Schizophrenia is a long term mental disorder where a person experiences delusions, hallucinations and other cognitive difficulties. It interferes with a person’s ability to think rationally, control his/her emotions, take decisions etc. It can involve breaks with reality and disrupt people’s thought processes and day-to-day functioning. The word ‘schizophrenia’ is derived from Greek for ‘split mind’. Schizophrenia does not relate to a split personality. It is a form of mental illness where a person is unable to differentiate between reality and his/her imagination. It can occur at any age, though the average onset tends to be in the late teens to early 30s. Statistics show that about 1% of the global population suffers from schizophrenia. It tends to be more severe in men than in women. It is possible to live well with schizophrenia.
Schizophrenia is caused due to several factors. Some of them are:
- Genetic Factors: People whose family members suffer from schizophrenia have a higher chance of getting affected by this mental disorder. No single gene is responsible for this disease; rather, a combination of several genes is associated with an increased risk of schizophrenia.
- Environmental Factors: It is widely believed that exposure to trauma or viral infection or malnutrition during pregnancy increases the risk of schizophrenia. Other factors that may contribute towards this disease are viral infections during infancy and substance abuse during teenage years.
- Abnormalities in the brain: Imbalance in the neurotransmitters such as dopamine, glutamate, and serotonin may increase the risk of schizophrenia. Other abnormalities in the brain structure, for example, enlarged brain ventricles can also cause schizophrenia as it affects the planning and decision making of the brain.
The symptoms of schizophrenia are classified into four categories:
- Positive Symptoms: These are also known as psychotic symptoms and refer to behaviours not associated with healthy people. They are disturbances that are added to the person’s personality. The severity of these symptoms varies according to time. For example: delusions, hallucinations, thought and speech disorders. Movement disorders (anxiety, agitation, tense), and disorganized behaviour like problems with hygiene, inappropriate dressing sense and unprovoked outbursts.
- Negative Symptoms: They are associated with disruptions to normal emotions and behaviours of a person. These refer to capabilities that are absent in an individual. For example: lack of pleasure, social withdrawal, inability to plan and perform tasks, extreme lack of interest or enthusiasm, lack of drive or initiative and absence of facial expressions etc.
- Cognitive Symptoms: These refer to mental and behavioural problems that are difficult to detect and treat effectively. There are disorganized symptoms such as thought disorder, confusion, and disorientation, difficulty expressing thoughts and feelings and memory problems.
The characteristic symptoms of Schizophrenia are:
- Delusions: These are false beliefs which a person clings on to, despite evidence to the contrary. For example, imagining conspiracies without any evidence, believing that the person is very special or famous, or imagining a major illness without any grounds for it.
- Hallucinations: These include seeing, smelling or feeling things that do not exist, or hearing voices which other people cannot hear.
- Disorganized Speech: These refer to frequent incoherence while speaking.
How is Schizophrenia diagnosed?
Currently, there is no lab test that can accurately diagnose schizophrenia, and medical experts usually rely on clinical symptoms for diagnosis. Some of the techniques which can help diagnose this ailment are:
- Physical Exam: The doctor will conduct a thorough physical examination to find the medical issues responsible for this disorder.
- Medical History: The personal and family health history of the person is probed in detail.
- Psychiatric Evaluation: The behaviour of the person is observed regarding any mood swings, delusions, hallucinations etc.
- Laboratory Tests: Blood and urine tests, MRI and CT scan can be conducted in order to rule out the possibilities of other health problems.
Treatment Options for Schizophrenia
Schizophrenia is a prolonged disorder which has no definite cure, but usually can be controlled. An effective treatment strategy uses a combination of medication, psychosocial treatments and lifestyle changes.
- Medication: Some antipsychotic medications such as Aripiprazole, Quetiapine can be taken to reduce the severity of schizophrenia. But, medications can also cause certain side-effects such as weight gain, dizziness, sleepiness etc. In some cases, doctors may prescribe antidepressants to control the symptoms.
- Psychosocial Treatments: These include therapy sessions, counselling programs and social skills training to improve the coping skills, stress management, improve communication of the patient.
- Self-Help: A person can also do certain things by himself/herself to help manage the symptoms and improve the way the he/she feels and increase his/her self-esteem. For example, seeking social support, ensuring adequate sleep, remaining physically fit and active, avoiding alcohol and substance abuse, keeping oneself busy with activities etc.
Common myths and facts about schizophrenia
- Myth: People with schizophrenia suffer from split personality.
Fact: This is completely false. This myth probably originated due to the fact that the word “schizo” means split. Actually, people with schizophrenia are split or cut off from reality and suffer from delusions and hallucinations, but do not have split personalities.
- Myth: People with schizophrenia are beyond any help and their condition is hopeless.
Fact: With long-term treatment, the symptoms and severity of schizophrenia can be controlled, and can enable people to lead happy and productive lives.
- Myth: People with schizophrenia have no adverse health problems.
Fact: On the contrary, the effects of the mental illness, the side-effects of medications and a stressed lifestyle impacts the health of the affected person and can even lower the life expectancy of the individual.
- Myth: Patients suffer only from delusions and hallucinations.
Fact: Although these are the most common symptoms, people with schizophrenia can also experience low motivation, disorganized speech, social withdrawal and lack of emotions.
- Myth: People with schizophrenia are dangerous.
Fact: Although the delusions and hallucinations can sometimes result in a violent behaviour in some people, a majority of them simply tend to withdraw themselves from the society and do not pose a threat to themselves or others around them.