Schizophrenia

What is Schizophrenia?

Schizophrenia is a severe mental disorder characterized by abnormalities in the perception of reality. It affects the way in which a person behaves, thinks and sees the world.

Schizophrenia usually begins during late adolescence or early adulthood, i.e., before the age of 30. It is a long-term illness, often lasting several months or years, requiring long-term treatment. Schizophrenia can be of different types with varied symptoms over a spectrum.

Schizophrenia is a mental disorder that changes the way a person thinks, feels and behaves. It is a form of one of the more severe group of mental disorders called ‘psychoses’. People with Schizophrenia may seem like they have lost touch with reality. Although Schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.

What are the causes of Schizophrenia?

Genetic Causes of Schizophrenia:

Only 1 percent of people develop Schizophrenia, but if a close person in the family, related by blood has it, then there is a greater chance that they will also develop it.

Environmental Causes of Schizophrenia:

• Damage to the brain: The brain of a person with Schizophrenia is different than the brain of normal people. This may be because the brain of the person with Schizophrenia was damaged at birth or because it was adversely affected by virus infection in the early pregnancy of the mother. Sometimes, it may be precipitated by injury or disorder of the brain.
• Substance Abuse: This can also increase vulnerability in those at risk. Drugs of abuse and alcohol can precipitate Schizophrenia in those who are vulnerable. Cannabis and amphetamines also precipitate the problem as can continuous or excessive alcohol consumption in vulnerable persons.
• Childhood or adulthood trauma: These experience can increase the risk of Schizophrenia. A stressful event like an accident, academic failure, loss of a loved one, etc. can also precipitate the problem but only in those who may have a tendency to develop the problem. Family tensions can make Schizophrenia worse.
• Neurodevelopment and Neurotransmitters: There have been observations of structural and functional abnormalities through brain imaging in some persons with Schizophrenia. Similarly, neurotransmitter abnormalities and imbalance, especially hyperactivity of dopamine have been implicated. However, there are no definite tests to diagnose Schizophrenia based on these.
• Schizophrenia is neither caused by black magic nor can be cured by exorcism.

What are the signs and symptoms of Schizophrenia?

If 3-4 of these signs are present for at least 1 month continuously, the person might be suffering from Schizophrenia:

• hearing voices that nobody else can hear (auditory hallucinations)
• lack of association of thought leading to mixture of ideas while talking or talk not making sense
• strange ideas and beliefs, such as – that everything on the radio or TV is referring to the person her/himself, or that everyone knows what the person is thinking, that she/he knows about other’s thoughts and ideas being transmitted to her/him
• laughing or talking to oneself
• complaints or ideas that someone is against him/her
• serious disturbances in sleep or lack of appetite
• lack of care about personal grooming and hygiene
• getting angry or crying without any apparent reason
• inability to show feelings and emotions
• not carrying out one’s own usual daily routine
• withdrawal from social activities and people
• unexplained violent behavior

What do we mean by active and passive symptoms?

Schizophrenia symptoms can be classified as either Active (Positive) or Passive (Negative).

Active symptoms normally involve having strange experiences not usually experienced by others. These symptoms can affect a person from time to time and worsen. They may become more intense as well as troublesome, pre-occupy the mind and cause the person distress or dysfunction at work or in relationships. These can be hallucinations and delusions such as, hearing voices commenting or commanding, feel that someone is controlling their thoughts or broadcasting them; extreme suspicion of someone planning to harm her/himself; talking incoherently, odd behaviors or agitation with disturbed sleep and appetite.

Passive symptoms consist of social withdrawal, slowed movements, decreased expression of emotions, reduced ability to think and speak in a proper appropriate manner, lack of motivation to do anything, have few friends or activities or interests, and poor interpersonal relations. Passive symptoms are less dramatic than active symptoms but are equally difficult to live with!

How is Schizophrenia treated?

Only a qualified medical doctor, usually a psychiatrist, can prescribe treatment for Schizophrenia. Following are the treatment of Schizophrenia:

• Family support and education: With the right support, medication and therapy, many people with Schizophrenia are able to manage their symptoms and function independently.
• Medications: They are the first line of treatment for anyone suffering from Schizophrenia. Anti-psychotic medications are quite effective. Schizophrenia is an illness which is difficult to cure. That is to say, it can relapse or come back again later, especially if the patient is irregular with medication or discontinues without the doctor’s advice. But it can and must be treated because the disease can prevent the person from living a normal life as well as prove damaging to the person’s family. With treatment and family support, the person can improve enough to live a near-normal life.
• Electroconvulsive Therapy (ECT): In cases where there are abnormal ideas and there is intense excitement in the person’s behavior, or when there is a danger of suicide or harming to others, ECT (Electroconvulsive Therapy) helps get rid of the symptoms.
• Cognitive Behavioral Therapy (CBT): CBT has been known to help a person cope with Schizophrenia. It will make them feel better and it also teaches how to solve problems of daily living and rebuild social skills. CBT has evidence to show it helps in controlling hallucinations and reducing delusions.
• Family Counseling: This is usually required when it is discovered that someone in the family has Schizophrenia. Guidance on how to handle the patient’s perplexing and difficult behaviors and how to give support during the treatment is important. Families can make a significant contribution to the patient’s recovery with their understanding and support in dealing with day to day problems and challenges. They can also be instrumental in ensuring that the patient is taking medications regularly and as prescribed. This prevents relapses of the illness.