Schizophrenia: The Misunderstood Mental Illness

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Although there is a stigma attached to many mental illnesses, schizophrenia may be the most mischaracterized. Unlike common portrayals in movies or television, people suffering from schizophrenia are not violent psychopaths with multiple or split personalities. In reality, schizophrenia is one of the most disabling and puzzling mental disorders, causing it to be severely misunderstood in American society.

What is Schizophrenia?

Schizophrenia is a complex, long-term medical illness that is part of a group of illnesses known as psychotic disorders. These disorders alter a person’s ability to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality and behave appropriately.

When symptoms are severe, people with schizophrenia have difficulty distinguishing between what is real and what is imaginary. They may also be unresponsive or withdrawn and may have difficulty expressing normal emotions in social situations. This often renders them unable to meet the ordinary demands of daily life. However, even severe schizophrenia is usually treatable.

How Common is Schizophrenia?

According to the National Alliance on Mental Illness, schizophrenia affects just over one percent of the world’s population—about 51 million people. The prevalence rates are generally similar from country to country.

Based on the standard prevalence rates, approximately 2.2 million Americans suffer from the illness in varying degrees. The rates of incidence indicate about 100,000 people in the United States will be diagnosed with schizophrenia this year.

Schizophrenia can occur at any age, but the average age of onset is in the late teens to early 20s for men and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40.

What Causes Schizophrenia?

The exact cause of schizophrenia isn’t known, but research indicates several factors may contribute to the risk of developing the disorder:

  • Genetics. Although it is not always the case, schizophrenia sometimes runs in families, which may indicate different genes increase the risk of schizophrenia. There is no single gene that causes the disorder, and it is not yet possible to use genetic information to predict who will develop the illness.
  • Environment. Interactions between a person’s genes and aspects of their environment also appear to be necessary for schizophrenia to develop. Environmental factors may involve exposure to viruses, malnutrition before birth and medical problems during birth.
  • Brain chemistry and structure. An imbalance in the complex, interrelated chemical reactions of the brain involving substances like dopamine and glutamate may also play a role in making one more vulnerable to schizophrenia.

What are the Symptoms of Schizophrenia?

The symptoms of schizophrenia will be different for everyone who gets the disease, but they can be very disabling. The symptoms also come and go, and those suffering from the illness may not experience all symptoms all of the time.

In general, there are three kinds of symptoms associated with schizophrenia:

  • Positive. These symptoms are “add-ons,” or things that start to happen in addition to normal behavior. They may include hallucinations, delusions, confused thoughts or speech and even different bodily movements, such as jumpiness or perfect stillness (catatonia).
  • Negative. These are “subtractions,” or things that stop happening compared to previous behavior. These symptoms can be more difficult to spot, like losing interest in or ability to do certain things or becoming emotionless or withdrawn. Individuals may also struggle with the basics of daily life, such as personal hygiene, or have difficulty with scheduling and finishing what they start.
  • Cognitive. These are related to how someone processes things. Schizophrenia affects how good the brain is at learning, sorting and using information. It can impact a person’s working memory, their ability to pay attention, to organize their thoughts and make decisions.

How is Schizophrenia Treated?

Treatment is usually life-long and involves a combination of medications and therapy to help manage the symptoms and improve the quality of life:

  • Medications. Antipsychotic medications such as Thorazine, Haldol and Abilify are proven effective in treating acute psychosis and reducing the risk of future psychotic episodes. Higher doses are typically used during an acute phase of the illness, followed by life-long treatment using lowered dosages, referred to as the maintenance phase.
  • Therapy. Even with successful drug treatment, many people with schizophrenia have difficulty with thinking, motivation, relationships, communication and aspects of daily living. In these cases, psychosocial treatments can be especially important. Many useful therapies have been developed for treatment, including individual psychotherapy, rehabilitation (vocational and skills counseling), cognitive remediation (to improve thinking skills, memory, planning, etc.), family education and self-help groups.
  • Electroconvulsive Therapy (ECT). ECT is often misunderstood but can be highly effective for certain types of schizophrenia where symptoms are unresponsive to several medications or other forms of therapy. ECT involves using general anesthesia to induce sleep and placing electrodes on the patient’s scalp. A finely controlled electric current is momentarily applied, which causes a brief seizure in the brain. Patients are carefully monitored during the treatment and awaken minutes later, not remembering the treatment or events surrounding it. The patient is often confused for a short period after treatment. ECT is usually given up to three times a week for two to four weeks.

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