Schizophrenia is a severe mental illness that leads people to interpret reality in an abnormal way. People with Schizophrenia experience hallucinations, get false illusions, and display an unusually disordered behaviour, which negatively impacts their daily life .
Schizophrenia is a serious condition that requires treatment for a lifetime. Early diagnosis and treatment can keep symptoms under control and prevent any serious complications from building up.
Schizophrenia is mainly associated with cognitive problems that is exhibited in a person's daily behavior or state of emotions. Though there may be difference in signs and symptoms across patients, but it majorly involves hallucinations, delusions, disordered speech, and impaired body functionalities. Common symptoms are:
- Delusions: These are false conceptions and interpretations of reality. For instance, a person with schizophrenia can have various delusions. He might think that he is targeted or harassed; he has supernatural abilities or power; he remembers his past life; or a huge tragedy is going to happen.
- Hallucinations: People with schizophrenia may see or hear things that do not exist. Such hallucinations have a powerful force and feel like a normal experience. Hallucinations can impact all the senses, but most commonly it is associated with hearing strange voices.
- Disordered thought (speech): Schizophrenia affects the cognitive abilities of a person. Often, it results in impaired speech ability and meaningless communication. People experiencing this ask questions that are partially or totally unrelated. Their speech is broken and without any clear sense or meaning.
- Highly disoriented motor behavior: Schizophrenia might lead people to behave weirdly. Sometimes, they may show childlike absurdity to episodic aggressiveness. The behavior is erratic and without any intention. You may notice people suffering with schizophrenia showing resistance to instructions, improper or eccentric posture, irresponsible reactions , or silly and unnecessary movement.
- Negative/withdrawal symptoms: This happens when there a person shows lessened or resistance to function normally. For instance, the person may disregard personal hygiene or be immune to any kind of emotion; does not respond to eye contact, shows no facial expressions or talks in a monotone). The person may withdraw himself from the society and refuse to part take in daily activities. Such persons are incapable of finding happiness in any thing and remain negative towards life.
Symptoms differ in form and severity and may change over time, sometimes with worsening show of symptoms and sometimes showing reduced impact. However, they do not go completely.
Men with schizophrenia may show signs of the disorder in the early to mid-20s. Women start displaying the impact of the mental condition during their late 20s. The mental illness is rare in children and those who are aged 45 and above.
Teenagers with Schizophrenia may have symptoms same as that of adults, though it might be difficult to identify the condition in teenagers as in adults . This is because a few of the early signs of schizophrenia in teenagers are usually the same as seen during the typical growth in teen years and noticeable change in behavior, like:
- Withdrawal or secrecy from friends and family
- A low performance in studies
- Difficulty in sleeping
- Irritability or erratic mood
- loss of motivation
In comparison to adults with schizophrenia, teens may not have symptoms like delusions. But teens might have visual hallucinations.
The real or exact cause of schizophrenia is not known. However, according to various researches and studies, a variety of factors like genetics, brain chemicals and external surroundings may lead to the development of the mental disorder.
It is believed that difficulties associated with some naturally occurring brain chemicals, like neurotransmitters called dopamine and glutamate, may develop into schizophrenia. According to neuroimaging studies, there are visible differences in the chemical component and structure of brain and certain imbalances in the central nervous system of people diagnosed with schizophrenia. Though researchers are not sure whether these changes or differences are of any significance, yet they stress that schizophrenia is a brain disorder.
The exact cause of schizophrenia is unknown, but there are some factors that may increase the risk of developing or inhibiting this mental disorder called schizophrenia. They are as follows:
- A known family history of schizophrenia
- Heightened immune system activation, emanating from inflammation or autoimmune diseases
- very old age of the father
- Few pregnancy and birth related complications, like malnutrition or vulnerability to toxins or certain viruses that negatively affect brain development
- Certain cognitive (psychoactive or psychotropic) drugs taken during teenage and adolescence period
If not treated, schizophrenia can lead to serious problems that hamper the day to day life. Complications associated with schizophrenia may be as follows:
- Suicidal thoughts and attempts of suicide
- harming and injuring self
- Anxiety disorders
- Depressive nature
- Alcohol or harmful drug intake, excessive tobacco use
- obsessive-compulsive disorder (OCD)
- low attention span at school and in studies
- problems understanding legal and financial issues
- Social withdrawal
- Health and medical issues
- Feeling victimized
- Sporadic bursts of aggressive or bizarre behavior
A proper diagnosis of schizophrenia will involve looking out for and ruling out any other mental state illness and determining whether symptoms are due to drug abuse, excessive alcohol intake, substance abuse or any other health condition. Determining a diagnosis of schizophrenia may include:
- Physical diagnosis: This is necessary to find and rule out any other issues behind the occurrence of the said symptoms and to determine any near complications.
- Clinical Tests and exams: All such tests and screenings may be done to aid ruling out similar symptoms for other medical conditions and checking for alcohol and drug abuse. The physician may call out for an MRI or a CT scan.
- Psychiatric evaluation: A person with symptoms of schizophrenia may be checked upon by a psychiatric or mental health professional for determining the mental order of the patient. The doctor will check the physical behavior and emotional conduct and discuss the patient's thoughts, mental state, experiences of delusions, hallucinations, drug abuse, and chances of for aggressive moments or suicidal attempts. This even involves finding out family and personal history of similar conditions .
Schizophrenia is a severe mental condition that necessities lifelong treatment, even though symptoms may subside. Medical attention and treatment coupled with psycho-social therapy can help keep the condition under control. In few cases, hospitalization might be necessary.
Treatment involves regular consultation with a psychiatrist having experience in dealing with patients of schizophrenia . Apart from that, the patient will require a social worker, a psychiatric nurse and often a case manager to manage the overall treatment and care. Treatment of schizophrenia involves a full-fledged team approach with expert clinical experience.
No patient diagnosed with schizophrenia can be treated without medications. Most commonly, antipsychotic medications are prescribed. They are meant to control common symptoms by impacting the brain neurotransmitter dopamine. Medications for schizophrenia are known to have various side effects, so patients of schizophrenia often refuse to take them. Often, there is reluctance to such medications and long-term treatment.
First-generation antipsychotics: Such antipsychotics are known to have frequent and highly significant neurological side effects that sometimes may lead to a motor disorder (tardive dyskinesia). This condition is non-reversible and dangerous. The most commonly prescribed first-generation antipsychotics include:
Second-generation antipsychotics: These are comparitively newer and safer medications that are usually preferred by many doctors. They have lower risks and possibilities of side effects as compared to first-generation antipsychotics. The common second-generation antipsychotics are:
- Asenapine (Saphris)
- Cariprazine (Vraylar)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Brexpiprazole (Rexulti)
- Quetiapine (Seroquel)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Paliperidone (Invega)
- Risperidone (Risperdal)
There is no sure formula to prevent schizophrenia, but continuing with the treatment can help manage and control the disease from worsening or aggravating. Apart from this, one can try and know the risk factors for schizophrenia to call for early diagnosis and treatment.
Myth #1: People with schizophrenia are harmful and dangerous to be around.
Fact: There may be times when people with schizophrenia act erratically or behave weird, but generally very few are violent. Moreover, people undergoing treatment are less likely to be violent. If people with this mental disorder turn violent, it is because of an underlying condition, such as childhood behavior issues or substance abuse.
Myth #2: Lack of good parenting causes schizophrenia.
Fact: Schizophrenia is a brain related illness. It has unknown causes. Various factors like genes, tragedy-aftereffect, and drug abuse can trigger the disease. Parenting has nothing to do with the development of the disorder.
Myth #3: People with schizophrenia should be admitted in a mental hospital.
Fact: It is not true completely. There are a few cases where patients need to stay at a meental health facility. Commonly, patients of schizophrenia stay with family or in supportive facilities within the society.
Myth #4 : A person can never recover f rom Schizophrenia.
Fact: Schizophrenia is a long term illness, but nothing is impossible. With proper treatment, medications and psychiatric therapy, it is possible that around 25% of people suffering from the disorder will recover . Again, about 50% cases show improvement in their symptoms. With managed care, people with Schizophrenia can live fully normal lives.
Myth #5: Schizophrenia is like having a split personality.
Fact: This is the most common myth about schizophrenia. A split personality is a condition medically termed as Dissociative Identity Disorder or a Multiple Personality Disorder. There are rare cases of MPD or DID. But, Schizophrenia is a cognitive illness, relating to the thinking ability of a person and is vastly different from the split personality disorder.
1) What are the different types of Schizophrenia?
Ans: The following are the different forms or types of schizophrenia:
- Paranoid schizophrenia
- Schizoaffective disorder
- Residual schizophrenia
- Disorganized schizophrenia
2) Is Schizophrenia curable?
Ans: Not exactly. There is no permanent cure for schizophrenia but one can get treated for the same. With proper care and treatment, psychiatric therapy and social rehabilitation, people with Schizophrenia can lead a fully normal life.
3) Can substance abuse cause Schizophrenia ?
Ans: Not known. Schizophrenia is a mental condition that is still under research and studies. The causes of it are not yet fully deciphered. There are a variety of factors including genetics, environment and other substance and drug abuse factors that can lead to the disorder. Some people are born with problems in the brain chemicals, which can get accentuated or triggered by substance abuse.
4) What is the future of people with the disorder?
Ans: Though significant developments have been made in research and studies on schizophrenia but still it is not clear why some patients have worsening symptoms than others; why some patients do not recover fast and why some people fail to respond to the given treatment and medication. However, there are also positive results in many cases where people have responded well and recovered with the right treatment, rehabilitation, and social support and care.
5) Are Schizophrenia Patients Depressed?
Ans: Depression is common in patients with schizophrenia. In fact, depression is a primary effect that is seen in schizophrenic patients. About 80% of people with this mental disorder get notable depressive attacks.
6) Are there any chances of relapse?
Ans: Medication can help control symptoms to an extent; however, there is no guarantee that a relapse will not occur. Though majority of the medications are known to lessen the occurrences of relapse by up to 80%. TO counterfeit, doctors prescribe secondary medications that are particularly meant to control depression, anxiety, or psychological attacks.
7) Is there any therapy apart from medicinal treatment?
Ans: Yes, additional therapy is necessary . Support and counseling from family and society works like psychotherapy. Sessions of psychotherapy usually stress the emotive and functional effects of the illness, and how the family and near ones can help in managing the illness. The therapy involves discussion over the signs and symptoms of the disorder, the nature of relapse, the role of sticking to medicines and the possible side-effects, recognizing and living with the symptoms, behavior with family members or colleagues, or continuing with a job or school. There are many programs designed specifically to address rehabilitation and practical abilities.
8) Is it possible for a person with schizophrenia to lead a "normal" life?
Ans: If appropriate treatment, social rehabilitation, psychotherapy and adequate family support is provided, it is easier to manage and control symptoms in schizophrenic patients. There are many examples of people leading an independent life with families, routine jobs, and social involvement.
9) How to manage depressive symptoms in schizophrenic patients?
Ans: To help patients manage depressive symptoms of Schizophrenia, you can do the following:
- Mingle and involve with them rather than leaving them alone.
- Put them on an antidepressant drug after consulting with their doctor managing their disorder.
- Supplement their medication with proper nutritional diet.
- Help them engage in regular physical exercise.
- In cases of severe depression, consult with their psychiatric for electroconvulsive therapy or transcranial magnetic stimulation.
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