Someone you know, maybe a person in your family or someone at work, has begun to behave strangely. He says he hears voices. He believes people are conspiring against him. The bizarre behavior continues, and he’s acting more and more afraid. He isolates himself to the point where he eventually stops coming to work and avoids interacting with friends and family.

This behavior may be an indication of a chronic and severe brain disorder known as schizophrenia.

About Schizophrenia

The word schizophrenia was coined about 100 years ago by German psychiatrist Paul Eugen Bleuler. Its Greek root words mean “split mind,” which has likely contributed to the popular myth that schizophrenics suffer from “split personalities.” The name actually refers to a split in perception between the real world and a fantasy world of paranoid delusions. Multiple Personality Disorder, or MPD, is a completely different illness with no connection to schizophrenia.

Schizophrenia is a chronic disorder in which a person’s brain chemistry is unbalanced, leading to abnormal thinking, delusions, and hallucinations. Someone with schizophrenia might have visions, or experience imaginary smells, tastes, and sensations that to them seem very real. With antipsychotic medications and treatment, some schizophrenics are able to cope with the illness and function quite well. Some, unfortunately, may lose the ability to take care of themselves.

The symptoms of schizophrenia can be placed into four major categories. They include positive, negative, cognitive, and disorganization.

Positive Symptoms

Positive symptoms are clearly identifiable actions that revolve around a separation from reality. Positive symptoms ebb and flow, ranging from mild to severe.

• Hallucinations: Hallucinations are characterized by the betrayal of a person’s senses. They may hear, see, taste, smell, or touch something that does not exist or cannot be perceived by other people. Most commonly this includes hearing voices in their head that comment on behavior or have an independent conversation with each other.

• Delusions: Delusions are false beliefs that do not correlate with the truths of reality. A person may think they are being followed or spied on, despite no clear evidence. Delusions can also cause a person to interpret books, television, or songs as direct messages intended for them. It is also possible to have delusions of grandeur, where a person believes they are someone famous, or even God.

Negative Symptoms

Negative symptoms can be seen as a decrease in a person’s normal functions. They resemble laziness and depression, which makes them difficult to spot.

• Blunted Affect: A person does not make eye contact, change their facial expression, or show emotions. This is especially noticeable during a time when an appropriate response, such as laughing or crying, is absent.

• Poverty of Speech: A person will not speak, even when spoken to. If they do answer, generally they will only use a word or two.

• Lack of Pleasure: A person with negative symptoms will have no interest in any activities, and rarely get any enjoyment out of anything.

• Lack of Relationships: No interest in maintaining relationships with people, no sense of purpose, or motivation.

Cognitive Symptoms

Cognitive impairment is more difficult to detect than positive or negative symptoms. Sometimes they are not discovered until a neuropsychological test is performed. Cognitive symptoms generally make it hard for a person to complete daily tasks.

• Inability to process information and make decisions based on what they know. Also affects a person’s attention to detail.

• Inability to concentrate or stay focused.

• Difficulty with memory. A person has trouble recalling newly learned information and making use of it.

Disorganization Symptoms

With disorganization, a person will jumble their speech and behavior.

• Thought Disorder: A person’s thought process is scrambled, making it hard for them to logically connect ideas. This can lead to indecipherable speech and made-up words. In addition, a person can experience thought blocking. They will stop mid-sentence and not be able to complete their thought.

• Disorders of Movement: Lack of coordination or repeated motions can occur with disorganization. In severe instances, a person may become catatonic. This odd behavior forces a person to become immobile and unresponsive, even when presented with stimulus. Catatonia has become a rare symptom due to successful treatment.

Schizophrenia affects men and women of every age, race, and economic class. It usually begins in men during their teens and twenties and in women during their twenties and early thirties. In rare cases, it can even affect children.

The exact cause of schizophrenia is unknown. Research suggests that it may be due to a combination of environmental and genetic factors. It is believed that an imbalance of the neurotransmitter dopamine, which helps carry messages between nerve cells the brain and enables thoughts and feelings, may be the root cause of schizophrenia. This imbalance may exist from the birth if a person has inherited certain genes, or it may be triggered by environmental factors that affect brain development, such as premature birth, viral infections during infancy, separation or loss of parents, and sexual or physical abuse in childhood.

Before diagnosing someone as schizophrenic, a physician might conduct a complete physical examination and medical testing, including a complete blood count (CBC), drug and alcohol screening, magnetic resonance imaging (MRI) or computed axial tomography (CT or CAT scan) in order to rule out another underlying causes or disease. A mental health provider might conduct a thorough psychological analysis of the patient, studying the patient’s behavior, appearance, and mental condition.

The criteria for a diagnosis of schizophrenia includes exhibition of at least two symptoms of schizophrenia, an inability to perform normal daily activities, and duration of symptoms for more than six months. A new blood test called “veripsych,” which was developed by researchers at Cambridge University, may also help in early diagnosis by measuring specific proteins found in the blood; although some physicians remain skeptical of this test.

 Schizophrenia is a chronic illness, and requires long-term or even lifelong treatment. The most common treatment is a combination of medications and psychotherapy.

Medication

For some patients, antipsychotic drugs that help regulate dopamine and other neurotransmitters are very effective in helping to control hallucinations and delusions. Some patients may require sedatives to control agitation or violent outbursts. Some may require a combination of the two. As with most medications, there can be side-effects. Antipsychotics may cause drowsiness, blurred vision, vertigo, skin rashes, increased heart rate, and increased skin sensitivity. Additionally, women may experience menstrual problems. There are atypical antipsychotic drugs available today that may have lesser side effects, but all medications must be prescribed and closely supervised by a doctor.

Psychosocial Treatment

In addition to medication, psychosocial treatment is very important. This may include family therapy to help educate families about schizophrenia, social skills training to improve the patient’s ability to interact and communicate with others, occupational therapy to deal with work-related issues, and cognitive behavior therapy to help develop coping skills. It is especially important for schizophrenics to learn to recognize the signs of relapse. Self-help groups can also help by creating a vital support network for the patient.

For someone experiencing severe symptoms, hospitalization may be necessary to carefully monitor the patient’s condition and ensure his or her safety.

Outlook

Coping with a chronic and serious condition like schizophrenia is challenging for the patient and their family. The outlook is better today, thanks to an increased awareness and understanding of the disease, and the development of medications with fewer side-effects.

For a schizophrenia patient’s health and well-being, it is imperative that drug regiments are consistent, and medications are taken on a consistent basis. Also, regular psychosocial therapy and attending support groups can help lessen the severity of the symptoms.

Most of all, the patient needs support from family and friends.