Schizophrenia

Last updated date: 14-Jun-2023

Originally Written in English

Schizophrenia


Schizophrenia is a severe mental/psychiatric condition that makes people interpret reality and facts unusually. It’s usually characterized by alteration in thinking, emotions, perception, behavior, language, and sense of self. Other popular experiences are delusions (false or fixed beliefs) and hallucinations (seeing unreal things and hearing voices). 

Globally, schizophrenia is related to substantial disability and can interfere with occupational and educational performance. In most cases, patients diagnosed with this condition are at risk of dying earlier. This is usually because of physical ailments, including metabolic disorders, cardiovascular disease, or infection. Fortunately, schizophrenia is a curable condition either through medication or psychological support. 

 

Causes of Schizophrenia 

Although the exact causes of schizophrenia are unknown, researchers think that genetics combination, brain chemistry, as well as environmental factors play a role in the disorder's development. 

Some naturally occurring brain chemicals issues, such as dopamine and glutamate neurotransmitters, can play a role in schizophrenia. Individuals with schizophrenia have different brain structures and central nervous systems, according to neuroimaging research. Although the significance of these changes remains unknown to experts, they suggest that schizophrenia is a brain-related disorder. 

 

Signs and Symptoms of Schizophrenia 

Schizophrenia is characterized by various complications with thoughts (cognition), feeling (emotions), and behavior. The common signs and symptoms can include;

Hallucinations:

Hallucination is the act of seeing and hearing something that doesn't happen is a common occurrence. An individual with schizophrenia, on the other hand, is subjected to the full force and effect of a usual experience. Hearing nonexistent voices is the most common hallucination, but schizophrenia hallucinations can occur in any context. 

Delusions:

These involve erroneous beliefs and views that are not supported by evidence. Examples of these beliefs can include; 

  • You believe you are being harassed or harmed 
  • Certain actions or remarks are aimed at you
  • You have an extraordinary capability or fame
  • Someone is in love with you
  • A major disaster is imminent

In general, most individuals with the disorder have schizophrenia delusions

Disorganized thinking and speech: 

Disorganized thoughts may infer incoherent speech. Proper communication may be hampered, and responses to questions can be partly or entirely unrelated. In rare cases, speech can involve the use of meaningless terms that are difficult to understand, a practice known as word salad. 

Negative signs and symptoms:

This involves a diminished or lack of the capacity to act normally. An individual with schizophrenia may, for example, desert personal hygiene or appear emotionless. This can be noticed when they don’t make any eye contact, do not change their facial expressions, or talk in a monotone. In addition, the individual tends to lose interest in daily activities, withdraw socially, or be unable to enjoy pleasure. 

Motor activity that is highly disorganized or abnormal:

This can manifest itself in a variety of ways, ranging from childish silliness to erratic agitation. It's difficult to complete tasks since behavior isn't based on a target. Resisting orders, improper or bizarre posture, a total lack of response, or unnecessary and repetitive movement are examples of schizophrenia behavior. 

 

The type and severity of schizophrenia symptoms will change with time with episodes of aggravation and remission. However, other signs can be present at all times.

Schizophrenia symptoms usually appear in men during their early to mid-twenties. Symptoms in women typically start in their late twenties. Schizophrenia is not common in minors, and even more so in people over the age of 45. 

 

Symptoms of Schizophrenia in Teenagers 

The symptoms of schizophrenia in children and adolescents are almost the same as those of adults. However, diagnosing the disease can be difficult. This may be due to the fact that some early signs of schizophrenia in adolescents are popular during normal adolescent development. These symptoms can include; 

  • Cutting off friendships and relatives
  • A drop or poor academic performance
  • Sleeping problems
  • Irritability or a down state of mind
  • Insufficient motivation

Symptoms of Schizophrenia in Teenagers 

At times, recreational substances, including marijuana and LSD, can lead to similar symptoms of schizophrenia in teens. But unlike the symptoms among adults, teenagers are more likely to experience vision hallucination and fewer to not delusions. 

 

Schizophrenia Onset

Schizophrenia onset is categorized into the following; 

Early-onset schizophrenia:

It’s usually uncommon to diagnose a younger child, aging below 13 years, with schizophrenia. It can, however, occur in rare cases. Early schizophrenia onset can lead to the following among the young minors;

  • Unusual or late crawling 
  • Difficulty speaking 
  • Abnormal movements such as rocking or flapping of the arm
  • Late walking 

 In teenagers, their parent can notice the following; 

  • Depression 
  • Bad mood 
  • Sleeping problems 
  • Lack of motivation
  • Use of drugs and alcohol 

 

Late-onset schizophrenia:

Schizophrenia can strike at any age. After the age of 45, a person is diagnosed with late-onset schizophrenia. The people who suffer from the disorder are more likely to experience delusions and hallucinations. Schizophrenia negative symptoms, impaired learning, disorganized thoughts, and difficulty understanding something are less likely in them.

Doctors believe genetics, just like early-onset schizophrenia, might be the cause. They also think that late-onset is a subtype that does not manifest before the right stimulus occurs. Those with cognitive, visual, or hearing impairments, as well as those who are suspicious, lonely, or reclusive, may be more susceptible.

 

Risk Factors of Schizophrenia 

Whereas the exact cause of schizophrenia is unknown, some factors may increase the possibility of developing schizophrenia. They include the following; 

  • A family history of a similar condition 
  • Certain problems associated with pregnancy and delivery, including malnutrition and exposure to contaminants or viruses. This may affect brain growth. 
  • Using mind interfering drugs (psychoactive or psychotropic) during the adolescent and young adulthood stage. 

 

Diagnosing Schizophrenia 

The process of diagnosing schizophrenia entails ruling out any psychiatric illnesses. It also involves identifying if symptoms are not caused by drug abuse, certain medicines, or a health condition. 

The following procedures can be considered when making a schizophrenia diagnosis;

Physical examination: This involves assessment of the overall physical health of the patient as well as the appearance. It aims at ruling out other health issues that may be causing symptoms and to look for any associated complications.

Psychiatric evaluation: A psychiatrist or mental health experts can assess a person's mental health by looking at their appearance and attitude. They can ask about their thinking, emotions, moods, delusions, hallucinations, drug abuse, and risk of violence or suicide. A discussion of personal and family history is also part of psychiatric examination.

Screenings and tests: Tests to rule out certain problems with common symptoms, as well as alcohol and drug screening, can be used. If necessary, the doctor can ask for imaging scans, including x-ray, MRI, or CT scans. 

Schizophrenia diagnostic criteria: A medical provider or mental health specialist can apply the criteria during the diagnostic and statistical manual of mental disorders. 

 

Schizophrenia Treatment 

Schizophrenia needs ongoing care and treatment even after the symptoms resolve. Schizophrenia medication and psychosocial treatment may be used to better treat and manage the disorder. Hospitalization might be necessary for some situations.

Medication:

Antipsychotic drugs are the widely prescribed medications and are the foundation of schizophrenia treatment. Medical providers believe that they work by influencing the dopamine neurotransmitter in the brain, hence managing the symptoms. 

Antipsychotic medication treatment aims to successfully control signs and symptoms by using the least amount of dosage. To attain the desired outcome, the psychiatrist can experiment with various medications, doses, and combinations with time. Antidepressants and anti-anxiety medications can also be beneficial. It might take a few weeks to see a difference in the symptoms. 

Some of the common antipsychotic drugs include; 

  • Quetiapine (Seroquel)
  • Risperidone (Risperdal) 
  • Olanzapine (Zyprexa) 
  • Ziprasidone (Geodon) 
  • Clozapine (Clozaril) 
  • Haloperidol (Haldol)

However, most of these medications have side effects, such as neurological problems and weight gain. On the other hand, the newer drugs tend to have less serious side effects. It’s thus crucial for one to continuously stick to the treatment schedule even when the symptoms subside. This is because the symptoms might recur if one stops using the drugs. 

Long-acting injectable antipsychotics:

Certain antipsychotics are administered intramuscularly or subcutaneously. Depending on the prescription, they are normally given after every two to four weeks. You should, however, inquire with your doctor about injectable drugs for more details. If one prefers fewer pills, this could be an alternative that can concur with adherence. 

Psychosocial interventions:

Psychological and social (psychosocial) treatments, apart from continuing with drugs, are critical after psychosis subsides. This can include the following; 

Individualized care: Psychotherapy can assist in the normalization of thinking patterns. Individuals with the disorder will also benefit from learning to deal with stress and recognizing early warning signs of schizophrenia relapse. 

Training on social skills: This aims at enhancing communication skills and social experiences. It also helps improve everyday activities participation.

Family therapy: Families living with schizophrenia receive care and education through this program. 

Supported jobs and vocational rehabilitation: This program focuses on assisting patients with schizophrenia in preparing for, obtaining, and maintaining employment.

The majority of people with schizophrenia need some kind of everyday living assistance. Most communities provide services to assist schizophrenia patients in finding employment, finding homes, joining self-help groups, and dealing with crises. A case administrator or a member of the care team may assist in the search for services. Overall, most individuals with schizophrenia can control their condition with the right medication. 

Encouraging physical health:

Individuals with schizophrenia are known for not taking care of themselves as they should. Smoking, obesity, lack of exercise, or unhealthy diets are all more popular among people with schizophrenia than in the general population. Antipsychotic medications can cause weight gain, which is a common side effect. All of these factors can increase your risk of developing diabetes and heart disease in the future. 

As a result, people with schizophrenia, like the rest of the population, are advised to live a healthier lifestyle. The following are some of the suggestions;

  • Refrain from smoking 
  • To exercise on a daily basis
  • To eat a balanced diet regularly 

Electroconvulsive therapy (ECT):

This procedure involves attaching electrodes to the patient's scalp throughout this treatment. Doctors administer a mild electric shock to the brain when they are unconscious under general anesthesia. ECT therapy normally entails 2-3 sessions a week for several weeks. A controlled seizure occurs after every shock treatment.

With time, a series of therapies result in a change in moods and thoughts. Scientists are not sure how ECT and the regulated seizures it triggers benefit. However, some researchers believe that ECT-induced seizures can impact neurotransmitter release throughout the brain. 

Generally, ECT has a lower success rate in treating schizophrenia than depression and bipolar disorder. As such, it is not recommended often if mood symptoms are not present. Contrarily, it can be useful when drugs are no longer effective or when extreme depression and catatonia make treatment difficult. 

 

Recovering from Schizophrenia 

Most individuals dealing with schizophrenia experience recovery journey processes that result in them living a good life. Schizophrenia recovery journey can be categorized into personal recovery and clinical recovery. 

Medical providers often categorize clinical recovery as the situation whereby the patient; 

  • No longer experiences the symptoms of mental disorder. 
  • The symptoms are under control by the treatment to the extent that they do not pose any significant issue. 

With personal recovery, the patient is likely to live a good meaningful life. Handling schizophrenia symptoms is essential in most people. However, others assume that recovery is much more than this; hence it’s known as personal recovery. 

What you consider to be meaningful in life can vary from what others believe to be so. You should consider what you want to do in your life to make it more meaningful and work to achieve that objective.

Here are some ideas on how to think about recovery; 

  • Taking the necessary action to get closer to your desired destination. For instance, you might want a more active social life. 
  • Creating a sense of optimism for the future. You can alter your objectives, abilities, responsibilities, or outlook.

The phase of recovery is never-ending. It's normal to encounter obstacles and setbacks throughout the journey. If you believe things are better than they were before, you can call yourself "recovered" at any point. 

 

Factors That Can Help You Recover

factors for Schizophrenia recovery

These are some of the factors that essential during recovery; 

Acceptance: Accepting your condition and focusing on the important things to do can be beneficial. It is also good to set achievable targets.

Control: This can assist you in gaining more control over aspects of your life, such as treatment and support options. 

Hope: Reading recovery stories from others or joining a support group can be beneficial to you.

Lifestyle: Sleep, diet, exercise, and routine may all play a role. Also, making improvements is essential. 

Relationships: Maintaining contact with others will assist you in staying healthy.

Stability: Having a secure housing and financial condition will help you recover; you will need assistance with such things.

Treatment: The correct form of treatment will aid in the beginning and maintenance of rehabilitation and recovery. 

 

Preventing Schizophrenia 

There is no specific way to avoid or prevent schizophrenia from occurring. However, determining who is at risk and preventing the condition from emerging in at-risk people has remained a major research priority in the past years. 

It is possible to live a symptom-free, stable life. Symptoms of schizophrenia will disappear for some time before reappearing. Therefore, the prognosis is likely to improve if you follow your doctor's advice.

It's essential to do the following to get started on the path to improvement;

  • Finding out more about your illness
  • Learning about the dangers and risk factors 
  • Adhering to the recommendations and treatment plan

 

Complications of Schizophrenia 

Schizophrenia is a serious condition that can lead to intense problems affecting every aspect of life. Some of the complications associated or triggered by schizophrenia include; 

  • Obsessive-compulsive disorder (OCD) and anxiety issues 
  • Suicide, including attempts to commit suicide or suicidal thoughts 
  • Depression 
  • Lack of the capacity to work or go to school 
  • Alcohol and substance abuse such as nicotine 
  • Social isolation 
  • Financial issues and homelessness 
  • Victimization 
  • Health and other medical issues 
  • Aggression, although it might be rare 

 

Helping a Person with Schizophrenia 

In most cases, schizophrenia patients are not aware of the difficulties caused by a mental condition that needs medical attention. Therefore, if you suspect a friend or family member has schizophrenia, speak with him or her regarding your concerns. You cannot make a person seek professional treatment. However, you can provide motivation and support, as well as assist your loved one in finding a competent physician or mental health expert. 

At times, your loved one is a threat to self or others or is unable to care for him or her. In such cases, you should contact 911 or any emergency facility for assistance. With this, your loved one will be assessed by a mental health professional and treated accordingly. 

Emergency hospitalization might be necessary in other cases. Involuntary engagement for mental health care is regulated differently in each state. For more information, call the local community mental health providers or police departments. 

 

Schizophrenia and Psychosis 

Psychosis and schizophrenia are sometimes confused, but they do not mean the same thing. While schizophrenia is a psychiatric illness, psychosis is a symptom. 

Psychosis is a state of being detached from reality. You can hear voices, see things that are not real, or believe things that are not true during a psychotic schizophrenia episode.

Psychosis is typically a component or symptom of a number of mental illnesses, including schizophrenia. It may also strike individuals who show no other signs of mental illness.

While psychosis may occur in individuals with schizophrenia, it does not happen to everyone who has the illness. If you have psychotic symptoms or know someone who has them, you should get medical help right away. 

 

Schizophrenia Versus Bipolar 

Both schizophrenia and bipolar disorder are chronic psychiatric illnesses. Although they might have some similarities, they have significant variations. 

Bipolar disorder is characterized by extreme mood swings shifts. Such swings alternate between depression and mania. A person with bipolar is likely to have hallucinations or delusions during these episodes, particularly during a manic episode. Having psychosis combined with mood swings can make it difficult to complete daily tasks. 

Similarly, individuals with schizophrenia can have hallucinations or delusions. However, they are normally prone to disorganized thoughts and expressions. The signs of psychosis are not followed by mania, unlike those of bipolar disorder during the manic period. 

There is no specific schizophrenia test procedure that doctors can use to determine the type of condition one has. Instead, they can conduct a thorough psychiatric examination and request other examinations to rule out any potential trigger. Blood checks, drug screening tests, and imaging tests are examples of these tests. The doctor will then start to track your actions and symptoms based on these findings. This is to obtain a diagnosis that matches what you're going through. 

 

Are Schizophrenia Patients Dangerous?

Individuals with schizophrenia condition and any other psychiatric disorders are often depicted as dangerous and aggressive in popular books and films. However, this is not always the case. The majority of people who have schizophrenia are not abusive. Instead, they tend to withdraw and choose to be left alone most of the time. 

Whenever a person with a mental disorder engages in risky or aggressive actions, it's usually due to psychosis or a fear of being disturbed in any way by their environment. Also, the use of drugs and alcohol can exacerbate the problem. 

Individuals with schizophrenia, on the other hand, might be a threat to themselves. Suicide is the leading cause of death for schizophrenia patients.

 

Bottom Line

In general, schizophrenia is a mental health condition that impairs how a person thinks and behaves. One out of 100 people are usually diagnosed with the disease. This condition can also develop at any age and can be associated with schizophrenia positive symptoms and negative signs. 

Although the actual cause of schizophrenia remains unknown, one can successfully recover from the condition. Doctors can address the issue using medication and psychological remedies. Moreover, it’s essential to seek medical care if you suspect to have the disease or have increased chances of developing it.