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Schizophrenia - a mental disorder

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Schizophrenia - a mental disorder

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Schizophrenia is a disorder that affects a person's ability to feel, think and behave normally. Such people start interpreting reality differently.

Written by

Dr. Ashok Kumar

Medically reviewed by

Dr. Sowmiya D

Published At September 26, 2013
Reviewed AtFebruary 26, 2024

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 Risk Factors of Schizophrenia?

Medical experts believe that both genetic and environmental factors can lead to the condition, and stressful life events might also trigger symptoms or affect how they develop. Because several things can play a part, scientists cannot say for sure what exactly causes the condition in each person.

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.

  • 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:

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.

Why Is Rehabilitation Important for Individuals Managing Schizophrenia?

Treatment can help many individuals with schizophrenia lead fulfilling lives. Like with other long-term conditions, some patients do really well, while others may still have symptoms and require support. Once schizophrenia symptoms are under control, different types of therapy can continue to assist people in managing the illness and enhancing their lives. Therapy and psychosocial support can help individuals learn social skills, handle stress, spot early signs of relapse, and extend periods of remission. Since schizophrenia often starts in early adulthood, those with the disorder can benefit from rehabilitation to learn life-management skills, finish vocational or educational training, and maintain employment. Sometimes, programs that offer supported employment have proven helpful in enabling individuals with schizophrenia to find jobs in the community.

Family support is crucial for those living with schizophrenia, and families themselves need to be well-informed and supported. Various organizations offer resources and assistance to individuals with schizophrenia, as well as to their families. Patients, family members, and mental health professionals need to remain optimistic, recognizing that many patients experience positive outcomes, challenges can often be addressed, and patients possess personal strengths that should be acknowledged and encouraged.

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.

Frequently Asked Questions

1.

What Causes Schizophrenia?

The causes of schizophrenia are genetic problems, environmental factors, abnormalities in the chemistry of the brain, and certain unknown factors. People with schizophrenia have issues with the dopamine and glutamate in the brain. Having a family history of schizophrenia can also be a causative factor.

2.

What Deficiency Causes Schizophrenia?

In the majority of the patients, a deficiency of vitamin D is known to be a contributing factor to the occurrence of schizophrenia. In some patients, vitamin B12 is also known to be the cause. Supplementation of vitamin B12 and vitamin D is known to be helpful in overcoming the serious effects of this condition.

3.

What Are the Different Types of Schizophrenia?

According to the Diagnostics and Statistical Manual (DSM), schizophrenia is categorized into the following types.
- Disorganized type.
- Residual type.
- Paranoid type.
- Undifferentiated type.
- Catatonic type.

4.

What Are the Symptoms of Schizophrenia?

The various symptoms associated with schizophrenia are:
- Delusions. These are false beliefs that are not based in reality.
- Hallucinations. The individual hears and sees things that do not exist in reality.
- Disorganized speech and thoughts.
- Lacking the ability to remain normal.

5.

What Does a Schizophrenic Episode Look Like?

A patient who is suffering from schizophrenia will experience a wide range of thoughts and symptoms that might be devastating. This might include sounds and images that are very strange. The person will experience a mental shock in response to these incidents. During the schizophrenic episode, the patients totally lose contact with reality and imagine ridiculous incidents.

6.

How Do You Calm a Schizophrenic?

Schizophrenic can be calmed in the following ways:
- Do not argue with them.
- It is essential to provide personal space for them.
- Keep things away that cause fear in their mind.
- In emergency situations, take them to a psychiatrist.

7.

Can Someone With Schizophrenia Live a Normal Life?

It is difficult for a patient with schizophrenia to lead a normal life. In some situations, they are relatively normal, but it is very rare for them to cure completely. A continuous treatment procedure is required to relieve the symptoms of schizophrenia. You must consult the doctor and ask for tips to recover faster.

8.

Why Do Schizophrenics Stay up All Night?

Schizophrenics are known to consume drugs that can interrupt the sleeping pattern of the individual. The normal sleep-wake cycle is greatly affected. Sometimes the unusual thoughts and fear created in their mind might keep them awake.

9.

Why Do I Hear Voices When I Try to Sleep?

Hearing unusual sounds at night might be a sign of mental illness. If this sign persists for a long period of time, the patient will need help from a mental health professional. They can also listen to relaxing music and soothing sounds.

10.

Why Do Schizophrenics Laugh?

The unusual laugh by schizophrenics is known as paradoxical laughter. It might indicate an unstable mood in an individual. They might also express unusual anger in some situations. If you notice such symptoms, you have to contact your doctor immediately.

11.

How Do You Talk to Someone With Schizophrenia?

The following tips can be followed while talking with a schizophrenia patient.
- A person should be calm enough to listen and talk softly.
- Use a communication style that is always positive.
- You should be encouraging and rational.
- Keep conversations very short.
- Do not make any arguments with schizophrenic patients.

12.

Will Schizophrenia Be Cured in the Future?

The cure for schizophrenia totally depends on the cooperation of the patient. Till now, there is no proper cure that has been identified for schizophrenia. With the modern advancement of medical science, it is possible to expect a positive advancement in the field of mental health. Many diagnostic procedures will be identified, and treatment options will be formulated.

13.

Does Schizophrenia Damage the Brain?

Schizophrenia can affect the normal functioning of the brain. There is an abnormality in the level of dopamine in the brain. Any head trauma is known to increase the level of risk for schizophrenia. Patients who are affected by schizophrenia are known to suffer degeneration of the brain tissues.

14.

How Can Schizophrenia Be Cured Permanently?

Schizophrenia cannot be cured permanently. Only the intensity of the symptoms can be reduced. A relief from the symptoms would require constant psychological counseling and great support from the family. If it is diagnosed in an earlier condition, then it is possible to cure the patient faster with the help of behavioral therapy and medications.

15.

What Is the Best Treatment for Schizophrenia?

The best treatment for schizophrenia includes both medications and psychotherapy treatment. The medications are given to reduce the negative effects caused by dopamine. This might include antipsychotic medications that are prescribed by the doctor. In addition to this, family therapy and cognitive behavioral therapy might be necessary. The doctors also advise a new medication called Lumateperone.

16.

Do Schizophrenics Have to Take Medication for Life?

Yes, schizophrenic patients would require lifelong medications even after the symptoms have subsided. There would be additional side effects that are related to the intake of antipsychotic medications. It would be necessary for the patient to consult your doctor and ask for advice on overcoming the symptoms.

17.

What Should Schizophrenics Avoid?

Schizophrenic should avoid the following:
- Drug abuse with cocaine and Amphetamine.
- Elevated intake of sugar.
- Caffeine.
- Refined carbohydrates.
- Stimulating drinks and drugs.

18.

Does Schizophrenia Get Worse as You Age?

Yes, schizophrenia can get worse with age. Loneliness is also a factor that can increase the state of schizophrenia. However, the patient’s occurrence and severity are not standard and can vary according to the individual’s mental status.
Dr. Ashok Kumar
Dr. Ashok Kumar

Geriatrics

Tags:

schizophreniasocial withdrawal of individualmental disorderaggression or suspiciousness
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