Schizophrenia
“In my senior year of high school, I began to experience personality
changes. I did not realize the significance of the changes at the time, and I
think others denied them, but looking back I can see that they were the earliest
signs of illness. I became increasingly withdrawn and sullen. I felt alienated
and lonely and hated everyone. I felt as if there were a huge gap between me
and the rest of the world; everybody seemed so distant from me.” This excerpt
describes part of Esse Leete 20-year battle with schizophrenia. She committed
herself to leading the fullest life her disease will allow and to educating
others about mental illness. Schizophrenia is a very serious disease, but
through defining schizophrenia and getting the patient help and treatment a
schizophrenic can lead a full life like any other person.

Schizophrenia is defined as any of a group of psychotic reactions
characterized by withdrawal from reality with highly variable affective,
behavioral and intellectual disturbances by the American Heritage Dictionary.

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No definition of schizophrenia can adequately describe all people with this
illness. Schizophrenia is an extremely complex mental illness. It is clear
that schizophrenia is a disease which makes it difficult for the person with the
illness to decide what is real and what is not (Swados 5). It is also clear
that this brain disease affects normal, intelligent people in all walks of life.

There are six concrete phrases that describe schizophrenia: it is a real
disease, has concrete and specific symptoms, is different from other mental
illnesses, is the result of flaws brain biochemistry, may be treated by specific
antipsychotic drugs, and is almost always treatable.

Scientist are unsure of the causes of schizophrenia, although research
is progressing rapidly. Scientist are almost certain that schizophrenia has
more than one cause. One cause could be a chemical imbalance. An imbalance of
the brain’s chemical system has long been suspected as the main cause of the
illness (Youth 2).A second cause could be stress. Most authorities disagree
that severe stress can cause the illness. Stress can however, worsen the
symptoms when the illness is already present. A third cause could possibly be
genetic predisposition. Genetic transmission has yet to be proven even though
schizophrenia tends to run is some families(Youth 3). For example,
schizophrenia occurs in 1% of the general population but children with one
schizophrenic parent have a 10% chance of developing the illness. When both
parents have schizophrenia the percentage of risk rises to approximately 40%
(Youth 3). Scientists today think that in some types of schizophrenia, the
illness may ride along not only on one common gene, but on various rare genes or
a combination of fairly common genes (Youth 3). While the causes are unclear,
schizophrenia definitely is: not caused by childhood diseases, poverty,
domineering mothers and/or passive fathers, or guilt, failure or misbehavior.

Just like an other illness, schizophrenia has signs or symptoms. The
symptoms are not identical for each person who has the illness. Approximately
one-third of those affected may have only one episode of schizophrenia in his
lifetime while another one-third may have recurring or continual episodes but
lead relatively normal lives in between. A final one-third have symptoms for a
lifetime (Youth 3). Schizophrenia always involves deterioration and changes
from a previous level of functioning. Family members and friends often notice
that the person is “not the same”. The person with schizophrenia has difficulty
in separating what is real from what is unreal. As the person becomes more
stressed by the demands of day to day living, the person may withdraw and the
symptoms become more pronounced (Video). Deterioration is noticeable in ares
such as: work or academic achievement , how one relates to others, and personal
care and hygiene (Video). Symptoms of schizophrenia are noticed in several
different areas. The first area is personality changes. Personality changes
are a key to recognizing schizophrenia. At first, the changes may be subtle,
minor and go unnoticed (Video). As they worsen they become obvious to family
members, friends and co-workers. There is a loss of feeling or emotions, a lack
of interest and motivation (Youth 5). A normally outgoing person becomes
withdrawn, quiet, moody, or inappropriate. When told a sad story, the person
may laugh; a joke may cause him/her to cry; or he/she may be unable to show any
emotion at all (Youth 5).

Another sign is thought change. Thought changes are one of the most
profound changes. These changes in thought are the barrier to clear thinking
and normal reasonableness (Youth 6). Thoughts may be slow in forming, or come
extra fast or not at all. The person may jump from topic to topic, seem
confused or have difficulty reaching easy conclusions. Thinking may be coloured
by delusions and false beliefs that resist logical explanations (Youth 6). A
person may express strong ideas of persecution, convinced that he is being spied
on or plotted against. Others may experience grandiose delusions and feel like
Superman, capable of anything and invulnerable to danger (Youth 7). Some may
feel a strong religious drive or mission to right the wrongs of the world.

Perceptual changes are also another symptom of schizophrenia.

Perceptual changes turn the world of the ill person topsy-turvey (Youth 8). The
nerves carrying sensory messages to the brain from the eyes, ears, nose, skin
and taste buds become confused and the person sees, hears, smells and feels
sensations which are not real. These are called hallucinations. Frequently,
persons with schizophrenia hear voices in their heads condemning them or giving
orders such as “hang yourself”(Youth 9). There is always the danger that the
order will be obeyed. These people see things that others do not see such as a
door in a wall where no door exists or carpets may appear to be walking. There
may be hypersensitivity to sounds tastes and smells. The ring of a telephone
may seem to be as loud as a fire alarm bell or a loved one’s voice as
threatening as a lion’s roar. The sense of touch may be distorted. They may
feel that things are crawling across their skin, or on other occasions they may
feel nothing, not even real pain. The sense of self is also a symptom. This is
when one or all five senses are affected, the person may feel out of time, out
of space, free floating and bodiless and non-existent as a person.

Psychiatrists have attempted to classify schizophrenia into several
types. These classifications are based on years of experience and research with
symptoms and feelings described by patients and observations made by family
members, nurses, doctors and psychiatrists. The first type of schizophrenia is
the disorganized type. This type of schizophrenia is commonly referred to as
the “hebephrenic” type (Youth 11).It has early symptoms which include poor
concentration, moodiness, confusion, and strange ideas. The person’s speech is
frequently incoherent, difficult to understand, rambling. The person’s
delusions or false beliefs are not well established. The person shows
noemotions or they are inappropriate, i.e. silly, giddy laughter (Youth 11).

The second type is the paranoid type. The paranoid type is characterized by
delusions and/or hallucinations with persecution, or less commonly an
exaggerated sense of self importance (Video). Other features may include
anxiety for no apparent reason, anger, argumentativeness, jealousy, and ,
occasionally, violence. The third type is the catatonic type. The criteria for
the catatonic type is a catatonic stupor (marked decrease in reaction to one’s
environment) or mutism (no speech). The person may have motionless resistance
to all instructions or attempts to be physically moved. The person may maintain
a rigid or bizarre posture. Another symptom could also be excited physical
activity which seems purposeless and the is not influence by the their
environment. Another type is the undifferentiated type. Sometimes the major
psychotic symptoms cannot be classified into any category listed, or may match
the criteria for more than one type of schizophrenia. In addition, to the
undifferentiated type there is the residual type. This category is used when
there is at least one recognizable episode of schizophrenia, but no ongoing
obvious psychotic symptoms, though less clear signs of the illness continue,
such as social withdrawal, eccentric behavior, inappropriate emotions, illogical
thinking, etc(Youth 12).

A person who is thought to have schizophrenia needs help and needs to
have treatment. The first step in getting treatment is taking the initiative.

The person with schizophrenia or the family of the patient should ask the family
doctor for an assessment when the symptoms of mental illness are suspected.

Family members will likely be the first to recognize that it is necessary for
the affected person to consult a physician for advice. The family needs to
remember that the ill person believes that the hallucinations, delusion or other
symptoms are real, and so may resist treatment(Youth 13). The second step of
getting treatment is being persistent. It is necessary to find a
doctor/psychiatrist who is familiar with schizophrenia. The assessment and
treatment of schizophrenia need to involve medical people who are well-qualified.

The specialist who is chosen should have an interest in the illness, be
competent, and has empathy with the patients. If there is any apprehension
about the physician/psychiatrist the family has the right to get a second
opinion. Assisting the doctor/psychiatrist is the third step of getting
treatment. Since patients with the illness may not volunteer much information
during the assessment, the family should speak to the doctor or write a letter.

In some cases, it may be necessary to send written information.The
information that is supplied will greatly assist the physician to make an
accurate assessment and outline a suitable course of action.

Presently schizophrenia is not a “curable” disease, but is controllable
(Youth 15). The treatment of schizophrenia could possibly be medication. Most
patients with schizophrenia must regularly take maintenance medication to keep
the illness under control. It is difficult for the doctor/psychiatrist to know
which medication will work best for a given individual. Many changes in type of
drug and dosage may be required. This period of trial and error can be
extremely trying for everyone involved. Some medications have unusual and
difficult side effect