Schizophrenia is a frightening disease that is not well understood. Although it has been well characterized in some movies such as A Beautiful Mind, this illness is more often thought of in vague and uncertain terms.
Some would say they think a person with schizophrenia is ‘crazy’, or that they have multiple personalities, or that they are usually violent and dangerous.
In truth, this illness, which affects one per cent of the population, is a disease of disordered thinking — the result of an organic problem in the brain. The majority of people who suffer from schizophrenia are not dangerous, and they do not have split or multiple personalities.
Most people begin to show signs of schizophrenia between the ages of 15 and 30, but it can begin at any age. Individuals with the disease may experience delusions (often that someone is controlling their thoughts or wanting to hurt them) and hallucinations (usually two or more voices talking about them).
In addition to these disturbing symptoms, schizophrenic individuals tend to have an altered sense of self, a lack of motivation, blunted emotions, and confused communication and thinking. Depression and social withdrawal are also very common.
What is particularly frightening about this illness is that, because its onset occurs in adolescence or early adulthood, the individual has experienced a ‘normal’ existence. When the symptoms begin, the individuals often leave school or work and experience serious relational difficulties.
Schizophrenia tends to develop slowly as gradual deterioration in the brain’s ability to process information or communicate with itself begins. Because of this gradual onset, family members may think the individual is simply going through a phase, or rebelling, and may not realize for some time that there is a serious problem.
Some early warning signs to be aware of include these symptoms: bizarre or unusual behaviour, an inability to sleep, a mixing up of day and night, social withdrawal or isolation, hyperactivity or inactivity, inability to concentrate, unusual preoccupation with religion or the occult, hostility, suspicion or fearfulness, over-reaction to peer or family disapproval, deterioration in personal hygiene, excessive writing or childlike printing with no clear meaning; flat, expressionless gaze, and peculiar use of language.
Although none of these symptoms in itself constitutes a serious problem, if you have a loved one who is exhibiting several of these behaviours, it may be worthwhile to seek medical advice.
It is unclear what causes schizophrenia although there are genetic and environmental factors. There have been many theories and false leads over the years.
There is no cure for schizophrenia. Anti-psychotic medication can control symptoms such as delusions and hallucinations, but lack of motivation and blunted emotions may not respond well to medication.
When symptoms begin, it is important to seek treatment as early as possible. Obviously, this disease is very upsetting to the individuals experiencing it, and the sooner it is treated the better. There is also a belief (not yet proven) that early intervention may lead to better functioning and more independence in the long run.
Some similarities exist between schizophrenia and bipolar disorder. Individuals with bipolar disorder may experience psychotic symptoms similar to those seen in schizophrenia; however, these are usually directly related to mood changes. When visiting a doctor, make sure to consider other disorders.
Finally, there are varying levels of severity in schizophrenia. When treated, some individuals can live relatively normal lives and function independently. Others remain quite ill and need constant supervision and a supportive housing environment.
People with this disorder should be followed by a psychiatrist, as well as their family doctor. The medications for this illness can have serious adverse effects and need careful monitoring. Weight gain, diabetes, movement disorders, smoking, dyslipidemia are among the physical problems that can adversely affect life expectancy, but can be treated.
Because people with this disorder tend to withdraw socially, are often unemployed, and are widely misunderstood, they need the advocacy of family members, or others. Without such assistance, they can end up being taken advantage of, or neglected.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.