Schizophrenia
Overview
Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isn’t as common as other major mental illnesses, it can be the most chronic and disabling.
People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn and could appear to have lost touch with reality. This lifelong disease can’t be cured but can be controlled with proper treatment.
Contrary to popular belief, schizophrenia is not a split or multiple personalities. Schizophrenia involves a psychosis, a type of mental illness in which a person can’t tell what’s real from what’s imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.
How severe schizophrenia varies from person to person. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively normal lives in between. Still, others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.
What Are the Early Symptoms of Schizophrenia?
The condition usually shows its first signs in men in their late teens or early 20s. It mostly affects women in their early 20s and 30s. The period when symptoms first start and before full psychosis is called the prodromal period. It can last days, weeks, or even years. It can be hard to spot because there’s usually no specific trigger. You might only notice subtle behavioral changes, especially in teens. This includes:
- A change in grades
- Social withdrawal
- Trouble concentrating
- Temper flares
- Difficulty sleeping
Positive Symptoms of Schizophrenia
In this case, the word positive doesn’t mean good. It refers to added thoughts or actions that aren’t based in reality. They’re sometimes called psychotic symptoms and can include:
- Delusions: These are false, mixed, and sometimes strange beliefs that aren’t based in reality and that the person refuses to give up, even when shown the facts. For example, a person with delusions may believe that people can hear their thoughts, that they are God or the devil, or that people are putting thoughts into their head or plotting against them.
- Hallucinations: These involve sensations that aren’t real. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person’s behavior, insult them, or give commands. Less common types include seeing things that aren’t there, smelling strange odors, having a funny taste in your mouth, and feeling sensations on your skin even though nothing is touching your body.
- Catatonia: In this condition, the person may stop speaking, and their body may be fixed in a single position for a very long time.
How Is Schizophrenia Diagnosed?
If symptoms of schizophrenia are present, the doctor will perform a complete medical history and sometimes a physical exam. While there are no laboratory tests to specifically diagnose schizophrenia, the doctor may use various tests, and possibly blood tests or brain imaging studies, to rule out another physical illness or intoxication (substance-induced psychosis) as the cause of the symptoms.
If the doctor finds no other physical reason for the schizophrenia symptoms, they may refer the person to a psychiatrist or psychologist, mental health professionals trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a psychotic disorder. The therapist bases their diagnosis on the person’s and family’s report of symptoms and their observation of the person’s attitude and behavior.
A person is diagnosed with schizophrenia if they have at least two of these symptoms for at least 6 months:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized or catatonic behavior
- Negative symptoms
One of the symptoms has to be
- Delusions
- Hallucinations
- Disorganized speech
During the 6 months, the person must have a month of active symptoms. (It can be less with successful treatment.) Symptoms should negatively affect them socially or at work, and can’t be caused by any other condition.
How Is Schizophrenia Treated?
The goal of schizophrenia treatment is to ease the symptoms and to cut the chances of a relapse, or return of symptoms. Treatment for schizophrenia may include:
- Medications: The primary medications used to treat schizophrenia are called antipsychotics. These drugs don’t cure schizophrenia but help relieve the most troubling symptoms, including delusions, hallucinations, and thinking problems.
- Older (commonly referred to as “first-generation”) antipsychotic medications used include:
- Chlorpromazine (Thorazine)
- Fluphenazine (Prolixin)
- Haloperidol (Haldol)
- Loxapine HCL (Loxapine)
- Perphenazine (Trilafon)
- Thiothixene (Navane)
- Trifluoperazine (Stelazine)