Schizophrenia

 

NB: Information presented here is only for educational purposes. While the information is accurate and up to date, it should NOT be used for self-diagnosis; only a trained psychiatrist is able to offer a mental illness diagnosis.

 

What is Schizophrenia?

 

What comes to mind when the word schizophrenia is spoken? Likely images of a dirty man or woman, with unkempt hair and tattered clothing, chatting away with someone that you can’t see, as they walk slowly down the town market. You might actually cross the road to avoid him or her, so as not to get caught up in their delusion.

Schizophrenia is the major illness that most people think of when they hear about mental illness. The Diagnostic and Statistical Manual of Mental Disorders –aka the Mental illness diagnosis Bible, or DSM-V) describes schizophrenia as “characterized by delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction. For a diagnosis, symptoms must have been present for six months and include at least one month of active symptoms.” 

People with schizophrenia experience some or all of the below symptoms. 

 

Symptoms of Schizophrenia:

 

Schizophrenia symptoms are grouped into ‘positive symptoms’ and ‘negative symptoms.’ Positive symptoms are behaviours not generally seen in healthy people (that is, they are seen as additions to normal behaviour, hence the name ‘positive symptoms’). 

1. Delusions – A delusion is an unshakable theory or belief in something false and impossible, despite evidence to the contrary. Examples include (1) belief that one is an important figure, such as the president or Jesus Christ, or (2) the belief that someone is being talked about or that (3) there are people out to get them (e.g. the police are trying to poison me with poisonous particles delivered through my tap water.)
2. Hallucinations – A hallucination may be a sensory experience in which a person can see, hear, smell, taste, or feel something that is not there. For example, a person suffering from schizophrenia may hear voices or sounds that no one else can ( A person with this symptom might say “I'm hearing 'voices'. The voices have a buzzing sound, and it seems like there are thousands of them. They are talking about me, but I can't make out what they say. Sometimes, I think I hear a voice whispering my name.")
3. Disorganized thinking – Disorganized thinking becomes apparent in a person’s speaking patterns. Affected people lose their train of thought during conversations, make loose associations of topics (often jumping from one topic to another at random, or on the barest of associations), and give answers to unrelated questions. This speech makes no sense to the typical listener. Referred to as ‘kuropokwa’, it may sound like this: “I went to the shop because the cow is on top of the table, looking at me. It said I had two purple teeth and no trousers.” 
4. Movement disorders. Movement disorders cause unusual movements and behavior in people with schizophrenia. These may appear as 
   1. Twitching (that is, sudden movement of a part of the body like the legs)
   2. Becoming agitated or upset for no known reason
   3. Taking frozen statue-like positions whereby one will not move, talk, or react to voices or noises.
   4. Excessive movement without a clear reason

Negative symptoms.  ‘Negative symptoms’ are symptoms that are associated with disruptions to normal emotions and behaviour (that is, they are seen as reduction in normal behaviour, hence the name ‘negative symptoms’). They include:

1. Apathy – A person with schizophrenia may lose interest in activities that previously were important to them such as their work, studies or recreational activities such as sports. They may also stop looking after themselves properly and their personal hygiene and appearance may suffer noticeably. They may be reluctant to leave the house or even their bedroom and may lie in bed for the larger part of the day.
2. Absent, blunted or inconsistent emotional responses – A person with schizophrenia may appear to display no reaction to good or bad news or to react inappropriately for instance laughing at sad news or appearing to become unhappy when hearing good news.
3. Reduction in speech – A person with schizophrenia may appear to have little interest in conversation and may give only very brief responses to questions. Their speech may be disrupted or there may be long pauses in the flow of their speech or in responding to conversation. The ability to make small talk is often completely lost and this loss of important communication skills can impact seriously on the person’s ability to take part in social activities or find employment. In extreme cases the person may become completely mute.
4. Social withdrawal – A Person with schizophrenia may avoid social contact and may prefer to spend the larger part of the day and night by themselves. 
5. Limited or lacking eye contact – When in conversations, a person with schizophrenia may avoid making eye contact with whomever they are speaking with. 
6. Trouble focusing or paying attention, and trouble understanding information and using it to make decisions.
7. Lethargy – A person with schizophrenia experiencing negative symptoms will often have a profound lack of energy and find it difficult to do even light activities. This may lead to them spending a large part of the day in bed or watching television.
8. Sexual problems – There may be a significant reduction or total absence of libido (sex drive), men may experience problems in achieving erections and both men and women may have problems achieving an orgasm.
9. Limited ability to feel pleasure – A person with schizophrenia who experiences this often describes life as being grey or empty, lacking the normal emotional ups and downs that we all take for granted.

 

Causes & Diagnosis:

There is no known single cause of schizophrenia. It is likely the result of several factors, including biological (genes), viruses, social (stressful events e.g. death of a loved one), psychological and environmental components that all contribute to the risk of developing schizophrenia.

 

• Genes: Schizophrenia – like all mental illnesses – runs in families. A person who has a family history of schizophrenia (or mental illness in general) is at greater risk for developing this condition. However, there are many people who have schizophrenia who don’t have a family member with the disorder and conversely, many people with one or more family members with the disorder who do not develop it themselves.

 

• Environmental factors: It is also thought that interactions between genes and aspects of the individual’s environment are necessary for schizophrenia to develop. Environmental factors may involve:
  • Exposure to viruses
  • Malnutrition before birth
  • Problems during birth 

 

Treatment

 

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include:

• Antipsychotics: Antipsychotics are medicines that are usually taken daily in pill or liquid form to manage positive symptoms like hallucinations and delusions. 

• Psychotherapy. People with schizophrenia can work with a therapist or psychiatrist to help them understand their illness, as well as deal with it’s symptoms. For example, a therapist can help a help a person with schizophrenia tell the difference between what’s real and what’s not, as well as how to manage their everyday life and pursue their life goals such as attending school or work. 

 

How can I help someone I know with schizophrenia?

Caring for and supporting a loved one with schizophrenia can be hard. It can be difficult to know how to respond to someone who makes strange or clearly false statements. It is important to understand that schizophrenia is a biological illness (just like diabetes).

Here are some things you can do to help your loved one:

• Get them treatment and encourage them to stay in treatment
• Remember that their beliefs or hallucinations seem very real to them
• Tell them that you acknowledge that everyone has the right to see things their own way
• Be respectful, supportive, and kind without tolerating dangerous or inappropriate behavior
• Check to see if there are any support groups in your area. If there is none, start one.

 

Wangari Murage