Schizophrenia is a very serious mental disorder that influences not only the life of the patient himself/herself, but also of those near them. Occurrence of schizophrenia in our society can be considered a factor that plays its role in the formation of society as it is. That is why it is essential to be able to recognize symptoms of this disorder and respond to its onset fast in order to preserve a "normal" life of the given patient to the greatest extent possible. However, the meaning of "normal life" is questionable in such cases.
Timely initiated appropriate treatment is very important as well as understanding by the patient's loved ones and general public need to be emphasized. The latter should be enhanced by effective awareness-raising policies which are sometimes neglected. That is why schizophrenia is the topic of this article; we strive to show this inscrutable disorder in an undemanding way also to those not directly affected by it. In average, schizophrenia affects 2% of world population, mainly between ages 16 to 30.
What Is Schizophrenia?
Lay interpretations describing schizophrenia as a certain personality split are wrong because schizophrenia doesn't entail permanent disorientation in space and time, memory disorder or learning disability. Schizophrenia is failure of intellectual abilities; patients are not able to use their mental capacity for particular activities. There are seven clinical forms of schizophrenia:
- paranoid schizophrenia
- hebephrenic (disorganized) schizophrenia
- catatonic schizophrenia
- Undifferentiated schizophrenia
- Residual schizophrenia
- Simple schizophrenia
- Post-psychotic schizophrenia
We could say that people suffering from schizophrenia feel more, understand differently and consequently suffer more. A schizophrenic person experiences various problems such as anxieties, fears and depressions that are so deep and intense they penetrate their life completely and influence them significantly. This is because the most frequent symptoms of schizophrenia are delusions and hallucinations. Practically, it means that a person with such handicap can seldom distinguish between important and unimportant information. We can imagine this condition as absence of a certain "filter" in the schizophrenic's head which usually suppresses secondary perceptions and thoughts. Consequently, the affected person is unable to concentrate because their thoughts are surrounded by an excessive amount of perceptions their mind cannot navigate. Naturally, this makes them confused and unable to think and act clearly. Another frequent symptom is weakened or lost will. In other words, the inability to make a decision, plan something, do something. The affected person loses interest in activities they used to enjoy before and they become very introvert. However, this is not a sign of laziness, unwillingness or malevolence. It is a symptom of the disease, same as the aforementioned delusions or hallucinations.
Periods of Remissions and Intense Manifestations
Despite the symptoms described above, affected people still have some residual work potential and period of so-called remission. Remission is a state when the disorder manifests with lower intensity and urgency. The remission period lengths vary. They alternate with so-called schizophrenic attacks, i.e. with periods of high disorder intensity and pressure on the patient.
When the Brain Doesn't Work Right
The disorder is caused in the brain where there is excessive amount of a chemical called dopamine in some of its parts. This substance serves to transmit information among individual brain cells. Then we are able to imagine that due to the excess dopamine, excessive amount of information simultaneously and the brain is unable to process them, i.e. distinguish important messages from unimportant ones. This all subsequently leads to distorted perception of reality, leading to a different frame of mind and finally to anxiety, fear and confusion.
Medical professionals classify schizophrenia as a psychosis because some of the aforementioned changes occur in the brain. It is a condition where the patient is convinced of bizarre and unfathomable things impossible to disprove by people around them (delusions); furthermore, the patient is convinced that they see or hear something other people don't (hallucinations, usually in the form of non-existent voices) and their speech and behaviour are strange and incomprehensible or disorganized.
Schizophrenia and Its Symptoms
Initial symptoms manifesting before schizophrenia actually develops tend to be non-specific (absent-mindedness, low motivation, reduced energy, depression, sleep disorders, anxiety, social withdrawal, suspiciousness, irritability). The important indicator is the change in behaviour and lifestyle. Early diagnosis and treatment start are therefore crucial. A longer period of untreated psychosis may influence its further development adversely. It sometimes happens that the affected person ends up in a mental hospital. Hospitalization is usually preceded by manifestation of psychotic symptoms, i.e. delusions, hallucinations, disorganized speech and weird behaviour.
Hallucinations are illusions that are significantly lively. The affected person reflects them to their surroundings and believes in them irrefutably. They have a decisive influence on the patient's behaviour. The affected person hears, sees or feels things others do not. We can classify hallucinations into several basic groups: tactile, auditory, visual, olfactory and gustatory.
The most frequent hallucinations are olfactory; we can imagine them as noise, rustle, crackles, whistling or animal voices (simple olfactory hallucinations), and furthermore words and sentences the patients refer to as the silent voices that mock them, terrorize them (verbal olfactory hallucinations). Another type of olfactory hallucinations urges or commands the patients to do something which makes them very dangerous (imperative olfactory hallucinations). Hallucinations may also take the form of removal, dubbing and forcing of thoughts (intrapsychical olfactory hallucinations). Visual hallucinations are less frequent. Gustatory hallucinations often make patients smell various unpleasant smells. Bodily hallucinations are strange bodily feelings, e.g. burning, electrocution and changes in bodily organs. It is therefore clear that schizophrenia and its symptoms are truly very serious.
Delusions, another typical symptoms of schizophrenia, can be explained as irrefutable faith in the correctness of an idea, resistance against proofs and reasons. Delusions differ from classic mistakes by not being rectifiable, so the patient doesn't consider them as symptoms. Same as hallucinations, delusions are classified into several groups - expansive, extrapotential, megalomaniac, depressing, insufficient, hypochondriac, micromaniac, guilt delusions and paranoid delusions.
Expansive delusions make the patient overestimate themselves and their interests, abilities and options. Extrapotential are delusions which make people overly and uncontrollably optimistic and overconfident about their abilities. Megalomaniac delusions make the patient consider themselves an extraordinary person (genius, millionaire, commander). Depressing delusions make the patient underestimate and humiliate themselves, their performance and manifest hopeless pessimism. Hypochondriac delusions make the patient believe they suffer from an incurable disease. Micromaniac delusions are delusions of self-redundancy, guilt delusions make the patient blame themselves for evil deeds and paranoid delusions make them believe they are being hunted, pursued and that someone wants them dead.
Treatment is based on administration of antipsychotics which specifically inhibit psychotic symptoms and therefore reduce the effects of dopamine in the brain. Another significant factor is also a non-pharmaceutical method involving psychoeducation, training of social skills and cognitive training. The first goal of treatment is to remove or at least mitigate psychotic symptoms. Then doctors try to stabilize and improve negative symptoms. The main goal of maintenance treatment is prevention of relapse of psychotic symptoms and maintaining the ability to function in normal life. It is essential that family or other close persons are also involved in the therapy, not only in the matter of help to the patient but also because their own awareness; the therapy helps them comprehend the entire context of schizophrenia.
Schizophrenia is a topic concerning the entire society and it should be approached as such. It is necessary to raise awareness and to show how the patient can preserve their normal life to the greatest extent possible. The truth is that schizophrenia makes patients lose their jobs, do common everyday tasks and keep friends who can misjudge the situation due to lack of information or who might be afraid to keep up a relationship with a person affected like that.