Introduction

You may have heard about a mental illness which makes people hear voices or see things, or perhaps they feel like they're being controlled by someone else. This is called schizophrenia and it's a mental illness that some people develop. It's an uncommon but not rare illness as it affects 1 out of 100 people. If you have any questions regarding schizophrenia or this thread, feel free to drop a reply. Anything that is troubling you is better said aloud, early diagnosis is better. Read this thread to find out what schizophrenia is, what the effects are and why people develop it.

What is Schizophrenia?

Schizophrenia is a severe mental disorder characterised by a profound disruption of cognition (how they think) and emotion (how they feel). This leads to an effect on a person's language, thought, perception and even a sense of who they are. Someone who suffers from schizophrenia is a schizophrenic, and they may believe ideas that are not true or see entities that do not exist. It is ranked as a Top 10 cause of disability and about 1 in 100 people will develop schizophrenia at some point in their lives. It affects both men and women equally and is difficult to recognise.  

Facts

In the U.S., approximately 2.2 million adults, or about 1.1 percent of the population age 18 and older in a given year, have schizophrenia.

Rates of schizophrenia are very similar from country to country-about 1 percent of the population.

There is a greatly heightened risk of suicide in people with schizophrenia.

Most people with schizophrenia suffer chronically or episodically throughout their lives, losing opportunities for careers and relationships.

 

Myths

Myth: Schizophrenia is a multiple personality disorder

Fact: Although the word stems from 'split personality' in Greek, it is not a split personality disorder. They may experience the delusions and hallucinations but it doesn't mean they have more than one personality.

 

Myth: Schizophrenia is a permanent, unrecoverable illness.

Fact: Actually, around 30% of people will have a lasting recovery from schizophrenia. Around 20% will show a significant improvement, but around 50% will have it long term, which is likely to worsen.

 

Myth: Schizophrenics are dangerous.

Fact: Schizophrenics are more likely to be victims of violence than the perpetrators. Violence is not a symptom of schizophrenia.

 

Myth: Schizophrenia only affects the mental health of someone, and not physical health.

Fact: Schizophrenia actually affects a persons physical health. It is through the use of anti-psychotics and the lifestyle factors of someone with schizophrenia that leads to physical effects, and that those people with schizophrenia are likely to have a life expectancy 20 years lower than the average.

 

Myth: Schizophrenics need to be monitored.

Fact: If a schizophrenic is regularly getting access to the treatment they require, they do not need to be monitored and there is no reason why they cannot lead happy and productive lives. Although some may live with family, many live independently and are active members of society.

 

 Diagnosis and Symptoms

Diagnosis is assessed through asking the patient questions and establishing what their beliefs are. There is no test for schizophrenia. Psychologists tend to use either one of two grading systems with established criterion which differentiate those that do have schizophrenia and those that do not, clearly defining the symptoms of schizophrenia, and these are the DSM and the ICD. The DSM (Diagnostic and Statistical Manual of Mental Disorders) is mainly the most common used, and the most recent version of the DSM (The DSM-5) states that the following characteristics are shown: 

Positive Symptoms 

Positive symptoms are symptoms which reflect and excess or distortion of normal, everyday functions. 

Delusions – These are beliefs that seem to be real to a person suffering from schizophrenia, but they are not real. These delusions can be paranoid or alter beliefs about the persons power.

Hallucinations – Unreal perceptions of the environment. These can come under 5 different types, and they affect each of the 5 senses.

  • Auditory: Hearing voices and sounds in real life, and not in the mind.
  • Visual: Seeing objects, people, faces and entities that are not real.
  • Gustatory: Tasting things that are not real.
  • Tactile: Literally feeling things that aren't there such as a hand crawling on your back.
  • Olfactory: Smelling things that are not real, changes in a previous smell or the smell of an environment, such as fog.

Experiences of Control – The feeling that someone else is taking over your body, like a puppet.

Disordered Thinking – This could be the feeling that someone is inserting thoughts or usurping them from your mind. It could also be the feeling that your thoughts are being broadcast to everyone and they can hear them.

Negative Symptoms

Negative symptoms are symptoms which reflect a flattening or loss of normal, everyday functions.

Affective Flattening – Reduction of emotional expression, such as eye-contact, facial expression and tone of voice.

Alogia – The poverty of speech such as reduction in tone, fluency and productivity. It is assumed this is a reflection of blocked thoughts.

Avolition – The inability of being able to take part in goal-directed behaviour, such as standing still for a very long time.

The DSM-5 states that an individual must exhibit two of the specified symptoms, and there is also the removal of subtypes (as mentioned in the previous thread).

What is an Episode?

People with schizophrenia often have episodes of schizophrenia. An episode is a period of time where their schizophrenic symptoms are particularly severe, followed by an episodic cooldown where there are few or no symptoms. This type of schizophrenia with episodes and cooldowns is called acute schizophrenia. An episode can be especially scary, as one of the most prominent features of episodes are hallucinations. During this time, a schizophrenic is unable to differentiate between what a hallucination is and what real life is. If someone you know is having an episode, the best thing to do is try to talk to them very calmly and make sure you're they're for them. There may be times where it seems like someone with schizophrenia is not listening to you, but the symptoms do not remove real life perception. They may not speak because they are too frightened to move, but they will still be able to hear you or see you.

If you have time, have a look at this video that shows the experience of schizophrenia. The psychotic episode begins at 1:01. (Don't worry, there's no shockers in this video)

 

 The voices in the video are not actually in the person's head. These voices are auditory hallucinations and to the schizophrenic, would sound like real life people in the room. The video would be more realistic if the voices were originating from someone in the room rather than being dubbed over the video during editing.

Here's some things to look out for in the video:

Auditory Hallucinations: The man and the woman speaking to the schizophrenic during the episode even though they do not exist.

Visual Hallucinations: Notice how the word 'PIZZA' on the pizza box changes to 'POIZZON' when the pizza box is put down on the table.

Olfactory Hallucinations: "The coffee smells terrible! Don't drink that!"

Delusions: Repetition of the word 'poison', 'you're worthless' and 'STOP!'

Avolition: The schizophrenic was not able to take his meds or answer the phone correctly.

Comorbidity with Depression

 Comorbidity means that two or more conditions can co-occur with each other. Schizophrenia shares comorbidity with many other psychiatric disorders, but the most comorbid is with depression. Many people that have schizophrenia will also show depressive symptoms, and are likely to also suffer from depression as well. Depression can either occur by chance with schizophrenia but it is mainly due to becoming a secondary disorder that has manifested itself from the core disorder, schizophrenia. The ICD specifies a type of schizophrenia that occurs with depression. This is called the schizoaffective disorder - depressed subtype. It states that someone will have this subtype if:

  • Both definite schizophrenic and definite affective symptoms are prominent simultaneously, or within a few days of each other, within the same episode of illness.
  • At least one and preferably two typically schizophrenic symptoms, as specified for schizophrenia, must be present.
  • There must be prominent depression accompanied by at least two characteristic depressive symptoms or associated behavioural abnormalities as for a depressive episode.
  • As a consequence of this, the episode of illness does not meet criteria for either schizophrenia or for a depressive or manic episode.

Causes of Schizophrenia 

The causes of schizophrenia are still unknown, but there are explanations that attempt to establish as to why some people develop it. One of the possible explanations is the Expressed Emotion theory. This describes a measure of family environment that is based on how highly expressed it is, such as comments made to the patient. It is believed that a hostile family environment impacts on someone's life, resulting in schzophrenia such as auditory hallucinations (such as hearing the voices of family members) and feeling controlled.

There have also been attempts to attribute the cause of schizophrenia to having faulty amounts of chemicals in the brain. However, this has been challenged as in the case of indentical twin studies, the rate of which both twins developed schizophrenia was not 100% even though they are genetically identical.

Is there a "Cure"

The causes of schizophrenia are still truly yet to be discovered as there are no cause-and-effect studies to show what causes schizophrenia, but rather what conditions exist when there is schizophrenia. However, there are some therapies that schizophrenics can go through, and in recently there have been advancements in the psychiatric medicine industry that gives a better prognosis (outlook) on a schizophrenic. 

 

Biological Therapies are generally through the use of antipsychotics and there are two types; Conventional antipsychotics and Atypical antipsychotics. These antipsychotics block certain neurotransmitters (the chemicals that travel in the brain) and are found to decrease symptoms of schizophrenia. Conventional antipsychotics block the neurotransmitter dopamine, whereas Atypical block dopamine temporarily. There is also ECT (Electroconvulsive therapy) which makes someone have a seizure for about a minute, but they are unconcious and given a nerve blocking agent to reduce paralysis. ECT is used less commonly as antipsychotic medication is becoming more popular and more successful at treating schizophrenia. As with all psychiatric medication, there will be side-effects. Antipsychotics are known to create side effects such as tardive dyskensia, the involutnary movements of facial muscles, the mouth and the tongue. This is more commonly developed with conventional antipsychotics, and is irriversible in 75% of cases.

Psychological Therpaies can be usually one of two therapies. Cognitive-Behavioural therapy which is where both the therapist and patient work at tackling delusions and beliefs, and challenge how valid someone's beliefs are. The patient also learns how to tackle challenges for themselves. Another therapy is Family therapy, in which the therapist and the family attempt to reduce expressed emotion in the house environment.

It has been found that using a combination of antipsychotic medication and psychological therapy has been the most successful in treating the symptoms of schizophrenia.

Epilogue

Thank you for taking the time to read this sticky. If you managed to read this entire thread, congratulations! I hope I've educated you about schizophrenia and make you more aware of it. You could help someone in need that might be suffering with schizophrenia or help diagnose it just by asking what someone feels and experiences. If you have any more questions that you feel have been unanswered by this thread, feel free to send me a PM as I study mental illnesses such as this one. If you have any concerns about your own mental health, please speak to a therapist as it's your health that matters, and a delay could play a big difference.


Read More

NHS Choices

Mind: for better mental health

Mental Health Foundation

Patient.co.uk

Schizophrenia World

National Institute of Mental Health

Sources and Citations

American Psychiatric Association

A2 Psychology Textbook

NHS Choices

Wikipedia

Rethink Mental Illness.

Original Thread by Maverick