What is Schizophrenia?
According to the National Institute of Mental Health (NIMH)
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals to engage in school or work, achieve independence, and enjoy personal relationships.
Different Types of Schizophrenia:
According to MedicineNet.Com
Paranoid-type schizophrenia is distinguished by paranoid behavior, including delusions and auditory hallucinations. Paranoid behavior is exhibited by feelings of persecution, of being watched, or sometimes this behavior is associated with a famous or noteworthy person a celebrity or politician, or an entity such as a corporation.
A person with disorganized-type schizophrenia will exhibit behaviors that are disorganized or speech that may be bizarre or difficult to understand. They may display inappropriate emotions or reactions that do not relate to the situation at-hand. Daily activities such as hygiene, eating, and working may be disrupted or neglected by their disorganized thought patterns.
Disturbances of movement mark catatonic-type schizophrenia. People with this type of schizophrenia may vary between extremes: they may remain immobile or may move all over the place. They may say nothing for hours, or they may repeat everything you say or do. These behaviors put these people with catatonic-type schizophrenia at high risk because they are often unable to take care of themselves or complete daily activities.
Undifferentiated-type schizophrenia is a classification used when a person exhibits behaviors which fit into two or more of the other types of schizophrenia, including symptoms such as delusions, hallucinations, disorganized speech or behavior, catatonic behavior.
When a person has a past history of at least one episode of schizophrenia, but the currently has no symptoms (delusions, hallucinations, disorganized speech or behavior) they are considered to have residual-type schizophrenia. The person may be in complete remission, or may at some point resume symptoms.
According to MedicineNet.Com
Schizophrenia affects about 1.1% of the world's population
3.5 million Americans have schizophrenia
Schizophrenia is most commonly diagnosed between the ages of 16 to 25
Schizophrenia can be hereditary (runs in families)
It affects men 1.5 times more commonly than women
Schizophrenia and its treatment has an enormous effect on the economy, costing between $32.5 - $65 billion each year
What is schizophrenia? - Anees Bahji
Discover what we know— and don’t know— about the symptoms, causes, and treatments of schizophrenia.
Schizophrenia was first identified more than a century ago, but we still don’t know its exact causes. It remains one of the most misunderstood and stigmatized illnesses today. So what do we actually know about its symptoms, causes, and treatments? Anees Bahji investigates.
ARTICLES ABOUT SCHIZOPHRENIA
For more than 30 years much of the focus of neurochemical research in schizophrenia has been on the dopamine hypothesis, although serotonin systems may also be dysfunctional. Certainly, the primary action of antipsychotic drugs is to diminish dopamine D2 receptor-mediated neurotransmission. Although there is little indication of primary disturbances in dopamine (or serotonin) neurotransmission in the schizophrenia, recent functional neuro-imaging studies have demonstrated an increase in stimulated release of dopamine in the brain of patients with schizophrenia. It seems likely that this neurochemical correlate of positive symptoms might be secondary to disturbances in other neurotransmitter systems.
Evidence from in vivo imaging and post-mortem studies of the brain in schizophrenia, as well as from experimental models, points to deficits of γ-aminobutyric acid (GABA)-containing neurons, and dysfunction of glutamate-containing neurons, in the cortex and elsewhere. Such regionally specific neuronal abnormalities probably underlie negative features and cognitive deficits, as well as contributing to a disinhibition of subcortical dopamine. Experimental models suggest that GABAergic deficits, perhaps of developmental origin, could result in progressive damage to other neuronal systems. Several of the recently identified genetic risk factors for schizophrenia also influence neurotransmitter and synaptic function, with some convergence on glutamate. This is providing new targets for antipsychotic drug treatment.
HOW DOES TREATMENT HELP?
"The causes of schizophrenia are complex and are not fully understood, so current treatments focus on managing symptoms and solving problems related to day to day functioning. Treatments include:
Antipsychotic medications can help reduce the intensity and frequency of psychotic symptoms. They are usually taken daily in pill or liquid forms. Some antipsychotic medications are given as injections once or twice a month, which some individuals find to be more convenient than daily oral doses. Patients whose symptoms do not improve with standard antipsychotic medication typically receive clozapine. People treated with clozapine must undergo routine blood testing to detect a potentially dangerous side effect that occurs in 1-2% of patients.
Many people taking antipsychotic medications have side effects such as weight gain, dry mouth, restlessness, and drowsiness when they start taking these medications. Some of these side effects subside over time, but others may persist, which may cause some people to consider stopping their antipsychotic medication. Suddenly stopping medication can be dangerous and it can make schizophrenia symptoms worse. People should not stop taking anti-psychotic medication without talking to a health care provider first.
Shared decision making between doctors and patients is the recommended strategy for determining the best type of medication or medication combination and the right dose. You can find the latest information on warnings, patient medication guides, or newly approved medications on the U.S. Food and Drug Administration (FDA) website.
Cognitive-behavioral therapy, behavioral skills training, supported employment, and cognitive remediation interventions may help address the negative and cognitive symptoms of schizophrenia. A combination of these therapies and antipsychotic medication is common. Psychosocial treatments can be helpful for teaching and improving coping skills to address the everyday challenges of schizophrenia. They can help people pursue their life goals, such as attending school, working, or forming relationships. Individuals who participate in regular psychosocial treatment are less likely to relapse or be hospitalized. For more information on psychosocial treatments, see the Psychotherapies webpage on the NIMH website.
Family Education and Support
Educational programs for family members, significant others, and friends offer instruction about schizophrenia symptoms and treatments, and strategies for assisting the person with the illness. Increasing key supporters’ understanding of psychotic symptoms, treatment options, and the course of recovery can lessen their distress, bolster coping and empowerment, and strengthen their capacity to offer effective assistance. Family-based services may be provided on an individual basis or through multi-family workshops and support groups. For more information about family-based services in your area, you can visit the family education and support groups page on the National Alliance on Mental Illness website.
Coordinated Specialty Care
Coordinated specialty care (CSC) is a general term used to describe recovery-oriented treatment programs for people with first-episode psychosis, an early stage of schizophrenia. A team of health professionals and specialists deliver CSC, which includes psychotherapy, medication management, case management, employment and education support, and family education and support. The person with early psychosis and the teamwork together to make treatment decisions, involving family members as much as possible. Compared to typical care for early psychosis, CSC is more effective at reducing symptoms, improving quality of life, and increasing involvement in work or school. Check here for more information about CSC programs.
Assertive Community Treatment
Assertive Community Treatment (ACT) is designed especially for individuals with schizophrenia who are at risk for repeated hospitalizations or homelessness. The key elements of ACT include a multidisciplinary team, including a medication prescriber, a shared caseload among team members, direct service provision by team members, a high frequency of patient contact, low patient to staff ratios, and outreach to patients in the community. ACT reduces hospitalizations and homelessness among individuals with schizophrenia. Check here for more information about ACT programs."
HOW TO HELP SOMEONE YOU KNOW STRUGGLING:
"Caring for and supporting a loved one with schizophrenia can be very challenging. It can be difficult to know how to respond to someone who is experiencing psychosis.
Help them get treatment and encourage them to stay in treatment
Remember that their beliefs or hallucinations seem very real to them
Tell them that you acknowledge that everyone has the right to see things their way
Be respectful, supportive, and kind without tolerating dangerous or inappropriate behavior
Check to see if there are any support groups in your area"
Educate yourself - do the research
Learn how to validate
"Some symptoms require immediate emergency care. If your loved one is thinking about harming themselves or others or attempting suicide, seek help right away:
Call 911 for emergency services or go to the nearest emergency room.
Call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255) or text the Crisis Text Line (text HELLO to 741741)."
BOOKS THAT EFFECTIVELY PORTRAY SCHIZOPHRENIA
the quiet room: a journey out of the torment of madness
By Lori Schiller, Amanda Bennett
"At seventeen Lori Schiller was the perfect child -- the only daughter of an affluent, close-knit family. Six years later she made her first suicide attempt, then wandered the streets of New York City dressed in ragged clothes, tormenting voices crying out in her mind. Lori Schiller had entered the horrifying world of full-blown schizophrenia. She began an ordeal of hospitalizations, halfway houses, relapses, more suicide attempts, and constant, withering despair. But against all odds, she survived. Now in this personal account, she tells how she did it, taking us not only into her own shattered world, but drawing on the words of the doctors who treated her and family members who suffered with her."
i never promised you a rose garden
by Joanne Greenberg
"I Never Promised You a Rose Garden is the story of a sixteen-year-old who retreats from reality into the bondage of a lushly imagined but threatening kingdom, and her slow and painful journey back to sanity.
Chronicles the three-year battle of a mentally ill, but perceptive, teenage girl against a world of her own creation, emphasizing her relationship with the doctor who gave her the ammunition of self-understanding with which to help herself.
"I wrote this novel, which is a fictionalized autobiography, to give a picture of what being schizophrenic feels like and what can be accomplished with a trusting relationship between a gifted therapist and a willing patient. It is not a case history or study. I like to think it is a hymn to reality." —Joanne Greenberg"
the gene: an intimate history
by Siddhartha Mukherjee
"Spanning the globe and several centuries, The Gene is the story of the quest to decipher the master-code that makes and defines humans, that governs our form and function.
The story of the gene begins in an obscure Augustinian abbey in Moravia in 1856 where a monk stumbles on the idea of a ‘unit of heredity’. It intersects with Darwin’s theory of evolution, and collides with the horrors of Nazi eugenics in the 1940s. The gene transforms post-war biology. It reorganizes our understanding of sexuality, temperament, choice and free will. This is a story driven by human ingenuity and obsessive minds – from Charles Darwin and Gregor Mendel to Francis Crick, James Watson and Rosalind Franklin, and the thousands of scientists still working to understand the code of codes."