What is Schizophrenia: The Causes, Symptoms, Treatments and Different Types
Schizophrenia is a mental illness that interferes with the ability to manage emotions, relate to others, make rational decisions and think clearly. When schizophrenia is not treated correctly, it also effects the persons ability to function to their highest potential. Schizophrenia affects about 3.5 million people in the United States, which is approximately 1% population.
Warning Signs of Schizophrenia
It is important to understand that there are several categories of schizophrenia, so the signs of schizophrenia are different for everyone. Some symptoms may appear abruptly, while others may not develop for several months or even years. The signs and symptoms of schizophrenia also come and go in cycles or remission and relapse. Some of the warning signs may include:
- Feeling indifferent during important situations
- Deterioration in work or school performance
- Personality changes
- Hearing and/or seeing something that is not there
- Continuous feelings of being watched
- Difficulties sleeping
- Difficulty concentrating
- Angry, fearful and/or irrational behaviors towards loved ones
- Bizarre and/or inappropriate behaviors
- Extreme preoccupation with religion
- Withdrawing from social situations
- Changes in personal hygiene and/or appearance
What is Schizophrenia’s Symptoms
The symptoms, like the signs of schizophrenia vary widely from one person to the next. There are three broad categories of schizophrenia symptoms; cognitive, negative and positive.
The cognitive symptoms of schizophrenia are more subtle than the positive and negative symptoms. Cognitive symptoms are often difficult to recognize and are usually only detected when there are other tests being performed. The cognitive symptoms typically cause a tremendous amount of emotional distress and can make it difficult to lead a “normal” life. Cognitive symptoms may include:
- Trouble paying attention or focusing
- Difficulties with the ability to understand provided information and using the information to make rational decisions
- Problems using information immediately after learning it
Negative symptoms are difficult to recognize, because they are associated with behaviors and emotions. Negative symptoms of schizophrenia are often mistaken for signs of other conditions, such as depression. The negative symptoms may include:
- Neglecting personal hygiene
- Social withdrawal
- Flat affect (no facial response to emotions)
- Extreme apathy
- Lack of initiative or drive
The positive symptoms of schizophrenia are psychotic behaviors not seen in healthy individuals. Positive symptoms typically come and go and are quite severe at times, while may not be noticeable at other times. Someone with positive symptoms may often lose touch with reality. Positive symptoms may include:
- Hallucinations, which are feeling, seeing, hearing, tasting or smelling something that does not exist. Hearing voices is the most common type of hallucinations.
- Delusions are false ideas the individual may believe, such as they may believe they are famous or that someone is spying on them. A common delusions is that the persons thoughts and behaviors are being controlled by someone else.
- Thought disorders is a disorganization in thinking.
What are the different types of schizophrenia?
There are several different types of schizophrenia, including:
- Catatonic schizophrenia, which means the individual is withdrawn, negative, mute and typically assumes extremely unusual body positions. This type of schizophrenia is the least common.
- Schizoaffective disorder means the person displays symptoms of both schizophrenia and another major mood disorder, such as major depression.
- Residual schizophrenia means the individual no longer experiences hallucinations and/or delusions; however, they no longer have an interest in life and have no motivation.
Paranoid schizophrenia and disorganized schizophrenia are the two most common types of schizophrenia.
Paranoid schizophrenia means the person feels grandiose, extremely suspicious, persecuted or they may experience a combination of all of these emotions. With paranoid schizophrenia the individual loses touch with reality. The primary features of paranoid schizophrenia are hallucinations and/or delusions. The person may have a better ability to function and think in daily life than with other types of schizophrenia; however, someone with this type of schizophrenia is at a high risk of serious complications, such as suicidal behaviors.
What is disorganized schizophrenia?
Disorganized schizophrenia is considered a severe type of schizophrenia, because the individual is typically unable to carry out daily activities, such as meal preparations and personal hygiene. Someone with disorganized schizophrenia displays speech, behaviors and thoughts that are inappropriate and that do not make sense. The individual is often difficult to understand when they are speaking and if they become agitated and/or frustrated it may cause them to lash out.
Although it is possible for children to be diagnosed with schizophrenia, it is uncommon for for children to have a psychiatric illness and it is extremely difficult to recognize a mental illness, such as schizophrenia in children during its early phases. The behaviors of children with schizophrenia typically differ from adults with this illness. It is extremely rare for the symptoms of schizophrenia to appear before the age of 12. Children with this illness often show a delay in language and other functions well before they display psychotic symptoms. The behaviors of children with this diagnosis typically change over time. The psychosis gradually develops and does not have the sudden psychotic break that typically occurs in adults.
What causes schizophrenia?
Although the exact cause of schizophrenia is unclear, there are several theories about the cause, including genetics, immune disorders, viral infections and/or biology.
- Heredity (genetics) is the most common theory for the cause of schizophrenia in children.
- Environmental events may trigger the illness, such as highly stressful situations and/or viral infections.
- A chemical imbalance of the brain chemicals (neurotransmitters), known as dopamine and serotonin.
Treatment of Schizophrenia
Although there is no cure for schizophrenia, with correct treatment most people with this diagnosis can lead fulfilling and productive lives. Since the exact cause of schizophrenia is unknown, the treatments focus on eliminating and controlling the symptoms of the illness. If you suspect someone is experiencing the symptoms of schizophrenia, it is important to seek medical treatment as soon as possible, because early treatment typically means a better outcome. Treatments may include medications and/or psychosocial treatments.
Antipsychotic medications help to reduce the chemical imbalances and help to decrease the chance of a relapse. There are two primary types of antipsychotic medications; conventional antipsychotics and atypical antipsychotics. Conventional antipsychotics help to control the positive symptoms of the illness, such as delusions, hallucinations and the confusion associated with the illness. Atypical antipsychotics are beneficial for treating both the negative and the positive symptoms associated with the illness and they typically have fewer side effects.
Antipsychotic medications have a range of common side effects, including mild side effects such as blurry vision, dry mouth, drowsiness, dizziness and/or constipation. There is also a risk of serious side effects such as tremors, facial ticks, trouble with muscle control and pacing.
Psychosocial treatments are typically recommended in conjunction with medications. Psychosocial treatments may include:
- Rehabilitation and recovery that includes case management, self-help groups, housing programs, drop-in centers, rehabilitation programs that help with life skills, employment, problem solving and stress management.
- Therapy and counseling typically include both individual and group. The most common type of therapy is psychotherapy, often called talk therapy. This type of therapy allows the individual to talk through their experiences with a professional that will help them identify their triggers, stresses and onset of symptoms.
- Cognitive behavioral therapy (CBT) is a form of psychotherapy typically used to treat those with schizophrenia. CBT has an emphasis on coping training, which means the individual is taught a variety of ways to deal with the illness and its symptoms. For example, coping skills may include stress reliving exercises, how to identify hallucinations from reality and dealing with ongoing problems.
One of the most difficult aspects of treating schizophrenia is getting the individual to take their medications. It is common for someone with this illness to not believe they are sick and when they are taking the medications, they begin to feel “normal” again and assume the medications have “cured” them, so they no longer need to take them.
There are a range of myths associated with schizophrenia, including that this is an untreatable disease. Those with schizophrenia are also often thought to be violent; however, those with this illness are typically not violent and the only risk of violence is usually associated with other factors, such as self-medicating with drugs and/or alcohol or combining these with the prescription medications. Even with substance abuse, those with schizophrenia are typically not violent, unless they are provoked.
Schizophrenia can have a profoundly negative impact on the persons life, their family and their community if the illness is not addressed. One of the primary concerns is the serious risk of suicide often associated with schizophrenia. If you suspect your loved one who is diagnosed with schizophrenia may be suicidal, it is extremely important to seek medical attention immediately. The individual with this illness believes they are not sick, because they believe their hallucinations and delusions are real, therefore, they will not typically seek help when they are having suicidal thoughts,especially if they are having a hallucination of someone or something “telling them to kill themselves”.
Family members and loved ones are typically the primary caregivers for someone with schizophrenia, so it is crucial for the family members to also seek counseling and therapy to help with cope with their loved ones illness. When the symptoms of schizophrenia become extreme, it is important for caregivers to recognize these signs and seek help for the person. In most situations those with schizophrenia will require hospitalization if they have been off of their medications for a long period of time. Hospitalization is essential for monitoring the behaviors, reducing the risk of suicidal behaviors and helping the person get back on a regular routine of medications and therapy.