Schizophrenia: Demystifying schizophrenia

For many people, schizophrenia remains a mysterious and terrifying illness. Numerous films have exploited the troubling aspects of this mental disorder, when in fact we can all benefit from gaining a better understanding of it.

What is schizophrenia?

Schizophrenia refers to a group of serious mental illnesses characterized by an abnormal interpretation of reality. It can lead to hallucinations and delusions, as well as thought and behaviour disorders. Schizophrenic individuals’ ability to function normally and take care of themselves tends to deteriorate over time. The prevalence of this disease is very stable across the world, affecting approximately one percent of the population.

Contrary to certain misconceptions, schizophrenia does not refer to dissociative or multiple personalities. While the etymology of the word schizophrenia does come from the Greek for “split mind,” the term actually refers to a disturbance in the balance between emotions and thoughts.

Schizophrenia is a chronic disease that requires lifelong treatment.

Recognizing schizophrenia

The symptoms of schizophrenia can also be attributed to other mental illnesses, so a single isolated symptom does not necessarily lead to a schizophrenia diagnosis. In men, symptoms of the disease usually manifest in late adolescence or early adulthood, while in women they manifest in the late twenties or early thirties. Schizophrenia symptoms are usually divided into three categories: positive, negative and cognitive.

Positive symptoms are the most spectacular. Patients develop ideas that have no basis in reality. Examples of symptoms in this category include a strong feeling of persecution, pathological jealousy and a sudden affirmation of mystical notions. Delusions arise from hallucinations, which are most commonly auditory (patients hear voices talking about them or giving them orders) or intrapsychic (“inner voices”). Visual, olfactory, gustatory or tactile hallucinations are also sometimes reported, as are hallucinations involving psychical or internal body sensations. Patient behaviour can be disjointed and incoherent.

Negative symptoms are very incapacitating, particularly due to the social isolation they bring about. The most common examples are social withdrawal, the loss of initiative or motivation, neglecting personal hygiene and a loss of interest in regular activities. The ability to communicate, reach out to others and enjoy pleasant activities is also greatly altered. Negative symptoms can appear months or even years before the onset of positive symptoms.

Cognitive symptoms refer to thought processing problems. They manifest as language impairments, attention deficits, and problems memorizing and decoding information received. Contradictory emotions, thoughts and behaviours can manifest at the same time.

When to seek help

Persons with schizophrenia are often not aware that their problems are caused by a mental illness that requires medical supervision. Usually a family member or friend must help the individual seek help.

You can’t force someone to consult a healthcare professional. Through discussion, however, we can encourage a person with symptoms of schizophrenia to seek medical help, and then support that person’s efforts.

Suicidal thoughts are common among persons suffering from schizophrenia. When these individuals pose a threat to themselves or others, or they cannot meet their vital needs, we can then contact emergency services or the police. When physicians suspect that a patient’s symptoms may be caused by schizophrenia, they will usually have the patient undergo a battery of physical and psychological tests to exclude other disorders that could explain the symptoms.

It can be helpful for a loved one to be present for the initial medical appointment in order to help provide a more complete description of the illness and take notes on the doctor’s explanations and recommendations.

Causes

There is no single known cause for schizophrenia: it seems that a combination of genetic and environmental factors contributes to the onset of the disease. It has been found, however, that persons with schizophrenia exhibit differences in the structure and composition of their brain’s chemical messengers.

Factors that increase the risk of developing schizophrenia include having a family member who suffers from the disease, undergoing stressful life conditions, or having taken psychotropic drugs.

Complications

Schizophrenia can lead to serious consequences for the individual’s emotional, physical, social and professional life. Persons with schizophrenia are more likely than others to be poor, unemployed or homeless. They also have a greater risk of suffering from drug or alcohol abuse, having family problems and committing suicide. However, early treatment can reduce the risk of such complications.

Treatment

Schizophrenia is a chronic disease that requires lifelong treatment, even when symptoms have disappeared. Medication and psychosocial therapy are usually sufficient to manage the disease. Hospitalization is sometimes required when severe episodes or symptoms manifest, in order to ensure that the person remains safe and receives proper nourishment, sleep and hygiene.

Medication is the cornerstone of schizophrenia treatment. Antipsychotics, a class of medication that includes numerous agents, are the most commonly prescribed. Sometimes several trials and adjustments are necessary before the best medication for the patient is identified. Like all drugs, antipsychotics can cause adverse effects, some of which lessen over time. It is important for patients to discuss any such reaction with their physician or pharmacist, who can provide tips for managing adverse effects. It may take several weeks before symptoms noticeably improve, so it is important to persevere. Most important of all is to pursue the treatment once the symptoms are under control, as they will return if the patient stops taking the medication.

Psychosocial therapy, which is often an important component of treatment, aims to improve social and family interactions, assist in obtaining and retaining employment, and help the individual live a fuller life with the disease.

Living with schizophrenia

Living with schizophrenia can be very challenging for individuals with the disease as well as for their loved ones. Initiatives that can facilitate the adaptation process include learning about the disease, joining a support group, practicing relaxation techniques and remaining focused on life goals.

Persons at risk for schizophrenia can help control symptoms and prevent them from worsening by avoiding illicit drugs, reducing their sources of stress, getting enough sleep and physical exercise, and promptly seeing a physician if symptoms do appear.

Schizophrenia cannot be prevented. However, early treatment of the disease can help control symptoms before complications develop and could improve the individual’s long-term prognosis. In addition, respecting the treatment plan established with the physician tends to prevent relapses and the worsening of symptoms associated with schizophrenia.