Schizophrenia and the Stigma of Psychology

Psychology is a study justifiably given more and more credence as the 20th century made way to the 21st. Our understanding of people as well as the brain and the complexities of its functions has led to a higher awareness of all the ways it can struggle and lead to mental disorders. Mental disorders are often heard but less understood, and with them being such a prominent part of so many people's lives it is important to gain a better understanding of the more common ones and the less. Schizophrenia, a rare disorder (yet maybe still more regular than you think), is one of the most highly stigmatized mental illnesses, according to the National Institute of Mental Health. This stigma of schizophrenia and general mental disorders is what defines much of the history and treatment of mental illnesses.

The history of schizophrenia begins in the early 20th century. The American Journal of Psychiatry writes that, The term schizophrenia was coined 100 years ago, on April 24, 1908, when Paul Eugen Bleuler gave a lecture at a meeting of the German Psychiatric Association in Berlin. They continue, the splitting of different psychological functions, resulting in a loss of unity of the personality, was the most important sign of disease in Bleuler's conception. Thus, he challenged the accepted wisdom of the time and advanced his purportedly less static and stigmatizing concept by juxtaposing the Greek roots schizen (to split) and phr?“n , phren- (originally denoting diaphragm but later changing, by metonymy, to 'soul, spirit, mind').

Bleuler, who had such notable pupils as Carl Jung and Karl Abraham, was foundational to the understanding and beginning treatment of schizophrenia, even if there is still so much that is uncertain. It's been learned that it usually forms in people around the early twenties, and it is understood to be a possible mixture of many factors that increase the risk, such as environment, genetics, drug abuse, and stress that might trigger it to start. But it still isn't known what exactly might cause it. The National Alliance on Mental Illness also mentions that It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability” common and nonspecific adolescent behaviour. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the "prodromal" period.

Schizophrenia is a less common mental disorder, being found in only 1% of people, and it is especially less common to find famous examples, as schizophrenia typically becomes prominent around the ages of 17-28 ” making it more difficult to make forward progress in a professional life. Yet even still, there are examples; a quick search can find cross-results for Peter Green, Brian Wilson, and Syd Barrett ” founders of their bands Fleetwood Mac, The Beach Boys, and Pink Floyd, respectively ” as well as Eduard Einstein (son of Albert Einstein), and Mary Todd Lincoln (First Lady to President Abraham Lincoln). There are also many others, such as Zelda Fitzgerald and Vincent Van Gogh, which are argued among psychiatrists as to if their illnesses were one thing or another, only showing how much more there still is to learn about Schizophrenia.

These debates go on because of schizophrenia's shared symptoms with bipolar disorder and anxiety. Schizophrenia's self-deprecating voices in the head might feel familiar to people with general anxiety, which can be somewhat the same, if much more muted. The main difference though would be that anxiety is an attack from your own thoughts, but the voices are always recounted by people with schizophrenia as other voices speaking to you in your head. Many people who live with Schizophrenia don't notice the symptoms at first because of the way it manifests in your own mind. Ashley, who was interviewed by CNN, stated that In the beginning, I tried to rationalize the symptoms of having schizophrenia ” like hearing the voices ” I would think that they were coming from myself or the people around me. This is one of the biggest concerns for people with schizophrenia. It can lead to a denial of any sickness no matter the stage, from before they are even diagnosed to while they are currently being informed of their condition by a medical professional.

The National Institute of Mental Health lists an overview of the signs and symptoms of schizophrenia. These are listed as:

Positive symptoms: Positive symptoms are psychotic behaviours not generally seen in healthy people. People with positive symptoms may lose touch with some aspects of reality. Symptoms include:

• Hallucinations
• Delusions
• Thought disorders (unusual or dysfunctional ways of thinking)
• Movement disorders (agitated body movements)
• Negative symptoms: Negative symptoms are associated with disruptions to normal emotions and behaviors. Symptoms include:
• Flat affect (reduced expression of emotions via facial expression or voice tone)
• Reduced feelings of pleasure in everyday life
• Difficulty beginning and sustaining activities
• Reduced speaking

Cognitive symptoms: For some patients, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Symptoms include:

• Poor executive functioning (the ability to understand information and use it to make decisions)
• Trouble focusing or paying attention
• Problems with working memory (the ability to use information immediately after learning it)

With the wide range of symptoms known, it becomes singular why treatment is often never sought. As with all psychiatric/mental disorders, one of the common things cited is how hard it is to deal with the prejudice of other people who don't understand what someone might be going through. In his Ted Talk 'Imagine There Was No Stigma to Mental Illness', Dr. Jeffrey Lieberman ” Professor and Chair of Psychiatry at Columbia University and past President of the American Psychiatric Association (as written in the video description) ” discusses the ways stigma negatively affects the culture around mental health. He explains, The brain is a three pound corrugated mass of tissue, composed of over one hundred billion neurons which make over thirty trillion connections and form an intricate array of a myriad number of neural circuits which simultaneously orchestrate functions as basic and vital as breathing, temperature regulation, hunger, coordinate movement, but also form what your personality is and who you are as a person. The brain gives rise to consciousness and creativity and it also houses the human spirit. It's no wonder that it's taken us so long to understand the brain and appreciate how it related to behavior in mental illness. He goes on to discuss treatments, saying, That is the power of science leading to knowledge and awareness of effective treatments. Treatments don't just eliminate the symptoms of the illness they also eliminate the prejudice and the stigma. He further goes on to list all the positive benefits we would have if we treated it more carefully and seriously for people young and old ” eliminating social problems and mass violence that have increasingly occured.

Stigma extends to schizophrenia as well of course, in factors entirely unique to itself. In another recent Ted Talk entitled 'I Am Not A Monster', Cecilia McGough of Penn State Schreyer Honors College talks about living with the disorder and her own struggles. I remember very distinctly within that time, on the phone with my mother, I would tell my mom, 'mom, I'm sick, I'm seeing things that aren't there. I need medicine, I need to talk to a doctor.' Her response: 'No no no no, you can't tell anyone about this, this can't be on our medical history, think of your sisters, think of your sisters' futures. People are going to think that you're crazy, people are going to think that you're dangerous and you won't be able to get a job.' What I say to that now is don't let anyone convince you to not get medical help. It's not worth it. It is your choice and it is also your right I am confident I would not be here today if I didn't get the proper medical help.

With the support she decided to seek, schizophrenia can be treated. The treatments for it work by finding whatever the symptoms someone has are and countering those. Some examples include antipsychotics ” injections or pills to take ” and psychosocial treatments. Psychosocial treatments, are helpful after patients and their doctor find a medication that works. Learning and using coping skills to address the everyday challenges of schizophrenia helps people to pursue their life goals, such as attending school or work. Individuals who participate in regular psychosocial treatment are less likely to have relapses or be hospitalized. (NIMH, Treatments and Therapies)

In one article on people with schizophrenia, Kristen Fescoe writes [the] disease is not discriminatory and affects even those with fame and fortune. a truism for many mental disorders. They can be found in anyone, and the easier this is understood the easier it will be to treat. In his Ted Talk Dr. Jeffrey Lieberman concludes saying, Compassion is something we all can show to people, including those with mental illness. Hopefully, in taking a look at just one example of disorders, a better understanding of illnesses and psychology in general can be understood, to work towards this point ourselves. If stigma is defined as a mark of disgrace, it only seems logical to find the reasons why these need not be, and overcome them.

References

Stein, D. J., Phillips, K. A., Bolton, D., Fulford, K., Sadler, J. Z., & Kendler, K. S. (2010, January 20). What is a Mental/Psychiatric Disorder? From DSM-IV to DSM-V. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101504/

Talks, T. (2016, January 11). Imagine There Was No Stigma to Mental Illness | Dr. Jeffrey Lieberman | TEDxCharlottesville. Retrieved from https://www.youtube.com/watch?v=WrbTbB9tTtA

Parcesepe, A. M., & Cabassa, L. J. (2014, September 1). Public Stigma of Mental Illness in the United States: A Systematic Literature Review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835659/

The New DSM-5: Schizophrenia Spectrum And Other Psychotic Disorders. (n.d.). Retrieved from https://www.mentalhelp.net/articles/the-new-dsm-5-schizophrenia-spectrum-and-other-psychotic-disorders/

Pearlson, D., G., M., J., & Ford. (2014, March 31). Distinguishing Between Schizophrenia and Other Psychotic Disorders. Retrieved from https://academic.oup.com/schizophreniabulletin/article/40/3/501/2338259

Fescoe, K. (2015, November). 20 Famous People with Schizophrenia. Retrieved from https://www.online-psychology-degrees.org/20-famous-people-with-schizophrenia/

Historical Roots of Schizophrenia. (2018, November 21). Retrieved from

https://www.medscape.org/viewarticle/418882_5

Fusar-Poli, P., M.D., & Politi, P., M.D. (2008, November 1). Paul Eugen Bleuler and the Birth of Schizophrenia (1908). Retrieved from https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2008.08050714

Johnson, J. &. (2011, November 03). Living with Schizophrenia - Ashley. Retrieved from https://www.youtube.com/watch?v=ZHpKvmTJOhA

Famous People with Schizophrenia. (2013, November 04). Retrieved from https://www.newhealthguide.org/Famous-People-With-Schizophrenia.html

Schizophrenia. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

Ahmedani, B. K., Ph.D. (n.d.). Mental Health Stigma: Society, Individuals, and the Profession. Retrieved from

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