Thursday, October 9, 2014


Schizophrenia is an insidious disease that strikes about 1% of the American population. It's marked by the inability to discern between what is and isn't real, a lack of normal emotional responses, inability to think clearly, and abnormal behavior in social situations. 

Most likely it's an interaction between genes and the environment that causes schizophrenia. There's a 10% greater risk for people with first degree relatives with the disorder (e.g., parent, sibling), and a higher than normal risk if other relatives have it. 

"Psychosis", by Dave Emmet
Scientists believe that an imbalance of neurotransmitters, particularly dopamine and glutamate, may play a significant role. In addition, many people with schizophrenia have larger brain ventricles (fluid filled spaces in the brain) and less grey matter than the average person.

Schizophrenia is an equal opportunity disease. Rates among men and women and between different ethnic groups are roughly the same.

Substance use and addiction is higher for people with schizophrenia. This is particularly true for nicotine. People with schizophrenia seem to be drawn to smoking and are addicted to cigarettes at a rate three times higher than that of the general population.

  • Schizophrenics are violent and dangerous: the majority of violent crimes are not committed by people with schizophrenia, although risk of suicide is particularly high. Approximately 10% die by suicide. This is especially true for young males.
  • People with schizophrenia have more than one personality: schizophrenia is not the same as split personality or multiple personality disorders.
  • People with schizophrenia can't lead productive lives and should be hospitalized: with the proper treatment and strong social support, people with schizophrenia can and do lead very productive lives.
  • Anti-psychotic medication side effects are worse than the symptoms of the disease.
  • Hallucinations: seeing, hearing, or smelling things that are not really there;
  • Delusions: unrealistic false beliefs. For example: believing one possesses extraordinary abilities or powers (e.g., the individual believes they are God, Ghandi, the President, etc.); feelings of paranoia that others are out to get or hurt the them (e.g., the government, aliens, people around the individual); belief that a major catastrophe is imminent, etc.;
  • Disordered behavior/movement: may include agitation, inappropriate or odd posture, lack of responsiveness, behavior that is not goal-focused, etc.;
  • Disordered thinking and speech: impaired communication which may include stringing together words that are meaningless ("word salad"), providing answers to questions that are off-topic and unrelated; and,
  • "Negative symptoms": lack of emotion, not making eye contact, flat speech, being less talkative, poor hygiene, loss of interest in activities, withdrawal/isolation, and inability to experience pleasure.
Symptoms tend to start between ages 16 and 30. It's often hard to differentiate symptoms in the early stage of the disease (prodromal phase) though, as some of the symptoms may not seem all that different from what one could expect from many teens: drop in academic performance, changes in friends, sleep problems, depression, and/or irritability. Additional signs that can lead to a diagnosis at this stage include: withdrawing/isolating, bizarre thoughts, suspicions and paranoia, and family history.  

It's important to seek help from a doctor if you or your loved one experience any of the symptoms. Help is needed immediately if you or your loved one are a danger to yourself/herself/himself or to others. 

Once again, if you or anyone you know is having thoughts of suicide, it must be taken very seriously. Call the suicide hotline immediately1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) -- or the deaf hotline at 1-800-799-4TTY (1-800-799-4889). 

  • Anti-psychotic medication
  • Psychosocial: therapy that focuses on helping patients with everyday challenges (e.g., communication, relationships, self-care, work)
  • Illness management: learning coping skills to manage symptoms and crafting a Wellness Recovery Action Plan (WRAP) as a wellness guide for the patient, the care givers, and the treating professionals.
  • Integrated treatment for co-occurring substance use disorders: substance use and addiction are common and treatment for both is needed.
  • Cognitive Behavioral Therapy (CBT) - see yesterday's post:
  • Social and vocational rehabilitation
  • Family education and counseling
  • Self-help support groups
Treatment for schizophrenia can often be complicated by the fact that many patients have trouble taking their medication regularly. In addition, because of delusional thinking, they may be resistant to treatment in the first place. This can be exacerbated by the very laws that are in place to protect all of us and allow us to make decisions about our own treatment. Unless a person is an imminent danger to her-/himself, a patient cannot be forced into treatment unless they have given the authority to a caregiver. 


Resources Online

Mayo Clinic

National Institute of Mental Health (NIMH)

Simulated Schizophrenia - (2 films): An excellent YouTube video that simulates a psychotic episode of schizophrenia.

Thirteen Myths of Schizophrenia,



Ben Behind His Voices: One Family's Journey from the Chaos of Schizophrenia to Hope, by Randye Kaye

Me, Myself, and Them: a Firsthand Account of One Young Person's Experience with Schizophrenia, by Kurt Snyder

The Quiet Room: a Journey Out of the Torment of Madness, by Lori Schiller

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