Schizophrenia

Schizophrenia is a mental disorder that affects over 50 million people worldwide (nearly twice as many as people with Alzheimer’s in the US alone), many of whom are unaware of the severity of their illness. Schizophrenia can interrupt ones daily functions and processes, making an ordinary lifestyle extremely difficult. In addition, those with schizophrenia often suffer from additional mental disorders such as depression or anxiety, and are often more at risk for health risks and suicide. As such, schizophrenia can be an extremely severe and dangerous condition, if left untreated.

Explanation- Schizophrenia affects a person’s cognitive faculties, resulting in an impairment in perception, thinking, and emotive responses. This often makes it difficult to differentiate between reality and unreal experiences, to exhibit logical reasoning and emotional identification, and to behave normally in social situations. Schizophrenia typically begins before the age of 45, and it manifests itself progressively over a period of up to 6 months before seriously affecting social and cognitive abilities. Though it occurs in equal rates for both sexes, it has been observed to typically begin at a later age for women than men.

Causes- The exact causes of schizophrenia are unknown, though the leading theories attribute it to a combination of genetic predispositions and a series of environmental conditioning and external stresses that trigger the onset. Complications during birth and development can lead to schizophrenic behavior, as can psychological and social factors in early life.

Brain imaging technology has displayed that dysfunctions in brain activity by those with schizophrenia tends to occur in the frontal and temporal lobes and the hippocampus. The function of dopamine receptors are thought to be particularly responsible in the development. As such drugs like amphetamines that trigger a release of dopamine are especially harmful, and thought to exacerbate the onset of schizophrenia.

Living in urban environments has been shown to increase risk for schizophrenia, as has social disadvantage like poverty, racial discrimination, family dysfunction, and unemployment.

Substance abuse is closely linked to schizophrenia, though a causal relationship has yet to be determined. It is often considered that while overuse of certain substances can lead to the development of schizophrenia, so too can schizophrenic behavior manifest itself in an inclination towards drugs use. The frequent use of cannabis had been previously thought to enhance the onset of schizophrenia, though recent studies indicate that countries displaying an increase in cannabis usage are showing no increase in corresponding schizophrenia. While the verdict is still out on the types of drugs and doses necessary to illicit such a response, it is ultimately dependent on each individual and their own predispositions.

Types: Schizophrenia is classified under five distinct types, based on the predominant characteristics and symptoms exhibited at a given time (though this is ultimately subjective and can vary over time).

  1. Paranoid schizophrenia is characterized by the presence of auditory hallucinations and delusional thoughts, typically centering around conspiracies and persecution, though those suffering from this tend to be far more socially functioning than the other forms, due to the late manifestation of these symptoms.
  2. Disorganized schizophrenia causes impairments in daily activities and thought processes, making routine tasks and speech difficult, and causing emotional instability.
  3. Catatonic schizophrenia involves dysfunctions in mobility, often resulting in the cessation of bodily movements for extended periods of time, or the contorting of facial and bodily positions.
  4. Undifferentiated schizophrenia refers to a person exhibiting behaviors that are not easily classified into one of the above categories.
  5. Residual schizophrenia is when one displays diminished symptoms from the acute phases.

Symptoms- Diagnosing schizophrenia is based on the patients observed behaviors and reported experiences, which can often indicate a break from normal cognition. Schizophrenia often manifests itself in a series of auditory hallucinations, paranoia, delusions, and a disorganization of patterns of speech and thought.

Schizophrenia can begin with mild symptoms such as feelings of tenseness, irritability, insomnia, trouble concentrating, and feelings of isolation and lack of social skills. As it progresses however, the symptoms of psychosis begin to manifest themselves. This can include a lack of emotion and motor behavior, false beliefs about reality, hallucinations (auditory or visual), and disorganization of thoughts. Depending on the type of schizophrenia, these can then escalate into a complete social withdrawal, delusional behavior, inability to take care of personal needs, repetitive behavior, anxiety and aggression, and utter incoherence.

If left untreated, some schizophrenic behavior can lead to displaying violent and suicidal behavior, making it a potential threat for society, as well as for those afflicted. (The United States and Australia are two of the few countries that can legally enforce administration of antipsychotic medication upon those with schizophrenia.)

Treatments- A new class of antipsychotic medication works to alleviate symptoms of schizophrenia by blocking dopamine function, a chemical released by the brain as a neurotransmitter that also regulates responses by the sympathetic nervous system. Many newer medications are preferable for initial treatmnent, though they can be more expensive lead to unpleasant side effects such as obesity and associated risks.

Medication is typically used in conjunction with individual therapies and family-based interventions/ education.

Electroconvulsive therapy can also be prescribed in extreme cases (typically for catatonic schizophrenia), usually after other methods have failed.

Regular exercise can also have a beneficial effect on controlling both the physical and mental symptoms of schizophrenia.

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