of Schizophrenia • Causes
Signs and Symptoms •
Living with Schizophrenia •
How Family and Friends Can Help
one of the most debilitating and baffling mental illnesses,
defines a group of disorders that cause distorted thought
and perception. Thoughts can be scrambled or jump from subject
to subject. Perceptions can be distorted beyond reality, causing
people to see or hear things that are not there.
with schizophrenia go through periods of getting better and
worse --- remission and relapse. They can go for long periods
of time without any symptoms, but because schizophrenia is
often a chronic illness, it requires ongoing medical attention,
like hypertension or diabetes.
Schizophrenia is neither a "split" personality
nor multiple personality disorder, a different and extremely
rare problem. Though often stigmatized for the behaviors caused
by the illness, people with schizophrenia did not bring the
illness upon themselves by becoming involved with the "wrong"
crowd or interests. And, contrary to the beliefs that are
reinforced by movies, television and books, people with the
disorder are more likely to withdraw into isolation or become
victims of crime than they are to hurt anyone else.
Much less common than other chronic diseases,
schizophrenia occurs in around 150 of every 100,000 people,
or about one to one and a half percent of the population,
and usually appears during adolescence or young adulthood.
However, it can be one of the most catastrophic illnesses
because it can cause devastating impairments, emotional and
financial loss and the need for long-term, intensive medical
and supportive care.
Types of Schizophrenia
Schizophrenia can appear in one of many forms.
For example, a person who has constant feelings of being watched,
followed or persecuted is said to have paranoid schizophrenia.
A person who is incoherent but has no delusions is said to
have disorganized schizophrenia. A person who lacks initiative,
motivation, social interest, enjoyment and emotional responsiveness
is said to have undifferentiated schizophrenia. Schizophrenia
can vary in intensity, severity and frequency of both psychotic
and residual symptoms from person to person. Therefore, scientists
use the word "schizophrenia to refer to a range of illnesses
from mild to severe.
has not yet identified the cause of schizophrenia. However,
most experts agree that a serious of factors combine with
a genetic risk to contribute to the start of the disorder.
as the risks for diabetes and heart disease are thought to
run in families, the risk to develop schizophrenia is often
thought to have a genetic link. For example, if one identical
twin develops schizophrenia, the other twin has a 50 to 60
percent chance of developing the illness as well.
what triggers the illness in those with a family risk for
schizophrenia is not yet known. Some theories suggest that
because schizophrenia most often first occurs during the hormonal
changes of puberty, these changes in biochemistry set off
the illness in those who are at risk. In addition, viral infection,
severe stress such as poverty or violence, and other similar
external factors are all viewed as possible causes of the
signs of schizophrenia may not be noticed by family and friends.
People who suffer from schizophrenia sometimes display one
or more of the following symptoms in the early stages of the
feelings of tension
disorder progresses, the symptoms become more intense and
bizarre. The person develops peculiar behavior, begins talking
nonsense and has unusual perceptions. These more severe symptoms
are usually the reason for seeking treatment.
are unusual beliefs that are not based in reality. For example,
people suffering from schizophrenia might believe that someone
can hear their thoughts or control their feelings, actions
are distortions of the senses. Auditory hallucinations cause
people to hear sounds that are not there. Visual hallucinations
cause people to see things that do not exist. Tactile hallucinations
are sensations without cause, like burning or itching. Olfactory
hallucinations, smelling non-existent odors, can also occur.
are thoughts that take on more importance in the sufferer’s
mind than they normally would. The same though returns often
and can become unrealistic. This may include a preoccupation
with health, or “doing the right thing”.
thinking interferes with planning, motivation and communication.
For example, a person may use words that make no sense, or
jump from one thought to another unrelated thought.
withdrawal causes the schizophrenic to seek isolation.
This may include an intolerance of being in crowds, small
gatherings or even with just one other person.
of motivation and emotion as well as apathy are symptoms,
which are troubling for family members to see in their loved
ones. Few people experience all these symptoms at once. Some
may occur during the remission phase and may worsen in the
most active phase of the disorder.
person with schizophrenia is incapable of making life decisions
and requires the help of a legal guardian.”
of schizophrenia does not mean that the person will always
be dependent upon others to make decisions and care for them.
In fact, most people with this illness handle their own affairs
successfully. However, just as people with other medical conditions
may have symptoms that cause periods when their ability to
make decisions is impaired, people with schizophrenia may
require the appointment of someone to handle their affairs
for a specified length of time.
‘pot’ can help sometimes more than regular medicine.”
is a myth. The use of any illicit drug is dangerous and illegal,
no matter who uses them. For people with schizophrenia, such
use can impair judgment, worsen symptoms and cause interactions
with medications. People with schizophrenia often have difficulty
with healthy social interaction. Being with people who use
or sell drugs can place an already vulnerable person in a
potentially dangerous position.
reasons, it is important to inform the treating psychiatrist
of any substance abuse or use. He or she will recommend steps
to take to avoid illicit drug use and deal with the reasons
why the medication appears not to help.
with schizophrenia are violent.”
is not a symptom of schizophrenia and is not common in people
with this disorder. In fact, people with schizophrenia are
more likely to become victims of violence themselves. However,
if violence or aggression occurs, it usually does when a person
feels cornered or misunderstands the intentions of the other
person. Usually hallucinations, delusions, preoccupations
or jumbled thoughts have caused the fears and misunderstandings
that lead to violence.
many other mental illnesses, schizophrenia is usually treated
with a combination of therapies, tailored to the individual’s
symptoms and needs.
medications under the supervision of a psychiatrist is the
treatment of choice for schizophrenia, because the illness
is related to biochemical imbalances. These medications can
reduce hallucinations, delusions and disordered thinking,
but few of them adequately treat the social withdrawal and
apathy that occurs in schizophrenia.
all medications, antipsychotic medications have side effects.
Some, such as dry mouth, dizziness, drowsiness and constipation,
go away with time. Other side effects include restlessness,
tremor and muscle spasms, cramping or stiffness. An irreversible
side effect is tardive dyskinesia, which causes abnormal movements
in the mouth, face and later in the arms and legs.
of these side effects can be helped or avoided when reported
to the psychiatrist. It is important not to abruptly stop
taking the medications, increase the medications or take additional
medications without consulting a doctor. Such changes can
cause relapse or other serious problems.
is usually prescribed through the remission phase of the illness
to prevent relapse. Though relapse may occur even when medication
is taken as prescribed, taking the medication provides the
best protection from future relapse.
and other supportive therapies address the emotional and practical
responses to these illnesses and are typically recommended
in addition to medication.
delusions and isolation caused by schizophrenia can impair
a person’s relationships with other people, daily living,
spiritual growth and job skills. Individual psychotherapy
helps patients to understand their emotions and deal with
life’s problems in a more confident, healthy way. Group
psychotherapy allows patients to learn social skills and gain
emotional support for the difficult times as well as offer
support to others.
therapy helps patients return to daily living skills and routines,
which may have been impaired by mental illness. Activity therapy
focuses on problems through recreational and group activities.
for people with schizophrenia has improved over the past two
decades. While no absolute cure has been identified, modern
treatments have allowed many schizophrenic patients to lead
independent, fulfilling lives. It is important, however, that
people who might have the disorder be diagnosed quickly so
that treatment can begin as soon as possible.
Family and Friends Can Help
way family and friends can help is to take an active role
in having the patient seek treatment. The schizophrenic person
usually believes that delusions and hallucinations are real
and that psychiatric treatment is not needed.
treatment begins, recognize that many of the antipsychotic
medications will likely cause the patient to require more
sleep than usual. Also, understand and be prepared to recognize
possible medication side effects as well as symptoms that
would require contacting the doctor.
clearly and simply. Because the illness can cause problems
with thinking, it is helpful to limit conversation to the
most simple statements and questions. Recognize delusions
and hallucinations as symptoms. The perceptions are real to
the patient; do not argue that the delusion is true or false.
Pointing out that he or she does not have to listen to the
voice or wait for the voice to speak again can be helpful.
a way to empathize. For example, the loud music played by
the neighbors at night might be interpreted in a delusion
as a tactic to control the patient’s thoughts. Rather
than insisting that this is untrue, acknowledge how upsetting
loud music can be while trying to sleep.
structure. Help the person recovering from the illness to
plan the days to include plenty of sleep, healthy food, fresh
air, time for exercise, cleanliness and social interaction.
and friends should plan ahead and be prepared for possible
crises. Medications, phone numbers and other important information
and materials should be kept readily available.
with a relative or friend with schizophrenia can be tremendously
stressful. Family and friends can find emotional support,
understanding and hope from outreach, education and advocacy
groups. Whether you are the victim, a family member or friend,
everyone who is affected by this mental illness should seek