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What is Schizophrenia ?

08.02.2020 - Dr. JPS Bhatia

Schizophrenia is a severe, long-term mental health disorder that we classify as a kind of psychosis. By that I mean that sufferers can’t correctly perceive what is going on in the world around them, and interpret occurring events in a different way than others. Symptoms may involve hallucinations, delusions, an inability to feel emotions or pleasure, and disorganized thinking. The disorder usually appears in the teens and one in their twenties, although it can show up in those in their thirties (more often in women).

Schizophrenia can be hereditary, and around 10 percent of people whose first-degree relatives are sufferers are affected. The disorder can’t be cured, but the symptoms can be managed to the point that sufferers can, for instance, hold a job, and maintain relationships. Treatment usually involves a combination of antipsychotic drugs and cognitive behavioral therapy.

Paranoia and Disorganization As the root cause of the disorder is unknown, schizophrenia is best understood by its symptoms. There are two main subtypes of schizophrenia — the paranoid subtype and the disorganized sub-type. The paranoid subtype suffers from auditory hallucinations — “hearing voices” — or delusional thoughts, or both, relating to idea of persecution and idea of conspiracy. The sufferer often thinks that a person, or a group of people, often family members , are “out to get” him or her.

The hallucinations revolve around a specific theme, which usually remains constant for the sufferer, and the individual’s actions generally relate to the content of this theme. The brain of a person suffering from schizophrenia mistakes the thought of a voice giving instructions as a real voice.The voices appear to be genuine to the sufferer. Delusions include the thought that, for instance, people talking on television are sending special messages, or giving instructions, to the sufferer.

The feelings of persecution can lead to hostility toward others, although those experiencing schizophrenia are rarely violent. As the condition progresses, memory and mental coherency can suffer. One problem is sufferers might not talk about their auditory hallucinations, so the disorder may be difficult to spot in the early stages. The paranoid subtype can more easily be treated, and sufferers can stabilize to a level where they can work, have relationships, and lead relatively normal lives.

The disorganized subtype suffers from disorganization of the thought process — sufferers become muddled and confused. This subtype experiences less pronounced hallucinations and delusions, but may not be able to think clearly enough to function normally. They might not, for instance, wash or perform other acts of personal hygiene. The sufferer will lose the ability to experience emotions, a condition which is called the “blunted” or “flat” affect, and may respond in an inappropriately cheerful manner to events, for example, by laughing at a funeral. Communication becomes difficult, and speech becomes garbled, with words being used in the wrong order. This is sometimes referred to as “word salad.”

Therapy Aids Recovery Psychosocial therapy can aid patients whose conditions have stabilized due to the use of antipsychotic medication. Therapists can encourage schizophrenia patients to stick with their medication, and can help with a patient’s self-management of the disorder, their relationships, and integration into society (like employment).

Cognitive behavioral therapy, which focuses on solving the current problems of a patient by breaking them down into smaller parts that can then be analyzed, can help schizophrenia sufferers work out whether their perceptions are true representations of the outside world. Therapy is an important part of the management process for schizophrenics.