Schizophrenia

Schizophrenia

Schizophrenia is a group of severe brain disorders which interfere with a persons interpretation of reality (happenings around him) resulting in combinations of hallucinations, delusions and disordered thinking and behavior.

Schizophrenia is an illness which yields best results when treated early. If not treated early it may become refractory to treatment and may not respond to treatment. If untreated  the ability of people with schizophrenia to function normally and to care for themselves tends to deteriorate over time.

Contrary to some popular belief, schizophrenia isn’t split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking.

Causes

 

Schizophrenia is a serious mental disorder. It is important to understand that the person is not deliberately behaving abnormally – it is not within his control.

Schizophrenia is caused by biological factors leading to disturbances in  chemicals in the brain. Sometimes the problem may disappear on its own, but most often it occurs with no apparent reason. The episode may start at the time of great stress and then the illness runs its course.

A combination of genetics and environment contributes to development of the disease. In a person with a genetic predilection, an environmental trigger causes an imbalance in  certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate, thereby causing the symptoms of schizophrenia. Neuroimaging studies support evidence that schizophrenia is a brain disease.

Risk factors

Certain factors seem to increase the risk of developing or triggering schizophrenia, including:

  • Having a family history of schizophrenia
  • Exposure to viruses, toxins or malnutrition while in the womb, particularly in the first and second trimesters
  • Stressful life circumstances
  • Taking psychoactive drugs during adolescence and young adulthood

Complications

Left untreated, schizophrenia can result in severe emotional, behavioral and health problems, as well as legal and financial problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:

  • Suicide
  • Self-destructive behavior, such as self-injury
  • Depression
  • Abuse of alcohol, drugs or prescription medications
  • Poverty
  • Homelessness
  • Family conflicts
  • Inability to work or attend school
  • Health problems from antipsychotic medications
  • Being a victim or perpetrator of violent crime
  • Heart disease, often related to heavy smoking

Treatment                                                             Schizophrenia is a chronic condition that requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene. 

Medications
Medications are the cornerstone of schizophrenia treatment. Today we have a wide range of medication with little or no side effects that can help a person with schizophrenia to lead a “normal” productive life. We have a large number of patients with schizophrenia who are leading productive lives as software engineers, top level managers, financial consultants etc. 

Antipsychotic medications are the most commonly prescribed to treat schizophrenia. They’re thought to control symptoms by affecting the brain neurotransmitters dopamine and serotonin. A person’s willingness to cooperate with treatment may affect medication choice. Someone who is uncooperative may need to be given injections instead of taking a pill.

Psychosocial treatments
Although medications are the cornerstone of schizophrenia treatment, once psychosis recedes, psychosocial treatments also are important. These may include:

  • Social skills training. This focuses on improving communication and social interactions.
  • Family therapy. This provides support and education to families dealing with schizophrenia.
  • Vocational rehabilitation and supported employment. This focuses on helping people with schizophrenia find and keep jobs.
  • Individual therapy. Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness.

Schizophrenia and work.

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Symptoms

  • laughing or talking to oneself
  • getting angry or crying without any apparent reason
  • complaints by the person of hearing voices when alone!
  • complaints or ideas that someone is after the person
  • not carrying out one’s own usual daily routine
  • sudden lack of care about personal grooming and hygiene
  • serious disturbances in sleep or lack of appetite
  • person reporting that he or she is seeing things others don’t
  • unexplained violent behavior
  • withdrawal from social activities and people
  • strange ideas and beliefs, such as, that everything on the radio or TV is referring to the person himself, or that everyone knows what the person is thinking, that he knows about other’s thoughts and ideas being transmitted to him
  • lack of organization of thoughts leading to mixture of ideas while talking or talk not making sense

Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive.

Positive symptoms
These reflect an excess or distortion of normal functions. These active, abnormal symptoms may include:

  • Delusions. These beliefs are not based in reality and usually involve misinterpretation of perception or experience. They are the most common of schizophrenic symptoms.
  • Hallucinations. These usually involve seeing or hearing things that don’t exist, although hallucinations can be in any of the senses. Hearing voices is the most common hallucination among people with schizophrenia.
  • Thought disorder. Difficulty speaking and organizing thoughts may result in stopping speech midsentence or putting together meaningless words, sometimes known as “word salad.”
  • Disorganized behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation.

Negative symptoms
Negative symptoms refer to a diminishment or absence of characteristics of normal function. They may appear months or years before positive symptoms. They include:

  • Loss of interest in everyday activities
  • Appearing to lack emotion
  • Reduced ability to plan or carry out activities
  • Neglect of personal hygiene
  • Social withdrawal
  • Loss of motivation

Cognitive symptoms
Cognitive symptoms involve problems with thought processes. These symptoms may be the most disabling in schizophrenia, because they interfere with the ability to perform routine daily tasks. A person with schizophrenia may be born with these symptoms, but they may worsen when the disorder starts. They include:

  • Problems with making sense of information
  • Difficulty paying attention
  • Memory problems

Affective symptoms
Schizophrenia also can affect mood, causing depression or mood swings. In addition, people with schizophrenia often seem inappropriate and odd, causing others to avoid them, which leads to social isolation.

Hospitalization is at times necessary when the person’s behavior is harmful to himself or others, or when the person is not looking after his own basic needs any more. Also, it may be necessary to make sure the person is getting his medication regularly. Schizophrenic patients can sometimes refuse to accept medicines from relatives because they imagine they are being poisoned.