Schizophrenia

Schizophrenia is a serious mental illness. There is disturbed and disorganized thinking, language, and behavior. Patients may see, hear, or feel things that are not really there. Sometimes speech is incoherent and there are multiple problems with day to day living. Schizophrenia should not be confused with multiple personality disorder (now called dissociative identity disorder) in which a person has at least two distinct personalities. About 1% of people have schizophrenia in their lifetimes. It affects men and women equally.

CAUSES

There are many theories about the cause of schizophrenia. The genes a person inherits from his or her parents may be partially responsible. Stress in a person's environment can trigger episodes. A person may have functioned normally for years and then have an acute (sudden) psychotic episode caused by stress. Some scientists believe that something might happen before birth, such as a viral infection in the womb, that causes schizophrenic symptoms (problems) decades later. Special scans, such as PET (positron-emission tomography) have been used to look at the brains of people with this illness. These pictures show that some parts of the brain seem to have metabolic or chemical abnormalities. Lab studies have shown that nerve cells in some parts of the brains of schizophrenics may be uneven or damaged. Another possible cause is that chemicals carrying signals between nerve cells may not be working. Schizophrenia does not appear to be caused by family problems. Stress does appear to make things worse for people with this illness.

SYMPTOMS

No single symptom defines this condition. Important signs are:

  • Hallucinations (hearing voices or seeing things that are not there to hear or see).

  • Dressing inappropriately.

  • Neglecting personal hygiene and grooming.

  • Withdrawing from social contacts and not speaking to anybody (autism).

  • Inability to understand what a schizophrenic is saying.

  • A growing distrust of people without good cause.

  • Being very bland or blunted emotionally (flat affect).

TYPES OF SCHIZOPHRENIA

  • Paranoid schizophrenia involves delusional thoughts. The patient believes people around them are against them and plotting against them.

  • In grandiose schizophrenia the patient may feel that he is God, or the President, etc.

  • Disorganized schizophrenia involves symptoms of disorganized speech.

TREATMENT

Medications are the most important part of the treatment of schizophrenia. Many medications are available that can relieve symptoms. It is often helpful if these can be administered by a more trusted family member because the patient may sometimes think they are being poisoned. It is important that the medications be given regularly even when the patient seems to be doing well. Do not stop giving medications without instruction by a caregiver. This could lead to a relapse. Hospitalization may sometimes be necessary if symptoms cannot be controlled with medications.

Schizophrenia may be lifelong. However, periods of illness may be inter spaced with long periods of normality. Medications can greatly improve the quality of life. Non prescribed drugs and alcohol should be avoided.

Assistance is available for care. The National Alliance for the Mentally Ill is an organization of family members of people with severe mental illness. They direct families and patients to support groups, education, and advocacy programs for additional help.

NAMI's (National Alliance for the Mentally Ill) toll-free help line number is 800/950-NAMI, or 800/950-6264.