Schizophrenia, a disease of the brain, is one of the most disabling and emotionally devastating illnesses known to man. But, because it has been misunderstood for so long, it has received relatively little attention and its victims have been undeservingly stigmatized. Schizophrenia is not a split personality, which is a rare and very different disorder.
Like cancer and diabetes, schizophrenia has a biological basis; it is not caused by bad parenting or personal weakness. Nor are individuals being treated for schizophrenia more prone to violence than the public, despite media focus on exceptions.
Schizophrenia is, in fact, a relatively common disease, with an estimated one percent of the U. S. population being diagnosed with it over the course of their lives. While there is no known cure for schizophrenia, it is a very treatable disease. Most of those afflicted by schizophrenia respond to drug therapy, and many are able to lead productive and fulfilling lives.
Schizophrenia is characterized by a constellation of distinctive and predictable symptoms. The symptoms that are most commonly associated with the disease are called positive symptoms that denote the presence of grossly abnormal behavior. These include thought disorder, delusions, and hallucinations.
Thought disorder is the diminished ability to think clearly and logically. Often it is manifested by disconnected and nonsensical language that renders the person with schizophrenia incapable of participating in conversation, contributing to his alienation from his family, friends, and society.
Delusions are common among individuals with schizophrenia. An affected person may believe that he is being conspired against (called “paranoid delusion”). “Broadcasting” describes a type of delusion in which the individual with this illness believes that others can hear his thoughts.
Hallucinations can be heard, seen, or even felt; most often, they take the form of voices heard only by the afflicted person. Such voices may describe the person’s actions, warn him of danger or tell him what to do. At times, the individual may hear several voices carrying on a conversation.
The deficit or negative symptoms that represent the absence of normal behavior are less obvious than the “positive symptoms,” but equally serious. These include flat or blunted affect (i.e. lack of emotional expression), apathy, and social withdrawal.
Who gets it?
While schizophrenia can affect anyone at any point in life, it is somewhat more common in those persons who are genetically predisposed to the disease. The first psychotic episode generally occurs in late adolescence or early adulthood.
Studies have shown that some individuals with schizophrenia recover completely, and many others improve to the point where they can live independently, often with the maintenance of drug therapy. Fortunately, this accounts for the majority of cases.
However, approximately 15 percent of people with schizophrenia respond only moderately to medication and require support throughout their lives, while another 15 percent simply do not respond to existing treatment. New therapies may offer hope for the treatment of these most seriously affected sufferers.
How is it treated?
Hospitalization is often necessary in cases of acute schizophrenia. This ensures the safety of the affected person. Once the most troubling symptoms are controlled by medication, the person often does not require hospitalization.
Depending on the seriousness of the disease, the person may utilize day programs, rehabilitation facilities, and be treated in an outpatient setting. This allows the psychiatrist to adjust medication dosages as necessary over the course of the disease. The person may also need assistance in readjusting to society once his or her symptoms are controlled.
Supportive counseling or psychotherapy may be appropriate for these individuals as a source of friendship, encouragement, and practical advice during this process. Relatives and friends also can assist in rebuilding the person’s social skills. Such support is very important.
Antipsychotic drugs are used in the treatment of schizophrenia. These medications help relieve the delusions, hallucinations, and thinking problems associated with this devastating disorder. These drugs appear to work by correcting an imbalance in the chemicals that help brain cells communicate with each other. As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need to try several different antipsychotic medications before they find the one, or the combination of medications, that works best for them.
Possible Antipsychotic Medication Side Effects:
As a group, antipsychotic drugs are safe, and serious side effects are relatively rate. Some people may experience side effects that are inconvenient or unpleasant, but not serious.
Most common side effects: dry mouth, constipation, blurred vision, and drowsiness.
Less common side effects: decreased sexual desire, menstrual changes, and stiff muscles on one side of the neck and jaw.
More serious side effects include: restlessness, muscle stiffness, slurred speech, tremors of the hands or feet, and agranulocytosis, which suppresses the production of white blood cells (when taking clozapine) and requires monitoring.
Tardive Dyskinesia is the most unpleasant and serious side effect of antipsychotic drugs causing involuntary facial movements and sometimes jerking or twisting movements of other parts of the body. This condition usually develops in older patients, affecting 15 percent to 20 percent of those who have taken older antipsychotic drugs for years.