role in schizophrenia.
Some experts also think that problems that occur in brain development before birth can lead to faulty connections since the brain also undergoes significant changes during puberty. These changes could trigger psychotic symptoms in vulnerable people due to genetic or brain differences.
Schizophrenia Diagnosis and Testing
Before diagnosing schizophrenia, other conditions must first be ruled out; the diagnosis is reached by observing the patient’s actions; if the doctor suspects possible schizophrenia, they will need to know the medical and psychiatric history of the patient.
Specific tests will be ordered to rule out other diseases and conditions that can trigger schizophrenia-like symptoms, such as:
- Blood tests: A blood test may be ordered in cases where drug use may be a factor. Blood tests are also done to exclude the physical causes of the disease.
- Imaging studies: To rule out tumors and problems in the brain’s structure.
- Psychological evaluation: A specialist will evaluate the mental state of the patient by asking about thoughts, moods, hallucinations, suicidal features, violent tendencies, or potential for violence, as well as observing their behavior and appearance.
Diagnostic criteria for schizophrenia
Patients must meet the criteria described in the Diagnostic and Statistical Manual of Mental Disorders; health professionals use this manual of the American Psychiatric Association to diagnose mental illnesses and conditions.
The doctor must exclude other possible mental health disorders, such as bipolar disorder or schizoaffective disorder.
It is also essential to establish that the signs and symptoms have not been caused, for example, by prescription medication or substance abuse.
The patient must:
- Have at least two of the following typical symptoms:
- Disorganized or catatonic behavior
- disorganized speech
- Negative symptoms that are present for much of the time during the last four weeks
- Experience a significant impairment in the ability to attend school, carry out work tasks, or carry out daily tasks.
- Have symptoms that persist for six months or more.
Treatments for schizophrenia
Ensuring that the patient continues on medication is the key to successful treatment; patients can lead productive lives with proper treatment. Therapy can help alleviate many of the symptoms of schizophrenia. However, most patients with the disorder have to deal with the symptoms for life.
Psychiatrists say that the most effective treatment for people with schizophrenia is usually a combination of:
- psychological counseling
- Self-help resources
- Anti-psychosis drugs have transformed the treatment of schizophrenia; thanks to them, most patients can live in the community rather than stay in a hospital.
The most common schizophrenia medications are:
- Risperidone (Risperdal): Less sedating than other atypical antipsychotics, weight gain, and diabetes are possible side effects but less likely to occur than Clozapine or Olanzapine.
- Olanzapine (Zyprexa): It can also improve negative symptoms. However, the risks of severe weight gain and the development of diabetes are significant.
- Quetiapine (Seroquel): Risk of weight gain and diabetes; however, the risk is lower than Clozapine or Olanzapine.
- Ziprasidone (Geodon): The risk of weight gain and diabetes is lower than other atypical antipsychotics. However, it could contribute to cardiac arrhythmia.
- Clozapine (Clozaril): Effective for patients who have been resistant to treatment and known to reduce suicidal behaviors in patients with schizophrenia, the risk of weight gain and diabetes is significant.
- Haloperidol: An antipsychotic used to treat schizophrenia, it has a long-lasting effect (weeks).
The primary treatment for schizophrenia is medication; sadly, compliance (following the medication regimen) is a significant problem. People with schizophrenia often take medication off for long periods throughout their lives, at enormous personal costs and often to those around them.
The patient must continue to take medication even when the symptoms disappear. Otherwise, they will return. The first time a person experiences schizophrenia symptoms, it can be very unpleasant, it can take a long time to recover, and that recovery can be a lonely experience; a person living with schizophrenia must receive the full support of their family, friends, and community services when it first appears.
Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.