Do you know what schizophrenia is? The following are some of the things you might have heard about the term or about a person who suffers from this mental illness:
- is just hearing voices
- it’s a split personality or multiple personalities
- they’re delusional
- they’re volatile, at risk, all dangerous and paranoid
- it can’t be treated
- they can’t go to uni or hold down a job
- they can be alright one minute and change into a different person the next
Most of the above are wrong. Some are mere myths—not the facts—and heavily influence how many people view schizophrenia.
What causes schizophrenia?
The exact causes are, as yet, unknown but research has suggested that a combination of
- social and
- environmental factors might play a role in the development of this disorder. While cannabis does not cause schizophrenia in itself, studies have shown it increases the risk of developing schizophrenia.
Definition of Schizophrenia
According to the Diagnostic and Statistical Manual (DSM-5), schizophrenia is a severe and chronic mental disorder. It’s characterized by disturbances in thought, perception and behavior.
The NHS agrees; schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms.
And finally, it is a serious mental illness in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behaviour that impairs daily functioning, and can be disabling, Mayo Clinic, 2020.
Skip to symptoms if facts and figures make your eyes glaze over, otherwise stay here to find out more about stats:
- schizophrenia affects less than 1 in 100 people during their lifetime and occurs in all countries, cultures, societies or class
- it runs in families, and if you have a parent or sibling with the illness you are more likely to suffer from it yourself
- men have a higher risk of developing schizophrenia during their lifetime
- psychosis usually first occurs in young people between the ages of 15 and 30 and the age of onset is lower in men
- 38% of people recover after a first episode of psychosis, and symptoms improve for 58% of people
- 25% recovers completely from their first episode
- early intervention and treatment methods, and newer medicines, mean better recovery rates for psychosis and schizophrenia. 10 years after diagnosis:
- 25% improves with treatment, recovery of (almost) all previous functioning and has very few relapse events
- 15% leads a chronic course with little or no improvement and repeated hospital stays over a prolonged part of adult life
- 25% improves, needs significant support to function normally and to get through relapse events
- 10% dies, as a result of suicide
- recovery is more likely if psychotic episodes are treated early
- psychotherapy on its own can’t treat schizophrenia effectively but it can be very useful, together with medication .
Although there’s currently no cure, the treatment success rate with antipsychotic medications and psycho-social therapies can be high. I trained as a Thorn Nurse using psychosocial interventions, and CBT for schizophrenia in Early Intervention and Family Work. The results were often remarkable.
Symptoms of schizophrenia
Schizophrenia has positive and negative symptoms.
Positive symptoms are thinking or behaviour that the person with schizophrenia did not have before they became ill. These can be thought of as being added to their psyche and include:
- hallucinations occur in the five senses, i.e. hearing things that others can’t, seeing, tasting, smelling, feeling/touch
- delusions – unusual beliefs not based on reality for example grandiose, persecutory, somatic, jealous or a mixture
- thought disorder; for example feeling like someone’s putting words into their mind.
Negative symptoms describe thoughts or behaviour that the person used to have before they became ill, but now no longer have or have to a lesser extent. They can be thought of as being lost or taken away from a person’s psyche and can include:
- flat affect; the inability to show emotions
- apathy, lacks motivation, lethargy losing interest in everyday activities
- difficulties talking
- and withdrawing from social situations, friends and relationships.
Everyone is different and not everyone with schizophrenia will get all of the above positive and negative symptoms.
Involves hallucinations and beliefs where the individual feels they’re being watched, harassed or persecuted. The beliefs fall into two categories:
Unusual – they believe for example that the CIA, Local Authority government or police are watching them.
Everyday – the individual may start believing that their mother is being unfaithful. They reached that conclusion because of “evidence” that has nothing to do with cheating (like their mum bought a particular newspaper ). Others around them can see there’s no evidence at all to suggest that their beliefs are true.
These delusions will obviously distressing for the individual and also for those seen as the ‘persecutors’ especially if they are friends or family members.
Paranoid schizophrenia is a common form of schizophrenia. The media often writes wild stories about people with this disease. Note that a schizophrenic is less likely to be dangerous compared to your average member of the public.
What treats schizophrenia?
Specific medications called antipsychotics reduce the symptoms of schizophrenia. The most common antipsychotic drugs include medicine such as Haldol (holaperidol) and Seroquel and(quetiapine) and Zyprexa (Olanzapine). The individual will most likely have to take such medication for the rest of their life. This is true even if symptoms improve. Medication can come in the form of a tablet, liquid, or as an injection.
Other treatments might include Cognitive Behavioural Therapy (CBT), specifically for schizophrenia, social skills training and family interventions. However, it’s important for families to educate themselves about schizophrenia, in the first instance, so that they’re able to support their family member with schizophrenia.
Prognoses differ very much from individual to individual. Treating schizophrenia should be done at at an early stage and will show a substantial deduction in symptoms when medication is used.
Many people with schizophrenia respond well to treatment and can live normal, fulfilling and productive lives in their community. Whereas, others can experience a chronic course with episodes of illness.
Over to you
Of course, the above information is not exhaustive and you might find different sources supply different material. What are your thoughts? Do you or someone you know have a diagnosis of schizophrenia and want to refute any of the above? Would you be able to explain what it means now? I look forward to reading your comments and I’m happy to answer any questions.