Schizophrenia

Schizophrenia and Related Disorders

 

Psychosis is a state in which the person loses contact with reality in different means. Schizophrenia is a psychotic disorder in which the person becomes unable to function in the world, in personal, social, and work life. His perception becomes unusual, and symptoms would comprise delusions and hallucinations. Hallucinations are sensory or perceptual experiences that happen without any external stimulus. Delusions are false beliefs that are strongly assumed even though the person has contradictory evidence. Schizophrenia involves a fixed false belief system – life reflects to confirm the deluded perceptions. If one person suffers from Schizophrenia, persistent fear and suspiciousness can occur (paranoid Schizophrenia). Such symptoms make sense if it was developed from your childhood experiences but if it happens afterward in life, it could be a symptom of being Schizophrenic. Such a person can walk into his workplace, and it could seem unfamiliar. People and places could seem new, and it can be frightening. It is like a dog getting into an elevator and getting frightened seeing another floor as the door opens. Sometimes when we sleep at a friend’s place, we could wake up wondering where we are! A normal person can get back the consciousness but someone who is Schizophrenic cannot get back oriented into the space and can feel the situation new. Unusual perceptions, odd thoughts, disturbing emotions, and motor abnormalities happen in the person. The person could be suspicious and as he perceives everyone as a threat, he won’t be open to counseling, or any form of treatment. Tablets and injections can seem threatening. The person may not recognize the staff, even more, he may not recognize his own family. 

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Schizophrenia:

•For 1 month, individual displays two or more of the following symptoms much of the time:

•Delusions: Fixed-False-Belief-Systems

•Hallucinations: Negative or Positive Hallucinations

•Disorganized speech

•Very abnormal motor activity, including catatonia, ‘waxy flexibility’

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At least one of the individual’s symptoms must be delusions, hallucinations, or disorganized speech. Individual functions much more poorly in various life spheres than was the case prior to the symptoms. Beyond this 1 month of intense symptomology, the individual continues to display some degree of impaired functioning for at least 5 additional months

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1% of the population experience schizophrenia at some time in life. There are 3.6 million in the United States and 21 million people in the world suffering from schizophrenia. Relatively, it starts early on average age of 23 for men and 28 for women. 

 

Typically, Schizophrenic people could have visual hallucinations. It could also be auditory or olfactory hallucinations. Hallucinations can be positive or negative hallucinations. Perceptions in the absence of external stimuli (auditory, tactile, visual, gustatory) may occur together. Positive means present and negative means absent. Positive symptoms include delusions, hallucinations, disorganized speech, and disorganized behavior. If a person sits in an office and feels that he is alone but cannot see anyone! Maybe the person can hear people but cannot see. He sees the person is not there, even if you go near the person, he still cannot see the person. On the other hand, the person can see but cannot hear. Positive Hallucinations are Hallucinations in which the person sees things that are not there. Positive symptoms include excesses additions to normal thoughts, emotions, or behaviors. Psychomotor symptoms include slow, awkward movements, repeated grimaces, and odd gestures. 

 

Negative Symptoms include an absence of normal behavior. Negative symptoms include emotional numbness, social withdrawal, uninflected speech, and lack of motivation. In Disorganized Schizophrenia, the person feels the loss of continuity from one moment to the next. The person loses the sequence of life. Such a person can see life as total disorganization. The person could feel pathological deficits. The person could have a scarcity of speech (alogia). Even if the person speaks a few words, it may not make sense to us. The person may feel fewer emotions and may avoid eye contact. The person also could become immobile and have an expressionless face. Having a loss of volition (motivation or directedness), he may feel drained of energy and lose interest in normal goals. The person won’t be having the ability to follow through with a course of action and complete a task. The person could also feel ambivalent - conflicted feelings about most things. The person could also lose the sense of time and may have a time slip. 

 

Schizophrenia primarily arises in the late teens and mid-thirties, and it occurs in three phases. In the first phase known as Prodromal, the person undergoes the beginning of deterioration. The symptoms would be mild in the beginning phase. In the second phase, ‘active,’ symptoms become apparent. In the third ‘residual’ phase, returns to prodromal symptoms. Each phase of the disorder may last for a few days or even years. A full recovery is possible whose disorder was triggered by stress, an abrupt onset, or started during middle age. There is a greater chance of recovery if the person received early treatment and support. 

Schizophrenia can be due to dysfunctional brain structures and circuitry. This circuit includes the prefrontal cortex, hippocampus, amygdala, thalamus, striatum, and substantia nigra, among other structures. There is also racial predisposition. African Americans are more likely than non-Hispanic white Americans to get it.