Schizophrenia - a mental disorder

What Is Schizophrenia?

Schizophrenia is a mental disorder that makes it hard for an individual to differentiate between what is real and unreal, think clearly, manage emotions, relate to others, and function normally. It affects about 1% of the general population. But this does not mean there is no other hope for a person with schizophrenia. Schizophrenia can be successfully managed.

A person with schizophrenia may see or hear things that do not exist for others, speak in absurd or strange ways, believe that others are conspiring against them, or feel like others are spying or trying to kill them. With such a faint line between the real and the unreal, schizophrenia makes it difficult or even frightening to manage the activities of daily life. In response to such perception, individuals with schizophrenia may isolate themselves from the outside world or may have confusion and fear.

What Are the Clinical Manifestations of Schizophrenia?

The majority of patients with schizophrenia experience the condition in the late second or early third decade of life. Although, schizophrenia can appear for the first time in middle age or even during old age. In very rare cases, schizophrenia can present at a very young age, even before the child attains puberty, although the symptoms are slightly different. It has been said that the earlier the onset of this disease, the more severe it is. Schizophrenia also appears to be more disabling in men than in women.

In this paragraph, I am going to mention a few warning signs that indicate impending danger or risk of developing schizophrenia in the near future.

• Social withdrawal of individuals.

• Aggression or suspiciousness.

• The decline of personal care.

• Flat, expressionless face.

• Inability to experience emotions such as cry or happiness.

• Laughing or crying without reason.

• Remaining sad and alone.

• Increased or decreased sleep.

• Odd or irrational talk.

• Forgetfulness and difficulty in concentrating.

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• Extreme sensitivity to criticism.

• Peculiar use of words or way of talking.

For some people, schizophrenia comes suddenly and without any warning. But for the majority, it appears slowly with minimal warning signs and a slow decline in functioning long before the first severe episode. Many friends and family members of people with schizophrenia acknowledge that if they had known earlier about schizophrenia, they would have brought their dear ones much earlier to the psychiatrist.

How Is Schizophrenia Diagnosed?

Schizophrenia is diagnosed by ruling out other mental health disorders and also by looking for symptoms that are not due to any medication, substance abuse, or other medical condition. Schizophrenia can be determined by:

• Physical Examination - It is done to rule out other problems that cause the symptoms and help check for any other complications.

• Screenings - It helps to rule out conditions with similar symptoms and screen for alcohol and drug abuse.

• Tests - The doctor may request imaging tests such as an MRI (magnetic resonance imaging) or CT (computed tomography) scan.

• Psychiatric Evaluation - A mental health professional or a physician will check the person's mental status by observing his or her appearance and asking about moods, thoughts, delusions, substance use, hallucinations, and potential for violence or suicide. The psychiatric evaluation also includes a personal history and discussion with the family.

• Diagnostic Criteria For Schizophrenia - A mental health professional or a doctor may use the diagnostic criteria published by the American Psychiatric Association.

How Is Schizophrenia Treated?

Even when symptoms have subsided, schizophrenia requires lifelong treatment. Medications and psychosocial therapy help manage the condition.

An experienced psychiatrist usually guides the treatment for schizophrenia. The treatment team may also include,

• Psychologist.

• Psychiatric nurse.

• Social worker.

• Case manager to coordinate care.

This full-team approach may be available in clinics, and in some cases, hospitalization may be required.

Medications:

Medications are the utmost important thing to manage schizophrenia, and antipsychotic medications are most commonly used. These antipsychotic drugs control the symptoms by affecting the brain's neurotransmitter dopamine.

The treatment with antipsychotic medications aims to manage signs and symptoms at the lowest possible dose effectively. Over time, the psychiatrist gives different drugs, doses, or combinations to achieve the desired result. The other medications that may also help schizophrenia are antidepressants or anti-anxiety drugs.

Second-Generation Antipsychotics:

These medications are preferred because they pose a lower risk of side effects than first-generation antipsychotics. Second-generation antipsychotics are:

• Cariprazine.

• Asenapine.

• Brexpiprazole.

• Aripiprazole.

• Clozapine.

• Lurasidone.

• Iloperidone.

• Ziprasidone.

• Olanzapine.

• Quetiapine.

• Paliperidone.

• Risperidone.

First-Generation Antipsychotics:

They have frequent neurological side effects, including the development of a movement disorder that may or may not be reversible. First-generation antipsychotics are:

• Fluphenazine.

• Chlorpromazine.

• Perphenazine.

• Haloperidol.

These antipsychotics are cheaper than second-generation antipsychotics, which is an important factor to consider when long-term treatment is necessary.

Long-Acting Injectable Antipsychotics:

Antipsychotics may also be given as an intramuscular (IM) or subcutaneous injection. Depending on the medication, the antipsychotics are injected every two to four weeks. Injectable antipsychotics are the preferred option if someone prefers fewer pills. The common medications available as an injection are:

• Fluphenazine decanoate.

• Aripiprazole.

• Haloperidol decanoate.

• Risperidone.

• Paliperidone.

Hospitalization:

During severe symptoms, hospitalization may be required to ensure proper safety, nutrition, adequate sleep, and hygiene.

Electroconvulsive Therapy:

If people with schizophrenia above 35 years of age do not respond to drug therapy, electroconvulsive therapy (ECT) may be considered. Electroconvulsive therapy (ECT) may be helpful for people who also have depression.

Conclusion:

Although schizophrenia is said to be a lifelong disorder, there is much help available currently. With the advancement of medical services, in the form of the development of newer medications, sophisticated support, and therapy, most individuals with this disease are able to function independently and lead a satisfying life. However, the outcome is best only when schizophrenia is diagnosed early and treated properly in a consistent manner. If any one of the readers spots the signs and symptoms of schizophrenia in themselves or their loved ones, they are suggested to seek help without delay. You or your loved one can take benefit of the safe and effective treatments available and improve the chances of recovery.

I hope this article has helped the readers and their needy family members and has spread awareness about this debilitating illness.