Useful Information about Schizophrenia
Schizophrenia is a major mental disorder that affects many people. About one in every one hundred people (1%) develops the disorder at some time in his or her life. It occurs in every country, every culture, every racial group and at every income level. Schizophrenia causes symptoms that can interfere with many aspects of people's lives, especially their work and social life. Some symptoms make it difficult to know what's real and what's not real. These symptoms have been described as being similar to "dreaming when you are wide awake." Other symptoms can cause problems with motivation, concentration, and experiencing enjoyment. It is important to know that there are many reasons to be optimistic about the future: - There is effective treatment for schizophrenia.
- People with schizophrenia can learn to manage their illness.
- People with schizophrenia can lead productive lives.
The more you understand about the illness and take an active role in your treatment, the better you will feel and the more you can accomplish toward your life goals. Schizophrenia is diagnosed based on a clinical interview conducted by a specially trained professional, usually a doctor, but sometimes a nurse, psychologist, social worker or other mental health worker. In the interview, there are questions about symptoms you have experienced and how you are functioning in different areas of your life, such as relationships and work. There is currently no blood test, X-ray, or brain scan that can be used to diagnose schizophrenia. To make an accurate diagnosis, however, the doctor may also request a physical exam and certain lab tests or blood tests in order to rule out other causes of symptoms, such as a brain tumor or an injury. It is important to keep in mind that the symptoms of schizophrenia can be found in other mental disorders. Specifying a diagnosis of schizophrenia is based on a combination of different symptoms, how long they have been present, and their severity. Symptoms that occur only when a person has used alcohol or drugs are not included. No one has the exact same symptoms or is bothered to the same degree. You may, however, recognize having experienced some of the following symptoms: - hallucinations
- delusions
- thought disorders
- cognitive difficulties
- decline in social or occupational functioning
- disorganized or catatonic behavior
- negative symptoms (lack of energy, motivation, pleasure or emotional expression)
"Hallucinations" are false perceptions This means that people hear, see, feel or smell something that is not actually there. Hearing voices is the most common type of hallucination. Some voices might be pleasant, but many times they are unpleasant, saying insulting things or calling people names. When people hear voices, it seems like the sound is coming in through their ears and the voices sound like other human voices. It sounds extremely real. - "A voice kept criticizing me and telling me that I was a bad person."
- "Sometimes I heard two voices talking about me."
Many people also experience visual hallucinations, which involves seeing things that are not there. Some examples: - "Once I saw a lion standing in the doorway to my bedroom."
- "I thought I saw fire coming in the window. No one else saw it."
"Delusions" are false beliefs These are strong beliefs that are firmly held and unshakeable, even when there is evidence that contradicts them. These beliefs are very individual, and not shared by others in their culture or religion. Delusions seem very real to the person experiencing them, but they seem impossible and untrue to others. One common delusion is a belief that others want to hurt them, when they don't (paranoid delusion). Another common delusion is believing that they have special powers, talents or wealth. Other delusions include people believing that another person or force can control their thoughts or actions, or believing that others are referring to them or talking about them. Some examples: - "I believed that someone was trying to poison me."
- "I was convinced that the TV was talking about me."
- "I thought that people were reading my thoughts."
A "thought disorder" is confused thinking This symptom makes it difficult to stay on the topic, use the correct words, form complete sentences, or talk in an organized way that other people can understand. Some examples: - "People told me I jumped from topic to topic. They said I wasn't making sense."
- "I'd be talking and suddenly I would stop in the middle of a thought and couldn't continue. It was like something was blocking my thought."
"Cognitive difficulties" are problems with concentration, memory and abstract reasoning This includes problems with paying attention, remembering things, and understanding concepts. Some examples: - "I had trouble concentrating on reading or watching TV."
- "I couldn't remember plans or appointments."
A "decline in social or occupational functioning" means spending much less time socializing with other people or being unable to go to work or school This symptom is especially important, because it must be present for at least six months in order to diagnose schizophrenia. It is also important because it has a big impact on people being able to carry out their roles in a wide variety of areas, such as taking care of themselves or their children or their household. Some examples: - "It became very uncomfortable to spend time with people. I went from loving to go out with friends to dreading it and avoiding it whenever I could."
- "My job was very important to me, but it became increasingly impossible to do it. I tried very hard, but I had trouble with even the most basic tasks. It was very hard to explain to anyone."
"Disorganized or catatonic behavior" refers to two different extremes of behavior Both are relatively rare. "Disorganized behavior" is behavior that appears random or purposeless to others. "Catatonic behavior" refers to when a person stops almost all movement and is immobile (or almost completely immobile) for long periods of time. An example of disorganized behavior: "I used to spend whole days moving all the pots and pans from the kitchen to the basement to the bathroom then back to the kitchen. Then I'd start all over again." An example of catatonic behavior: "I don't remember this, but my brother told me that before I started getting help, I used to sit in the same chair for hours and hours. I wouldn't move a muscle, not even to take a drink of water." "Negative symptoms" are the lack of energy, motivation, pleasure and expressiveness. Negative symptoms lead to people having problems with initiating and following through with plans, being interested in and enjoying things they used to like, and expressing their emotions to others with their facial expression and voice tone. While these symptoms may be accompanied by feelings of sadness, often they are not. While others may call these symptoms a sign of laziness, it is NOT laziness. Some examples: - "I stopped caring about how I looked. I even stopped taking a shower."
- "It was so hard to start a conversation with people, even when I liked them."
- "I didn't have the energy to go to work or go out with friends."
Schizophrenia is nobody's fault. This means that you did not cause the disorder, and neither did your family members or anyone else. Scientists believe that the symptoms of schizophrenia are caused by a chemical imbalance in the brain. Chemicals called neurotransmitters send messages in the brain. When they are out of balance, they can cause the brain to send messages that contain wrong information. Scientists do not know what causes this chemical imbalance, but they believe that whatever causes it happens before birth. This means that some people have a "biological vulnerability" to develop schizophrenia, which then develops at a later age. In addition to biological vulnerability, stress is also believed to play a role in the onset of schizophrenia and the course of the disorder. Many questions about schizophrenia remain unanswered. There are many research projects underway to try to learn more about the disorder. Most people develop schizophrenia as teenagers or young adults, approximately age 16 to age 30. People vary in how often they have symptoms, the severity of their symptoms and how much the disorder interferes with their lives. Schizophrenia affects people in very different ways. Some people have a milder form of the disorder and only have symptoms a few times in their lives. Other people have a stronger form and have several episodes, some of which require hospitalization. Some people experience symptoms almost constantly, but do not have severe episodes that require hospitalization. Schizophrenia tends to be episodic, with symptoms varying in intensity over time. When symptoms reappear or get worse, this is usually referred to as a "symptom exacerbation" or an "acute episode" or a "relapse". Some relapses can be managed at home, but other relapses may require hospitalization to protect the person or others. With effective treatment most people with schizophrenia can reduce their symptoms and live productive, meaningful lives. Examples of people who have schizophrenia Famous people and everyday people who have developed schizophrenia and live productive lives: - John Nash is an American mathematician who made discoveries in math that had very important applications in the field of Economics. He won the Nobel Prize for Economics in 1994. His story is told in A Beautiful Mind, a book that has also been made into a movie.
- William Chester Minor was an American Army surgeon who also had vast knowledge of the English language and literature. He made major contributions to the Oxford English Dictionary, the most comprehensive dictionary in the world.
- Vaslav Nijinski was a Russian dancer who is legendary because of his physical strength, light movements and expressive body language. He is especially remembered for a dance piece called "Afternoon of a Faun."
- Other people who have developed schizophrenia are not famous, but are quietly leading productive, creative, meaningful lives:
- Mr. X works in an art supply store. He has a close relationship with his two brothers and goes bowling with them regularly. He likes to draw and plans to take an evening art class in the coming year.
- Ms. Y is married and has two children in elementary school. She participates in the home and school association and enjoys gardening.
- Mr. Z lives in a group home and volunteers at the zoo. He used to need frequent hospitalizations, but has successfully stayed out of the hospital for two years. He is looking for paid employment.
This article is adapted from the Illness Management and Recovery Workbook, an Evidence-Based Practice, available on the Substance Abuse, Mental Health Services Administration (SAMHSA) website, a branch of the United States Department of Health and Human Services. |
