Understanding Schizophrenia

Goal

To understand what schizophrenia is and how it develops.

What is Schizophrenia?

Schizophrenia is a mental health disorder that involves a psychosis, which is a condition of the mind that causes a person to lose contact with reality. Most mental health professionals believe that psychosis is caused by a combination of brain dysfunction and stress.

What are the symptoms of psychosis?

• Mood swings such as extreme excitement or sadness for no apparent reason.
• Changes in behavior that may include being very active or moving very slowly.
• Laughing or becoming angry without any identifiable reasons.
• Confused thinking that can cause difficulty concentrating, following a conversation or remembering things.
• Delusions, which are strong beliefs in things that aren’t real.
• Hallucinations, or when a person sees, hears, feels, smells or tastes things that aren’t actually there.

There are different types of psychosis:

• Schizophrenia - When a person has experienced behavioral changes and/or symptoms for at least six months.
• Schizophreniform disorder - similar to schizophrenia, except symptoms last for less than 6 months.
• Schizoaffective disorder - When a person has both psychotic symptoms and mood problems such as depression or mania.
• Psychosis caused by recreational drugs.

Prevalence and Cause

Schizophrenia affects about 1% of Americans at some point in their life.

Symptoms usually begin in late teen-age years or young adulthood.

Research suggests that schizophrenia may be caused by a combination of genetic vulnerability and external environmental factors.

What are the symptoms of Schizophrenia? (NIMH)

Positive symptoms (Psychotic behaviors)

• Hallucinations - Things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. “Voices” are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about their behavior, order the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem”.
• Delusions - False beliefs that are not part of the person’s culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves”.
• Thought disorders - Unusual or dysfunctional ways of thinking. One form of thought disorder is called “disorganized thinking”. This is when a person has trouble organizing their thoughts or connecting them logically”. They may talk in a garbled way that is hard to understand. Another form is called “thought blocking”. This is when a person stops speaking abruptly in the middle of a thought. When asked why they stopped talking, the person may say that it felt as if the thought had been taken out of their head. Finally, a person with a thought disorder might make up meaningless words.”
• Movement disorders - Agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic but this is rare today, as treatment for schizophrenia evolved.

Did you know? Positive symptoms generally respond well to medication[1].

Negative symptoms

Negative symptoms are deficits of normal emotional responses or of other thought processes, and are generally less responsive to medication[2].

They include:

• Flat expressions.
• Poverty of speech.
• Inability to experience pleasure.
• Lack of desire to form relationships.
• Lack of motivation.
• Cognitive symptoms. According to NIMH these symptoms include:
  • Poor “executive functioning” (the ability to understand information and use it to make decisions).
  • Trouble focusing or paying attention.
  • Problems with “working memory” (the ability to use information immediately after learning it).

Negative symptoms affect the daily living and may conclude in daily difficulties such as keeping personal hygiene or getting by independently. People who suffer from schizophrenia may be seen as lazy by the lay person, but actually their behavior is mainly the result of these negative symptoms.

Did you know?

Negative symptoms have a crucial impact on people’s life quality, ability to function in work environment and to rehabilitate. They are the symptoms that mostly associate with poor adjustment within the community after the hospitalization period.

Next Step

Hear from Ashley about the experience of suffering from schizophrenia: