Understanding Schizophrenia

Abstract

Schizophrenia knows no bounds and often comes unannounced. It cuts across all peoples of the worldvarious cultures, age, gender and socioeconomic strata. It causes a lot of difficulty, chaos, and confusion to both the one suffering it and all involved in a close relationship with this individual. Sometimes it lies dormant for a period and at other times, its episodes suddenly resurface. Schizophrenics are unable to perform simple activities of daily life such as preparing meals to taking a bath, etc. This illness continues to boggle the minds of the sufferer, his family, friends, worldwide psychiatrists, psychologists, researchers, and so many more.

Introduction

In this paper, I will discuss Schizophrenia with the intention of giving the reader more insight to this illness that remains a puzzle. I will present a definition of Schizophrenia, some signs, and symptoms, causes including susceptibility, the process of diagnosis, as well as treatment options. According to the World Health Organization, Schizophrenia is a mental illness affecting millions of people in the world today. In the United States alone, the illness affects an estimated 2.4 million adults.

What is Schizophrenia?

Schizophrenia can be defined as a chronic, highly complex mental disorder characterized by a distortion of the mind whereby an individual's general way of life becomes altered with respect to his thought process, actions, feelings, and general perception of the reality of life and people surrounding. The behavioral display of schizophrenia is portrayed by a blatant loss of touch with reality which psychiatrists refer to as psychosis, while the individual suffering from schizophrenia is said to be psychotic. The individual does not always display the same behavior; thus, it differs inexplicably amongst various individuals and is unpredictable. That is the reason it is said about the medications and treatment options for Schizophrenia, that not one size fits all.

The term Schizophrenia was coined by Eugen Bleuler (1857-1939), a Swiss psychiatrist. According to Hooley et al. (2017), In 1911, Bleuer used schizophrenia (from the Greek roots of sxizo, pronounced schizo and meaning to split or crack, and phren, meaning mind) because he believed the condition was characterized primarily by disorganization of thought processes, a lack of coherence between thought and emotion, and an inward orientation away (split off) from reality. Although the term is often thought to reflect a Jekyll and Hyde split personality, this is a major misconception. The splitting does not refer to multiple personalities (an entirely different form of disorder, now called dissociative identity disorder). Instead, in schizophrenia there is a split within the intellect, between the intellect and emotion, and between the intellect and external reality.

Signs and Symptoms of Schizophrenia

The common signs and symptoms of a schizophrenic individual is marked by a strange and outlandish mode of thought, words, actions, feelings and general perception. Having said that, some of the signs and symptoms of schizophrenia include but are not limited to reduced cognitive ability, bizarre dressing and appearances, spontaneous, incoherent speech and body movements, hallucinations, hearing voices, withdrawal, isolation, paranoia, utter distrust and suspicion of everything and everyone, irrespective of how familiar the people, situations, and surroundings have always been. Such behaviors inevitably result in difficulties within their relationships (family, friends, coworkers, and all). Due to the paranoia, they harbor unreasonable beliefs about their family and loved ones. It increasingly becomes almost impossible to reason with them because they are incapable of thinking rationally. Other signs and symptoms include being extremely argumentative, having uncanny attitudes and delusional thoughts, unnecessary anger and intense conversations which could lead to violence and irrational behavior, irritability, confusion, and being quick to accuse others of lying against them or wanting to hurt them.

With respect to Parks, schizophrenia is uncommon among children under the age of 13. When it does happen, it often starts out gradually with the child losing interest in activities or friends, deterioration of school grades, lethargy, and the exhibition of odd behaviors such as running out of the house naked or talking strangely about being poisoned or expressing distrust in their parents. In the case of the elderly, due to other complications of behaviors associated with aging, psychologists and other experts alike tend to dismiss schizophrenia in the elderly. Not to say that schizophrenia in the aforementioned age groups is absent, but it is rare and understudied. Research shows that both men and women are affected by schizophrenia, however men seem to be slightly more affected.

Causes of Schizophrenia

There is no single maintained cause of schizophrenia. The cause of schizophrenia is multi-factorial. Some of the common causes are as follows:

• Genetics - Though genes predispose a person to schizophrenia, they are not solely responsible for the illness. Having a close relative with the illness certainly increases one's chances of diagnosis whereas in the absence of a family history about 1% of the adult population stands the risk of having schizophrenia. According to the National Institute of Mental Health, the highest risk occurs when an identical twin is diagnosed with schizophrenia. The unaffected twin has a roughly 50% chance of developing the disorder. Research also shows that children born to fathers who are 50 years or older, are about three more susceptible to developing schizophrenia eventually.
• Prenatal conditions - According to Langwith (2011), maternal pre-birth malnutrition, exposure to certain viruses especially in the first and second trimesters has been known to elevate the risk of schizophrenia. Other prenatal conditions include lack of oxygen, traumatic labor and delivery, which can damage the baby's brain.
• Brain chemistryParks (2011) mentions that schizophrenia occurs as a result of inexplicable defective brain chemistry. Certain brain chemicals, as well as neurotransmitters like dopamine and glutamate, may contribute to schizophrenia.
• Substance use - Research proves that the ingestion of mind-altering drugs in the teenagers and young adults serve to elevate the risk of schizophrenia. According to the National Institute of Mental Health, A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk. Another study has found that smoking marijuana led to earlier onset of schizophrenia and often preceded the manifestation of the illness.

Diagnosis of Schizophrenia

Using the DSM 5 Criteria as a diagnostic tool for schizophrenia is highly recommended because as Parks (2011), mentions, Schizophrenia can be challenging for mental health professionals to diagnose. She further explains that the reason being that its symptoms are very similar to those of various mental illnesses such as bipolar disorder, which constitutes severe mood swings and depression. Schizophrenia in teenagers is especially difficult to diagnose, as the National Institute of Mental Health explains: This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritabilitybehaviors that are common among teens.

With respect to Parks (2011), prior to the diagnosis, a complete physical examination with blood work is necessary to rule out the possibility of any medical condition. The physician orders a series of tests to check for medically related problems such as neurological conditions, thyroid problems, hypoglycemia, kidney disease, or substance abuse. There is no single physical or lab test that can detect schizophrenia. As soon as medical conditions have been ruled out, a psychiatrist takes over and will usually conduct a complete mental status workup. Such an assessment constitutes observance of the patient's behavior for at least 6 months, as well as interviewing family members to gather information relating to the circumstances that led to the problem at hand.

As mentioned earlier, the DSM 5 Criteria for schizophrenia is ideal. A person must have two or more of the following symptoms during a 1-month period:

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior
• Negative symptoms such as a reduction or absence of emotional expression

It is important to note that cultural bias often play a part in the under-diagnosis of individuals. Peoples of different cultures will explain things differently. African Americans and Latinos are often under-diagnosed. It is therefore helpful for individuals to locate providers that understand their culture and thought process, in order to avoid being under-diagnosed or overlooked.

Treating Schizophrenia

Unfortunately, there is no cure for schizophrenia. Nevertheless, it can be successfully managed. Due to the stigma associated with schizophrenia, many individuals do not seek or complete therapy. Relapse prevention and reduction of symptoms is the goal of proposed treatment, however, of the ones that seek treatment, many do not follow through with the treatment recommendations. Antipsychotic medication and psychotherapy are highly effective and remain the primary treatment for schizophrenia. Recent studies show that cognitive behavioral therapy also produces great results.

Bollas (2016), a psychoanalyst employs the therapeutic method of free talk. According to Bollas (2016), Many psychotic patients will refuse to discuss their hallucinations or report exactly what the voices have said to them. But if helped to associate --- or free talk, as I like to call it - then they, like anyone else, will begin to reveal threads of thought that are preoccupying them In addition, talking about everyday reality instead of struggling with their internal disturbance feels anchoring and safe. When they realize, in time, that they are nevertheless disclosing their thoughts, they may have an initial paranoid reaction, but generally they then discover that this is a mental process that is not harming them; indeed, it is generative and can be nourishing.

Bollas (2016) promotes a more basic method of compassionate, natural body therapies like daily massages and methodical interpersonal communication, which he terms free talk, between the psychotherapist and patient. Despite the success stories using his unique methods shared in his book, many other professionals disregard the unique perspectives and treatment alternatives of Bolla (2016).

Conclusion

In conclusion, the causes or roots of Schizophrenia have still not been fully understood. There is no cure for it. Early intervention, just as Bolla(2016) believes, may be the major component to combating schizophrenia. He mentions in his book When the Sun Bursts: The Enigma of Schizophrenia that if the family of a teenage schizophrenic bring him to psychotherapy consistently, about five times weekly prior to the outbreak of a complete schizophrenic breakdown, then there is the possibility that the schizophrenia

can be corrected, and the teenager can live a normal life. Ongoing research continues to gradually attempt to unravel the web that seems to surround this complex mental illness called schizophrenia. Nevertheless, painful as the case may be, we will simply have to wait for time to tell.

Reference

Bollas, C. (2016). When the sun bursts. New Haven & London: Yale Univ Press.

Hooley, J. M., Butcher, J. N., Nock, M. K., & Mineka, S. (2017). Abnormal psychology. Boston: Pearson Education.

Langwith, J. (2011). Perspectives on diseases and disorders: Schizophrenia. Detroit: Greenhaven Press.

National Alliance on Mental Illness. (2008, June). Schizophrenia. Retrieved December 7, 2018 from https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia

Parks, P. J. (2011). Schizophrenia. San Diego, CA: ReferencePoint Press.

Zuckerman Institute (2018, December 5). Friend or Foe? Brain Area That Controls Social Memory Also Triggers Aggression. NeuroscienceNews. Retrieved December 5, 2018 from https://neurosciencenews.com/social-memory-aggression-10307/

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