Schizophrenia

What is schizophrenia?

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.

Who gets schizophrenia?

Schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. .

What causes schizophrenia?

Research suggests that schizophrenia may have several possible causes:

  • Genetics. Schizophrenia isn’t caused by just one genetic variation, but a complex interplay of genetics and environmental influences. While schizophrenia occurs in 1% of the general population, having a history of family psychosis greatly increases the risk. Schizophrenia occurs at roughly 10% of people who have a first-degree relative with the disorder, such as a parent or sibling. The highest risk occurs when an identical twin is diagnosed with schizophrenia. The unaffected twin has a roughly 50% chance of developing the disorder.
  • Environment. Exposure to viruses or malnutrition before birth, particularly in the first and second trimesters has been shown to increase the risk of schizophrenia. Inflammation or autoimmune diseases can also lead to increased immune system
  • Brain chemistry. Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.
  • Substance use. Some studies have suggested that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk. Another study has found that smoking marijuana led to earlier onset of schizophrenia and often preceded the manifestation of the illness.

What are the Early Warning Signs of Schizophrenia?

It’s important to realise that schizophrenia affects everyone differently. Some people have many symptoms, while others have only a few. Symptoms may develop slowly over months or years, or may appear very abruptly. Schizophrenia appears to come and go in cycles, worsening in periods known as relapse or a psychotic episode, but improving or disappearing completely during recovery.

  • Hearing or seeing something that isn’t there
  • A constant feeling of being watched
  • Peculiar or nonsensical way of speaking or writing
  • Strange body positioning
  • Feeling indifferent to very important situations
  • Deterioration of academic or work performance
  • A change in personal hygiene and appearance
  • A change in personality
  • Increasing withdrawal from social situations
  • Irrational, angry or fearful response to loved ones
  • Inability to sleep or concentrate
  • Inappropriate or bizarre behavior
  • Extreme preoccupation with religion or the occult

What are the Symptoms of Schizophrenia?

A medical or mental health professional may use the following terms when discussing the symptoms of schizophrenia.

Positive symptoms are disturbances that are “added” to the person’s personality.

  • Delusions— false ideas–individuals may believe that someone is spying on him or her, or that they are someone famous.
  • Hallucinations–seeing, feeling, tasting, hearing or smelling something that doesn’t really exist. The most common experience is hearing imaginary voices that give commands or comments to the individual.
  • Disordered thinking and speech— moving from one topic to another, in a nonsensical fashion. Individuals may make up their own words or sounds.

Negative symptoms are capabilities that are “lost” from the person’s personality.

  • Social withdrawal
  • Extreme apathy
  • Lack of drive or initiative
  • Emotional unresponsiveness

 What are the Different Types of Schizophrenia?

  • Paranoid schizophrenia— a person feels extremely suspicious, persecuted, or grandiose, or experiences a combination of these emotions.
  • Disorganized schizophrenia— a person is often incoherent in speech and thought, but may not have delusions.
  • Catatonic schizophrenia— a person is withdrawn, mute, negative and often assumes very unusual body positions.
  • Residual schizophrenia— a person is no longer experiencing delusions or hallucinations, but has no motivation or interest in life.
  • Schizoaffective disorder–a person has symptoms of both schizophrenia and a major mood disorder such as depression.

 How is Schizophrenia Treated?

 Treatment involves ALL of these: medication, psychological treatment (talking therapies), psychosocial treatment, and community support. The sooner help is provided for schizophrenia, the better the chances for treatment to be effective.

Your treatment plan and psychological support

Your mental health team will work with you to create your treatment plan. This looks at ways for you to work towards personal goals – things to look forward to when you feel better, such as seeing friends and family, returning to work, going back to study, or exercising regularly. Forming a good relationship with your mental health team will help you learn about your illness, develop skills to minimise stress and other triggers, and learn to manage your symptoms.

Medication is essential for treating schizophrenia.

The main types of medicines are called antipsychotics and they target the imbalance of brain chemicals. Medication will restore normal brain function, not alter it. If you have any questions, ask your psychiatrist, GP or pharmacist. Medication can be given in daily pill or syrup form, as dissolving wafers, or as a fortnightly or monthly injection. A once-monthly injection is useful because it’s one less thing for you to remember to do daily. You may experience side effects when taking antipsychotics. It’s very important to mention any unusual or worrying side effects you experience to your doctor. Side effects may include: muscle spasms, muscle tremors, slowness in movement, dizziness, tiredness or weight gain. These can be treated.

Dispel the myths

There are many misconceptions and stigmas surrounding schizophrenia.

Myth:
People with schizophrenia are violent.

Fact:
People receiving treatment for schizophrenia are no more violent than the rest of the population. They are more likely to be victims of violence due to the misconceptions surrounding the condition.

Myth:
Schizophrenia is a split personality disorder.

Fact:
People with schizophrenia have only one personality. Schizophrenia is an illness that affects the normal functioning of the brain,  interfering with a person’s ability to think, feel and act.

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Dr Somanath CP
Psychiatrist

Dr Somanath is a leading and eminent psychiatrist based in Kochi. He did his MBBS at Medical College Kottayam and post graduation in psychiatry from NIMHANS Bangalore. He has 20 years of experience in the field of psychiatry and worked as faculty in NIMHANS, SH Hospital Painkulam, Thodupuzha, Child Care Centre Gandhinagar and Lakeshore hospital Kochi. His current research interests are Genetics of Psychiatric disorders, Developmental disorders in children, psychosomatic medicine, Health education & Public awareness programme.

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