Schizophrenia is a chronic and complex mental illness that impacts the way one feels, behaves, and interprets reality. It’s characterized by delusions, hallucinations, and disorganized thinking, which can severely impact daily functioning. If treatment is sought early on, it can help with symptom management and improve the long-term prognosis.
The average age of onset is between the late teen years to early 20’s in men and late ’20s in women. Though it affects men and women equally, women tend to have higher functioning levels because of the delayed onset.
Schizophrenia is characterized by positive, negative, and cognitive symptoms:
- Positive symptoms:
- Hallucinations- include seeing, hearing, or smelling things that are not there though they seem very real to the person experiencing them. Voices heard are often threatening or critical, making them gravely disabling to live with.
- Delusions- Strongly held false beliefs that don’t change despite the evidence provided against them.
- Negative symptoms:
- Flat affect- lack of emotional expression
- Decreased feelings of pleasure
- Monotone speech
- Lack of motor movements and gestures
- Cognitive symptoms: the degree of cognitive symptoms vary amongst individuals; they can be subtle for some and severe for others.
- Poor executive functioning (e.g., planning, information processing, decision making).
- Poor concentration
- Working memory issues (e.g., inability to apply information recently learned).
- Disorganized thinking
- Lack of insight into their condition
The disruptions in thought and affect severely impact the quality of life of those living with schizophrenia. They interfere with a person’s ability to maintain relationships and properly engage in social interactions. This often leads to social withdrawal and feelings of isolation despite how badly one may crave connection with others. Symptoms also interfere with occupations and make it difficult to hold a job. Those with schizophrenia often have a comorbid substance use disorder which exasperates symptoms.
Causes
Currently, science believes there are several risk factors that contribute to the development of schizophrenia. Genetics, brain chemistry, and environmental factors are all thought to play a role.
- Genetics: Having a family history of schizophrenia greatly increases the risk of developing the disorder. Though it is not yet possible to predict which genes cause someone to develop schizophrenia, it is believed to be a combination of several genes and their interaction with environmental factors (e.g., exposure to viruses or psychosocial factors).
- Brain chemistry: Research shows that schizophrenia is a disease of the brain. It involves the overproduction and over-release of the neurotransmitter, Dopamine. Other neurotransmitters such as Glutamate are also implicated in this disorder. According to the Mayo Clinic, some neuroimaging studies have also found differences in brain structure and central nervous systems of those with schizophrenia.
- Environmental factors: Certain environmental circumstances can trigger schizophrenia in those who already have a predisposition for the disorder.
- Taking psychoactive or psychotropic drugs during the teen years or early adulthood.
- Exposure to toxins or viruses
- Stressful life events
Treatment
The goal of treatment is to help the individuals with symptom management so that they can reintegrate back into society and live the best quality life possible given their disorder. The gold standard in treating schizophrenia includes a combination of antipsychotic medication, psychotherapy, and other adjunctive resources. It’s crucial to maintain medication compliance to prevent further psychotic episodes and consequent hospitalizations. Unfortunately, schizophrenic patients are known for non-adherence and poor compliance, resulting in high relapse rates and a less than hopeful prognosis. One study reported that nonadherence rates in schizophrenia range from 37% to 74%. Therefore, it is crucial to provide psychoeducation about the importance of medication compliance and risks associated with relapse.
Those suffering from schizophrenia benefit from personal therapy involving cognitive-behavioral therapy (CBT) as well as daily involvement in groups at outpatient facilities. Additionally, the involvement of families in the treatment process greatly improves outcomes for patients as well as providing support for the families.
Other treatment interventions can include social skills management, personal hygiene management, and job skills training.
Though schizophrenia is a very severe, life-long disease, people can go on to lead happy and healthy lives if they seek and adhere to treatment.