What is Schizophrenia?
Schizophrenia is a psychic disruption that causes the person to lose track of reality and no longer be able to differentiate the real from the imaginary. It is one of the main mental disorders of which we are aware.
Initially, it was described by the psychiatrist Emil Kraepelin, at the end of the 19th century. At the time, he called the disease Early Dementia. At the beginning of the 20th century, another psychiatrist, Eugen Bleuler, because he found the previous term inappropriate to what the disease really represents for the patient and also for society, called it schizophrenia.
Contrary to what many people think, the schizophrenic patient is not extremely dangerous, nor does he have a dual personality. These misunderstandings are common due to the population’s lack of information regarding the disease.
According to the World Health Organization (WHO), schizophrenia is the third leading cause of loss of quality of life between 15 and 44 years of age, among all diseases. The disease affects about 1% of the world population and affects people of any age, but it has a higher incidence in the early adolescence until the early 20s in men and, in women, in the late 20s until the early 30s.
Because it develops precisely at a time when the natural conflicts of adolescence or early adulthood – schizophrenia often goes unnoticed by the patient’s parents and even their own. This is because the symptoms are confused with existential crises, revolts against the system and / or the world, selfish alienation, etc.
Currently, there are 7 types of schizophrenia. Check out what they are and what their characteristics are:
Paranoid schizophrenia develops, in most cases, at a more advanced age than other types. It is the most common type of schizophrenia and is characterized by persistent hallucinations and / or delirium, as well as changes in speech and emotions.
Hebephrenic or disorganized schizophrenia
This type of schizophrenia usually develops between 15 and 25 years of age. Characteristics such as disorganized behavior and thoughts are very common. In contrast, delusions and hallucinations, when they happen, pass very quickly.
Catatonic schizophrenia has typical characteristics of movement and speech, which can switch from extreme agitation to extreme stillness. It is the rarest of all types.
This type of schizophrenia usually presents characteristics of other types, such as paranoid, hebephrenic or catatonic, but does not fully fit into one of them.
People affected by this type of schizophrenia already have a history of mental illness, but only have negative symptoms as you will see below.
Negative symptoms are recurrent in this type of schizophrenia and tend to get worse very quickly. Positive symptoms of the disease are very rare.
In cenestopathic schizophrenia, the patient has characteristics that are not covered by any other type reported here.
It is still unclear what are the real causes of schizophrenia. However, scientists and researchers believe that some factors may be related or, at least, influence the development of the disease in someone.
After several researches, it was found that genetics is responsible for at least 50% of schizophrenia cases and the other 50% are due to environmental factors. The greatest evidence of this data is related to studies carried out with identical twins, that is, people who have the same DNA.
In addition, a recent North American research, published on October 19, 2016 in the Journal Nature, found that the disease is developed more actively while the brain of the fetus is still being formed. Another important point reported in the research is that the cause of the disease is not composed only of one gene, but of a series of them, which is called heterogeneity.
Chemical brain circuits
Schizophrenic people have abnormal regulations in some of their neurotransmitters and, consequently, affect cells related to thinking and also to behavior.
Due to the high methodological complexity, few studies have been carried out regarding the relationship of environmental factors with the development of schizophrenia in a person. However, some points were discovered and analyzed:
Periods of brain development
Environmental risk factors
Viruses (influenza, rubella, herpes) in the mother, especially when they occur in the second trimester of pregnancy.
Death of the husband.
High impact event on the mother’s emotional life.
Depression during pregnancy.
Pregnancy complications (bleeding, diabetes, rH incompatibility, pre-eclampsia).
Abnormal fetal growth or development (low birth weight, prematurity, congenital malformations, reduced brain perimeter).
Complications at the time of delivery (asphyxia, emergency cesarean delivery).
Atypical or non-existent mother-child interaction.
Early loss of a parent.
Central Nervous System infections, such as meningitis, encephalitis or measles.
Negative psychological experiences.
Trauma, such as physical and / or sexual abuse.
Use of certain drugs, such as marijuana and LSD.
Before knowing what are the characteristic symptoms of schizophrenia, it is necessary to pay attention to the first signs that the disease causes. Check it out below:
First signs of Schizophrenia
The signs can present themselves in different ways in each person. Sometimes, they may appear mildly, as the months go by. However, in other situations, these signs may appear quite abruptly.
Among the behaviors that can be directly related to schizophrenia, are:
- Listening or seeing something that does not exist;
- Constant feeling of being watched;
- Quirky or meaningless way of writing or speaking;
- Strange body position;
- Feeling indifferent in the face of important situations;
- Regression in performance in studies or work;
- Changes in personal hygiene and appearance;
- Changes in personality;
- Very visible distance from social activities;
- Irrational, fearful or angry responses to relatives and / or friends;
- Inability to sleep or concentration;
- Inappropriate or strange behavior;
- Extreme concern with religion or the occult.
Positive symptoms are considered to be anything that is not normal to have, but that the patient has. They are characterized by psychotic behaviors that make the person lose track of some aspects of life.
Positive symptoms include:
Hallucinations are understood as what the patient sees, hears, has smells and tastes or, still, feels the presence of things that do not exist, however, for those who experience all this, hallucinations are very real.
The most common hallucination among schizophrenics is to hear voices. Most of the patients say that they are rude, critical, abusive or disturbing, but there are those who say that these voices are friendly and pleasant.
Typically, people with schizophrenia do activities, discuss thoughts or talk directly to those voices. In addition, they can come from different places or just one in particular.
Delirium occurs when someone is fully convinced that something is happening and that he or she is the target of some persecution or espionage. Because of this, their behaviors are affected, which can make a person more aggressive.
Delirium episodes can start suddenly or develop over time weeks or months.
Because of these hallucinations and delusions, many people who suffer from schizophrenic disorder may have difficulty in ordering their thoughts and actions, which ends up affecting, even, the way of communicating and / or talking with other people. Some patients say that they feel their minds “foggy”, making it impossible for them to work on their thoughts better.
Disordered movements (agitated movements)
People with schizophrenia can sometimes show disordered and / or agitated movements from one hour to the next and for no apparent reason. Still because of hallucinations, patients say that this happens because of someone else who is controlling it.
Unlike positive ones, negative symptoms are part of the chronic phase of the disease and are characterized by a lack of a person’s normal emotions and behaviors. Symptoms include:
Reduced expression of emotions through speech or tone of voice
Patients who have this characteristic symptom are usually not able to practice empathy, a feeling that makes someone understand what others are going through / feeling. However, this does not mean that the person has no feelings or the like, but only that, at the moment, he is unable to demonstrate what is going on.
Difficulty starting and sustaining an activity
For those who do not understand about the symptoms of schizophrenia, this unwillingness to initiate or sustain something can be interpreted only as laziness on the part of the patient. However, the complexity of the issue is much greater, as the act of starting something becomes challenging. Because of this, many people end up choosing to perform passive activities, which do not require as much effort or reasoning, as watching television.
Feeling of pleasure diminished over the days
No matter how much something pleases that patient, he will not respond positively to the practice of the activity in question. Pleasure is reduced and, therefore, many times the person with schizophrenia ends up abandoning something in half.
Talks and thoughts can lose their chain logic when spoken by someone schizophrenic. For those who live with the patient, it is very important to understand the phrases, so that they feel welcomed and supported.
In some patients, these symptoms are quite mild, but in others, they are more severe and noticeable. Some of the cognitive symptoms present in schizophrenia are:
Difficulty making decisions
With very peculiar thoughts, schizophrenics end up not understanding much of what is said and, for that reason, make immature decisions at first.
Difficulty paying attention to something
Schizophrenic patients are more distracted and dispersed than those who are not, actions that end up impairing reading and / or writing. Because they are unable to focus 100% on something, they end up losing money, too, when it comes to understanding something.
Low comprehension skills
Because many patients are unable to keep an eye on something that is being explained, some of them are unable to understand, in fact, what is happening.
With the lack of understanding of things, many people end up forgetting things that were said to them a little while ago. Learning can also be affected by these faults in memory, having to ask for an explanation about something more than once.
Patients who have the disease in its earliest or most severe form may have neurological signs, such as:
- Facial ticks;
- Impairment in certain movements (which makes the patient more awkward or awkward);
- More abrupt and uncoordinated movements;
- Increased frequency of blinking eyes;
- Disorientation about right-left.
Many of these symptoms are present in other disorders as well, such as Tics Disorder and Gilles de La Tourette Syndrome, which makes it even more difficult when making a diagnosis.
It is not known for certain why these symptoms happen, not least because most of the patients do not have them. However, for those who present the symptoms, they end up going unnoticed by people who do not have great intimacy.
Because of the symptoms mentioned above, some patient behaviors can be affected as well. Once again: they can present themselves in different ways, it will depend a lot on each case.
The behaviors that can be recurrent when there is a schizophrenia are:
A suicide attempt can happen both in the acute phase of schizophrenia and in the chronic phase, and in order for this not to happen, friends and family need to be aware if the patient is constantly complaining about voices or if he is mutilating himself.
Suicide attempts are not uncommon when related to schizophrenia and already add up to 50% among patients with the disease. Of these, about 15% result in a tragic end to death.
Aggressive patients are rare, as aggression is not a common symptom in schizophrenia. However, isolated cases of impulsive reactions or attacks of anger and / or fury can happen.
Resistant to change, some patients have some difficulty in breaking out of the pre-established pattern for them. Hygiene, clothing or food habits are just a few examples of what can happen. Some people with schizophrenia may still develop rituals and repetitions very similar to those of Obsessive-Compulsive Disorder ( OCD ).
Chatting alone / Laughing for no reason
As many schizophrenics hear voices, they can convey the idea that they are talking alone, when, in fact, they are just talking to those who are so present in their daily lives. The same can happen with unmotivated laughter. These symptoms are involuntary and automatic and, therefore, often cannot be controlled.
Symptoms in adolescents
Symptoms in adolescents are very similar to those seen in adults. However, in these cases, they are much more difficult to recognize. This happens, often, because they are confused with typical adolescent behaviors, such as:
- Removal of friends and family;
- Performance drop at school;
- Trouble sleeping;
- Irritability or depressed mood;
- Lack of motivation.
Compared to adults, some symptoms may appear exclusively in adolescents, upwards or downwards:
- They are less likely to have delusions;
- They are more likely to have visual hallucinations.
A patient, in order to be diagnosed with schizophrenia, needs to be under observation by a psychologist or psychiatrist, who will evaluate his actions and behaviors. If the disease is suspected, the specialist will ask for information regarding the patient’s medical history.
There is still no test capable of detecting the presence of schizophrenia in someone, but some tests can be done to eliminate suspicions of other diseases that have similar symptoms in their development process.
These tests are:
- Imaging studies to rule out tumors and / or problems in the structure of the brain;
- Psychological assessment to assess the person’s mental state, as well as to analyze behavior and appearance.
Criteria for diagnosis
As there is no specific exam for the detection of schizophrenia, some specialists use criteria established by the Diagnostic and Statistical Manual of Mental Disorders. Therefore, in order for a person to be diagnosed as schizophrenic, they must have:
- At least two typical symptoms, such as: Delusions; Disorganized behaviors; Disorganized speech; Hallucinations; Negative symptoms that last at least 4 weeks.
- Considerable deficiency in school capacity or, even, in professional or domestic functions.
- Symptoms that persist for 6 months or more.
The treatment for schizophrenia can be divided into 4 types, the most important of which are medication and psychological counseling. Better understand each one of them below.
Medications for Schizophrenia
Medicines are usually used to control the signs and symptoms that the disease causes in the patient. The psychiatrist will be able to try different types of drugs in different doses and compositions – until he finds the one that gets the best result.
The most suitable drugs for schizophrenia are divided into 3 groups, which are:
Typical (or “conventional”) antipsychotics
These drugs control positive symptoms, such as hallucinations and delusions. Among them are:
- Clomipramine ;
- Thioridazine ;
Side effects caused by the use of these drugs are quite recurrent. Among these effects are:
- Dry mouth;
- Blurred vision;
- Constipation ;
Atypical (or “new generation”) antipsychotics
Medicines belonging to this group treat both positive and negative symptoms. They are:
- Aripiprazole ;
- Lexotan ;
- Equilid ;
- Olanzapine ;
- Paliperidone ;
- Risperidone ;
Assorted antipsychotic agents
These drugs have a different function from drugs belonging to the other two groups. They are used to treat the agitation present in people with schizophrenia.
Loxapine is the most indicated medication within this group.
In addition to the use of medications, it is important, in parallel, to do psychological monitoring as well, in addition to social interventions. The forms of therapies can be:
- Individual therapy : This therapy can help the individual to normalize his thoughts, in addition to making him learn to deal with stress and identify early signs of relapse.
- Social skills training: Aims to improve communication and social interactions, including those needed in daily activities.
- Family therapy: Super important to provide support and education about schizophrenia to family members of people who suffer from the disease.
- Professional readaptation: Helps the person to find and keep a job.
People who are in a crisis, or who have very severe symptoms of the disease, may need to be hospitalized to preserve their safety, nutrition, sleep and basic hygiene.
For those who do not respond to drug treatment, electroconvulsive therapy is an option to be considered. It consists of provoking changes in the electrical activity of the brain induced by the passage of electrical currents.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
There is still no way to prove a cure for schizophrenia, but the disease can be very well controlled through the forms of treatment indicated to the patient. To live without major complications with the disease, some measures need to be considered:
If you have schizophrenia, some ways to control your illness are as follows:
- Control stress: Stress can be a trigger for psychosis, so keeping it under control is essential for its improvement.
- Try to practice plenty of sleep: When using medication, you will most likely need more than 8 hours of sleep a day. Many schizophrenics have problems with sleep, but some practices can make it better. Regular exercise and avoiding caffeine are some of them.
- Avoid the use of alcohol and drugs: The abuse of any chemical substance affects the effects of the drugs, in addition to making the symptoms worse.
- Maintain relationships: Try to keep your friends and family in your life and in your treatment plan. If you consider participating in support groups, participate!
Helping a family member or friend
Learning about psychotic disorders and schizophrenia will help you understand what the patient experiences. In addition, there are some ways to support it, which are:
- Respond calmly: To the patient, hallucinations seem real. So, try to talk calmly with him, explaining that you see things differently, in addition to respecting him.
- Pay attention to the triggers of symptoms: With this, you can help the patient avoid the practice or ingestion of substances that harm his mental health.
- Help him with the prescription drugs: Many patients wonder if they really need to use the medication. At such times, you will need to encourage your acquaintance to make use of it in the right way.
- Understand the patient’s lack of awareness: Some people who suffer from schizophrenia do not have the notion that they actually have the disease. So don’t try to convince them of this, just support them and be helpful.
- Help the person to avoid drugs and alcohol: If you are aware of some type of chemical addiction by the patient, help him to avoid the consumption of the substances, as they can trigger a considerable worsening in the symptoms.
When left untreated, schizophrenia can cause several problems and limitations in the patient’s life. Some complications of the disease can be caused or associated with:
- Suicide, suicide attempts or suicidal thoughts;
- Hurt yourself;
- Anxiety disorders and obsessive-compulsive disorder;
- Abuse of alcohol or drugs, including tobacco;
- Inability to work or accompany the school;
- Financial problems;
- Social isolation;
- Health problems;
- Being too victimized;
- Aggressive behavior.
There is no way to prevent schizophrenia or any other mental disorder. However, it is noteworthy that the sooner the disease is diagnosed, the better the treatment and the greater the control of symptoms.
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