Lesson 4: Psychosis
6 - Schizophrenia
Schizophrenia involves a serious brain malfunction that greatly disturbs feelings, perceptions, and rational thoughts. It is the most common of the major mental illnesses. It carries a strong social stigma. Schizophrenia occurs in 1% of the general population, but children with one schizophrenic parent have ten times more of a chance of developing the mental condition. Approximately one-third will have only one episode during a lifetime (acute schizophrenia), about one-third will have recurring episodes but will be relatively normal in between, and one-third will have symptoms for a lifetime (chronic schizophrenia). Often schizophrenic symptoms appear in young men and women between 15 and 30 years of age. When something happens to “normal” people, they respond with appropriate emotions.
When a person develops schizophrenia, a certain behaviour does not result in the appropriate emotional response. Anhedonia, or the inability to experience pleasure, is also common with this condition.
True schizophrenia is a condition that evolves gradually over an extended period of time. Distorted thought and behaviour patterns become entrenched, making a return to good mental health very difficult. The first stage of schizophrenia or period of breakdown is very disturbing to the individual. Confusion, anxiety, and panic are the individual’s reactions to the strange things that seem to happen at the onset of schizophrenia. In the second stage, the schizophrenic has grown accustomed to the symptoms. By the third stage, the condition has worsened to the “burned out” phase. Sometimes the individual becomes apathetic and responds to life’s situations in very basic, simple terms.
Causes
Schizophrenia is not caused by childhood experiences or by poor parenting. Most researchers believe that both a biological predisposition and environmental factors interact to determine who becomes schizophrenic. Some scientists believe that a chemical imbalance in the body may be a factor in some cases of schizophrenia. The control centre of the brain, which acts like a switchboard for incoming data, malfunctions.Â
Heredity may be responsible in that the person inherits a predisposition to schizophrenia. Schizophrenia may develop when stress from environmental situations combines with the heredity component. Stress can trigger or worsen the symptoms when the illness is already present.
Symptoms
Personality changes are a major factor in recognizing schizophrenia. A loss of feeling or emotions is accompanied by a lack of interest and motivation. Changes occur in thought patterns as the person drifts away from reality. Thinking may be coloured by delusions and false beliefs. Schrizophrenics often believe their thoughts are being controlled by someone or even broadcast to others through a TV set, for example. People with schizophrenia often “hear voices in their heads”. Sometimes the voices are threatening. Sensations are distorted. Sometimes they feel nothing—not even real pain. They mistrust most people including those with whom they have close ties, and they lack feelings of empathy toward others.
Identifying early warning signs can ensure family and friends get early treatment for the individual. Social withdrawal is a key symptom. Other symptoms include
• deterioration of personal hygiene
• excessive fatigue or the inability to sleep
• flat emotions or inability to express emotions appropriate for the situation
• flat, emotionless gaze (described as reptilelike)
• unexpected hostility
• unusual sensitivity to stimuli (noise and light)
• sensitivity to being touched by others
• “racing” thoughts
• bizarre behaviour and irrational statements
Schizophrenia has many different categories each with its own symptoms. With paranoid schizophrenia, delusions are prominent. Hebephrenic schizophrenia is characterized by intellectual disorganization, silliness, and absurd ideas.
Treatments
Because schizophrenic behaviour is unpredictable, the individual is often required to be hospitalized for treatment. Such precautions ensure protection for both the individual and for those around them. Patients who have improved sufficiently after treatment are able to return to the community, but they may still show some signs of disturbance. Assistance from family and friends is important for schizophrenics. When this is lacking, often they fail to take medication, fail to find steady employment, and become one of the many homeless “street-people” in our society. Schizophrenia is the second highest type of mental illness for suicide risks. There is no cure. Schizophrenia has been treated primarily with antipsychotic medications that sufferers must take for the rest of their lives.
A crisis is the time when the person experiences a severe break with reality. If you are with a schizophrenic person during a crisis episode, follow these hints to calm the person and allow him/her to focus on you and be cooperative. Decrease all distractions such as a TV set being on. Speak slowly and clearly. Repeat the message until the person understands. Get the person to a hospital as quickly as possible so medical treatment can be administered.