Schizophrenia or she may have the mental illness
Schizophrenia is a most misunderstood disease. It will affect one in every100 Americans during their lifetime, yet too often it is hidden in the closet by families and ignored by professionals. A revolution is underway, for schizophrenia is emerging. Schizophrenia is now known to be a disease of the brain and is not caused by any guilty acts or failures of the patient.
Like diabetics, schizophrenics may be able to control their symptoms with medication. This paper will discuss the effects, symptoms, and treatments for this illness.Schizophrenia is a mental disorder marked by the loss of contact with reality.
When a persons thinking, feeling, and behavior is abnormal, it interferes with his or her ability to function in everyday life. Delusions, hallucinations, and irregular thinking and emotions are produced. If these signs are present, he or she may have the mental illness called schizophrenia. Inter-episode residual symptoms are common. This often-chronic illness can be characterized by three phases that merge into one another without absolute, clear boundaries between them. The first phase is the acute phase.
During this florid psychotic phase, patients exhibit severe psychotic symptoms, such as delusions and/or hallucinations and severely disorganized thinking, and are usually unable to care for themselves appropriately. Negative symptoms often become more severe as well. In the next stage, the stabilization phase, acute psychotic symptoms decrease in severity. This phase may last for 6 or more months after the onset of an acute episode.
The third phase is the stable phase. Symptoms are relatively stable and, if present at all, are almost always less severe than in the acute phase. Patients can be asymptomatic; others may manifest non-psychotic symptoms, such as tension, anxiety, depression, or insomnia. When negative (deficit) symptoms and/or positive symptoms, such as delusions, hallucinations, or thought disorder, persist, they are often present in attenuated, non-psychotic forms (e.g., illusions rather than hallucinations, overvalued ideas rather than delusions) (American Psychiatric Associations guideline for the Treatment of Patients with Schizophrenia).About one hundred years ago, schizophrenia was first recognized as a mental disorder and researchers have been searching for a cure ever since.
The cause of the disease is still unknown today and scientists have concluded that it has more than one cause. Scientists have developed dozens of theories: the Genetic Theory, the Environmental Theory, the Biochemical Theory, and the Bio-Psycho-Social Theory. The Genetic Theory argues that schizophrenia is caused by traits in a persons genetic makeup. A normal person has twenty-three pairs of chromosomes. Each pair contains one chromosome from each parent. In corresponding locations called loci of each chromosome, the genes can cause schizophrenia.
We inherit our genes form out parents, but this does not mean that the parents of a schizophrenic are mentally ill. Problems in a persons genetic makeup could come from a mutated chromosomes or recessive genes. In an attempt to prove this theory, scientists studied identical twins. Due to the fact that identical twins have identical genetic makeup, researchers are able to determine if the heredity is the main cause of schizophrenia. However, evidence seems to disprove this theory. In some instances, both identical twins are schizophrenics and other times only one is affected. To defend this theory it should be noted that this research is complicated.
Identical twins are relatively rare, especially twins who are both diagnosed with schizophrenia. Studies have also shown that children with one parent diagnosed with schizophrenia have a ten percent chance of suffering from schizophrenia. When both parents are schizophrenic their risk raises to approximately forty percent. Little is known about the Environmental Theory. The theory is built mainly on the effects of stress on human behavior. Most researchers agree that stress alone cannot be the main cause of schizophrenia. Most researchers agree that stress could possibly trigger or worsen the symptoms when the illness is already present.
Other researchers focus on drug abuse, like stress, certain drugs such as amphetamines can make psychotic symptoms worse if a person already has schizophrenia. Furthermore, these drugs can, in a sense, create schizophrenia. Other researchers that support the Environmental Theory believe that slow viruses may be to blame. Slow viruses are viral infections that go undetected for long periods of time. Signs and symptoms are delayed and may occur many years after the first infection. The Bio-Chemical Theory suggests that schizophrenia is caused by mixed up signals in the brain. When something acts upon one of our senses, electrical impulses are sent to the brain.
These impulses allow us to feel, smell, taste, hear, and they may also manage our thought processes. In our body we have a complex nervous system.For example, there is not simply a single nerve that travels from our feet to our brain.
In order for information to be sent to the brain, the nerves must interact with each other, translating the messages from one nerve to the next. Because the system is so complex it is possible for the signal to get mixed up. When this happens, our brain may misinterpret the signal or may not receive it at all. If the signal does get mixed up on the way to the brain the makeup of the impulse can undergo a chemical change resulting in irregular thought processes and abnormal behavior. Scientists have undergone in-depth studies on a chemical in the brain called dopamine. They believe that schizophrenics have higher levels of this chemical than a mentally sound person does.
To experiment on this theory, researchers have injected animals and humans with amphetamines, increasing the amount of dopamine reaching the brain. Following the injection, the animals exhibited the same type of behavior as humans who have been diagnosed with schizophrenia, such as standing still for ling periods of time or continually pacing. In humans, research has shown that when given small doses of amphetamines the amount of dopamine in the brain increases slightly. Although the increase is small it still causes delusions and hallucinations.
In conclusion, researchers believe that an increased amount of dopamine to the brain causes abnormal behavior; however, they cannot safely say that this is the sole cause of schizophrenia.The Bio-Psycho-Social Theory combines all the previous theories. Some researchers believe that bio-chemical abnormalities area contributing factor but that other events must also occur. They suggest that environmental and social problems have to be considered along with biological problems. Social scientists believe that no chemical factors are involved; instead they believe mental disorders are described as a consequence of human motivations, drives, and unconscious forces.
(Douglas W. Smith, 1993). These scientists suggest that people become overloaded with the anxiety which accompanies these stressors.
Instead of dealing with their problems they seek peace in their own world. For example, it is common for individuals to return to happy times in their life such as infancy and they begin to act like a child. Scientists have asked if there is a particular nationality that suffers more than any other. Studies have been done in Ireland and it appears that one in every twenty-five people show signs of schizophrenia, opposed to on in every hundred in the United States. E. Fuller Torrey has spent a great deal of time researching a number of schizophrenics in Ireland. Torrey has discovered that the population of schizophrenics has been rising since the 18th Century.
After he made his findings public other scientists began asking questions as to why the Irish were suffering so badly. The basis of their research focused around their diet; mainly potatoes. If potatoes are exposed to too much sunlight they produce an alkaloid called solaine.
Solaine has the ability to induce gastro-intestinal problems and psychotic symptoms such as hallucinations. The idea that schizophrenia in Ireland is caused by the potato is not as far fetched as people might think. Closer to home, a mental disease that afflicted southerners, pellagra was caused solely form the lack of the vitamin niacin. This may lead us to believe that a mental disorder can be caused by too much exposure or lack of a certain type of food. Another possibility if the amount of insecticides the Irish consume from the potato. At planting time farmers use high amounts of chemicals in their potatoes to protect them from insects. When an insect ingests the chemical they are easily killed because the chemicals interfere with the normal functioning of the nervous system by disrupting the transmission of nerve impulses.
If large doses of these chemicals have the same effect on humans as they do on insects this could answer the Irish dilemma. These toxins could be especially dangerous to women who are pregnant by damaging the fetal nerve tissue. Despite all there theories, it is quite evident that the cause of schizophrenia is still a mystery.
It also seems clear that this disease is not caused by any one factor. As of now, researchers are leaning toward the Bio-Chemical Theory. The brain is the most complex organ in the human body and an imbalance of the brains chemical system has been suspected as the main cause of schizophrenia for a long time.
As previously mentioned, some researchers point to an excess of or lack of dopamine. Others suspect different neurotransmitters which are substances that allow communication between nerve cells. The area of the brain thought to be affected in most cases of schizophrenia is the limbic system.
This is the area of the brain that acts like a gate for incoming stimuli or messages. In any case, it appears that all schizophrenics have some sort of abnormal chemicals that are not found in healthy people. Schizophrenia is a complicated and difficult disease.
It is hard to diagnose mental disorders because there are no physical indications. In the case of schizophrenia, a person can be mistaken for a shy child or person. The onset of the first psychotic episode may be abrupt, but the majority of individuals display a slow and gradual development of a variety of signs and symptoms (e.g., social withdrawal, loss of interest in school or work, deterioration of hygiene and grooming, unusual behavior, outbursts of anger).
The following table indicates common symptoms schizophrenics develop. Reported rank of order in at least 50% of schizophrenic patients before hospitalization.SYMPTOMSPERCENTAGETense and Nervous80.
4Eating less71.4Trouble concentrating69.6Trouble sleeping67.
4Enjoying things less65.2Restlessness63.0Memory loss63.2Depression60.9Preoccupied59.6Seeing things less59.6Feeling laughed at59.
6Loss of interest56.5More religious thinking54.3Feeling bad for no reason54.
3Feeling too excited52.2Hearing voices and seeing things50.0**Source: American Journal of Psychiatry 137: 801-807**More severe symptoms of schizophrenia are delusions. The delusions are usually common to a type of called paranoid schizophrenia. People suffering from this often think they are a historic, great or famous person.
These people often believe that someone is out to get them and have a great deal of suspicion. Another common symptom is hallucinations. Hallucinations cause the affected person to imagine hearing things or seeing things. Schizophrenics are usually detached from reality. They are not in touch with their surroundings. Besides recognizing these symptoms, other methods of diagnosing schizophrenia are the use of pictures and drawings. The doctor till listen to what a patient sees and analyze it.
In doing this it is possible to determine their state of mind. Another process used in the diagnosis is Rorschach, better known as inkblots. These inkblots are used worldwide and doctors have analyzed normal and abnormal answers.
By listening to answers a doctor can determine what a common answer from a schizophrenic is. A normal persons answer would be something ordinary like a person or a mountain. A person suffering from schizophrenia would see something strange like a beast or some conflict.For most people, young adulthood means leaving home, starting a job and starting a family.
For most schizophrenics, it also means the first admission to psychiatric hospital. Am unfortunate reality for young schizophrenics if the need for hospitalization during their most vibrant and productive time. The age of the first admission is younger for men than women; early twenties for males and mid-twenties to early thirties for women. Another question raised is who gets schizophrenia more commonly, men or women? Studies have shown there is no great variation in the numbers but in the severity of the symptoms. Men seem to suffer more severely.
Scientists have attempted to explain this through differences in the brain. Research has shown schizophrenia tends to affect the left side of the brain; Males are generally left-brained or right-brained while females have less specialization on either side of the brain.Although schizophrenia is a serious and devastating disease the outcome is not always bad.In the past individuals who have schizophrenia were labeled as crazy and families were embarrassed to have a mentally ill person in their family. These people would be isolated in a mental institution with bars on the windows, the building dark and desolate. Another common treatment for schizophrenia was insulin shock treatment.
A patient would receive enough insulin to induce a seizure. This treatment worked for very few patients. The environment that these patients lived in was more damaging to them than helpful.
Mental illness was not accepted or thought of as a disease. When patients were taken to the hospitals it was common for them to be left there. Family would generally desert them because the environment was terrible–family and friends dreaded visiting. Unlike in the past, hospitals now have a happy environment. The family is involved with the treatment of the patient.
The family themselves try to cope. They learn how things can change when the patient returns home. After the patient is released it is possible for them to go on living normal life. A schizophrenic will most likely have to take doses of medication for the rest of their life. Side effects will be felt and unreasonable fears may still be evident but their life will be basically normal.
The modern day treatment for schizophrenia has many aspects. It involves medicine, counseling, electro-convulsive therapy and hospitalization. The medications most commonly used are; anti-psychotics which are used to help calm agitation diminish destructive behavior and hallucinations and may help calm correct disturbed thought processes.
Secondly are anti-depressants, normally slow acting drugs but if no improvement occurs within three weeks, they may not be effective at all. Thirdly, are mood normalizers such as lithium carbonate used in manic depressive states for calming agitation and anxiety. “Antipsychotic medications are indicated for nearly all acute psychotic episodes in patients with schizophrenia.” (The American Psychiatric Association’s “Guideline For The Treatment Of Patients With Schizophrenia”) There are two main classifications of medications (from a layman’s perspective) the traditional antipsychotic medications (Haldol, etc.), and the newer, “atypical” antipsychotic medications that have come out in the past decade (Clozapine, Geodon, Seroquel, Risperdal, Zyprexa, Abilify, etc.
). Unfortunately, along with these medications come some side effects such as inability to concentrate and tiredness. However, there are side effect controls available.
Electro-convulsive therapy is the application of electrical current to the brain. It is mainly used for patients suffering from extreme depressions who are suicidal and who seem unable to shake the depression under any circumstances. ECT is the treatment of choice for pregnant women who can’t take anti-depressant medications because of the possible damage to the fetus. The one major side effect is a small chance of partial memory loss. (http://nami-nyc-etro.
org//; 27 Nov. 2003)Researchers anticipate massive progress on the treatment for schizophrenia in the future. They believe hospitalization will be a thing of the past. Patients will be injected with medications monthly and attend group therapy with their family. The disease can be detected early because of education and research and the drugs used for treatment have a few side effects.
Scientists hope that in the years to come treatment for schizophrenia will be non-existent. Researchers hope to pinpoint the cause and eliminate it at birth through screening. With this treatment, schizophrenia could be wiped out. Although it may surprise some people, schizophrenia is a common disorder, striking one person in every hundred. The majority of patients alternate between acute psychotic episodes and stable phases with full or partial remission but at least 25% if the treated schizophrenics recover fully to live a normal life in every aspect. The “Rule of Thirds,” commonly held by American psychiatrists and found to hold true in Europe is one-third of all people diagnosed and hospitalized with schizophrenia will recover completely, one-third will be improved, needing only occasional hospitalization if any, and one-third will remain unimproved (Torrey, 2001).ReferencesMayer, Robert M.
D. Satans Children, New York: G.P. Putnam and Sons, 1991Smith, Douglas. Schizophrenia, Toronto: Franklin Watts, 1993Torrey, Fuller. Surviving Schizophrenia: A FamilyManual. New York: Quill, 2001Wallis, Claudia and James Wellsworth.
Awakenings. Time, July 7, 1992,pp 36-44American Psychiatric Associations Guide for the Treatment of Schizophreniahttp://www.psych.org, 12 October 2003http://nami-nyc-etro.org//; 27 Nov. 2003