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Schizophrenia

Schizophrenia is a serious mental illness that affects a person’s thoughts, feelings and behaviors, and causes one to abnormally interpret reality. The symptoms of schizophrenia can impair one’s daily functioning, and the illness requires lifelong treatment. It is most often diagnosed between the late teen years and early thirties, and tends to be diagnosed earlier in males than females.

The symptoms of schizophrenia fall into three main categories: psychotic, cognitive and negative symptoms. Psychotic symptoms are those in which one’s sense of reality is distorted, and includes delusions, hallucinations and disorganized thinking, speech, and behavior. Delusions are unrealistic, false beliefs, for example the belief that one can control the weather, or that an enemy is trying to kill you. Hallucinations are defined as seeing or hearing things that aren’t really there. Auditory hallucinations are more commonly associated with schizophrenia. Disorganized thinking, another psychotic symptom, can lead to disorganized speech and impair the ability to communicate clearly. Though uncommon, some may communicate in strings of words that do not make sense together, known as ‘word salad.’ Finally, disorganized or abnormal behavior may present in any number of ways, from resisting instruction, to a complete lack of responsiveness, to useless or excessive movements.

Cognitive symptoms of schizophrenia may include difficulty processing information, trouble learning new information, poor short-term memory, and deficits surrounding attention. Negative symptoms are those in which there is an absence of thought and behavior that is common to most people. This may include lack of attention to personal hygiene, loss of interest in everyday activities, and appearing emotionally restricted or “flat.”

Individuals with schizophrenia can experience any or all of these symptoms, though age can influence which symptoms are most prominent. During the teenage years, common symptoms include a decreased engagement with friends, decreased performance in school, insomnia, irritability, depression, and lack of motivation. Diagnosing schizophrenia in this age group is challenging, as these can be common behaviors for adolescents. Other, more specific, symptoms might include isolating oneself from family and friends, an increase in suspicious or delusional thinking, and visual hallucinations. Those with late-onset schizophrenia, which is diagnosed after the age of 45, most often experience delusions and hallucinations.

The symptoms of schizophrenia are unique to each person suffering from the disease. Symptoms can appear suddenly, or may gradually develop over a period of months or years. Behavior changes that tend to be early warning signs of schizophrenia include hearing or seeing things that aren’t there, feeling as if one is being watched, speech that doesn’t make sense, indifference to situations that are of importance, a change in personal hygiene and appearance, a sudden deterioration in performance at work or school, withdrawal from social activities, angry or irrational reactions to close family and friends, poor sleep, difficulty with concentration, and extreme preoccupation with religion. If several of these symptoms are present for at least two weeks, it is important to get help.

Research indicates that a combination of genetics, brain chemistry, and environmental influences contribute to the development of schizophrenia. Certain risk factors can increase the probability of developing schizophrenia, such as having a family history of the disease and certain pregnancy and birth complications. Some research suggests that taking mind-altering drugs, including marijuana, during early and late adolescence can make one more susceptible to developing schizophrenia.

Schizophrenia is a lifelong disorder, though with appropriate treatment, one can live well with the illness. Treatment focuses on decreasing the severity of symptoms, rather than eradicating symptoms, and on helping individuals learn to navigate life with schizophrenia. The most common treatment approaches include antipsychotic medication and psychosocial treatment. Antipsychotic medication helps to decrease symptom severity, particularly the severity of psychotic symptoms. Psychosocial treatment is multifaceted and includes cognitive behavioral therapy, behavioral skills training, supported employment, and cognitive remediation interventions (training in a set of tasks designed to improve cognitive abilities and social function). Psychosocial treatment helps to address the cognitive and negative symptoms of schizophrenia. Individuals who participate in psychosocial treatment find it easier to navigate the challenging symptoms of schizophrenia.

In addition to these focused modes of treatment, those suffering from schizophrenia also benefit from coordinated specialty care and assertive community treatment. In coordinated speciality care, a team of health experts work together to provide various forms of treatment for the schizophrenic individual. This is typically initiated after the first psychotic episode. Assertive community treatment provides personalized outpatient treatment for those with serious mental illness, specifically aiming to help individuals who are at risk of repeated hospitalization and/or homelessness.

Oftentimes, individuals with schizophrenia are unaware that their social and personal difficulties stem from a mental disorder. If a loved one is exhibiting symptoms of schizophrenia, voice your concerns to that individual. Offering support and encouragement as the individual navigates their symptoms, communicates with medical professionals, and begins treatment is important.