Schizophrenia: Explained and Treatments
Schizophrenia is a devastating brain disorder affecting people worldwide of all ages,
races, and economic levels. It causes personality disintegration and loss of contact
with reality (Sinclair). It is the most common psychosis and it is estimated that one
percent of the U.S. population will be diagnosed with it over the course of their lives
(Torrey 2).
Recognition of this disease dates back to the 1800's when Emil Kraepelin concluded after
a comprehensive study of thousands of patients that a "state of dementia was supposed to
follow precociously or soon after the onset of the illness." Eugene Bleuler, a famous
Swiss psychiatrist, coined the term "schizophrenia," referring to what he called the
"splitting of the various psychic functions" (Honig 209-211).
Having a "split personality" is often incorrectly associated with schizophrenia.
Possessing multiple personalities on different occasions is a form of neurosis vice
psychosis (Chapman). Symptoms most commonly associated with schizophrenia include
delusions, hallucinations, and thought disorder (Torrey 1).
Delusions are irrational ideas, routinely absurd and outlandish. A patient may believe
that he or she is possessed of great wealth, intellect, importance or power. Sometimes
the patient may think he is George Washington or another great historical person
(Chapman).
Hallucinations are common, particularly auditory, as voices in the third person or
commenting upon the patient's thoughts and actions (Arieti). Persons may also hear music
or see nonexistent images (Sinclair).
Schizophrenic thought disorder is the diminished ability to think clearly and logically
(Torrey 2). Many times, schizophrenics invent new words (called neologisms) with unique
meanings (Chapman). Often it is apparent by disconnected and meaningless language that
renders the person incapable of participating in conversation and contributing to his
alienation from his family, friends, and society (Torrey 2).
There appears to be three major subtypes of Schizophrenia: paranoid, hebephrenic, and
catatonic. Delusions, often of prosecution, are prominent in the paranoid type (Arieti).
Hebephrenic schizophrenia is characterized by thought disorder, chaotic language,
silliness, and giggling (Eysenck, Arnold, and Meili 961-962). In the catatonic form, the
person may sit, stand, or lie in fixed postures or attitudes for weeks or months on end.
The person may also have a symptom known as "waxy flexibility" in which the victim will
maintain positions of the body in which he is put for long periods of time, even if they
are uncomfortable (Arieti).
There have been many theories to explain what causes schizophrenia. Heredity, stress,
medical illness, and physical injury to the brain are all thought to be factors but
research has not yet pinpointed the specific combination of factors that produce the
disease (Sinclair). While schizophrenia can affect anyone at any point in life, it is
somewhat more common in those persons who are genetically predisposed to the disease
(Torrey 3).
Studies have shown that approximately 12% of the offspring will be schizophrenic if one
parent has the disorder and 50% if both parents have the disorder. This may be due to
the fact that the offspring are reared in an environment other than normal. Although
statistics from adoption agencies show that these rates are more affected by genes rather
than environment (Chapman). Three-quarters of persons with schizophrenia develop the
disease between 16 and 25 years of age. Onset is uncommon after age 30, and rare after
age 40 (Torrey 3).
Psychiatric patients are generally insulted by contentions that their trouble was brought
on by bad parenting, childhood trauma, or week character (Willwerth 79). Sigmund Freud
has suggested that schizophrenia is developed from a lack of affection in the
mother-infant relationship in the first few weeks after birth. Increased levels of the
neurotransmitter dopamine in the brain's left hemisphere and lowered glucose levels in
the brain's frontal lobes have been coupled to schizophrenic episodes (Chapman).
Treatment for schizophrenia includes electroconvulsive treatment (shock therapy),
psychosurgery, psychotherapy, and the use of antipsychotic medications (Torrey 5). Shock
therapy is the application of electrical current to the brain (Long). In 1937, shock
therapy was first introduced and was the popular mode of treatment until the late 1950's
(Chapman). It is effective in the most severe catatonic forms of schizophrenia, but its
use in other forms is debatable (Eysenck, Arnold, and Meili 964-965).
Psychosurgery became common in the 1940's and 1950's but is now in disrepute.
Lobotomies, most often removal of the frontal lobes, was the most widespread form of
psychosurgery. Scientists have since found that by artificially creating lesions in the
area of the frontal lobes, one's personality can seriously be modified (Baruk 196-197).
For the most part, society has condemned this form of treatment as inhumane.
Psychotherapy achieves the best results when the physician listens carefully to his
client's symptoms, diagnosis promptly and accurately, advises the person of the
diagnosis, and then prescribes a successful treatment program (Humphrey and Osmond, 189).
Psychotherapy can offer understanding, reassurance, and suggestions for handling the
emotional problems of the disorder and help to alleviate stressful living situations
(Long). The majority of mental health professionals believe that psychotherapy combined
with drug therapy produce the best treatment of schizophrenia (Walsh 103-104).
Since the late 1950's, schizophrenia has been treated primarily with medications. Most
of these drugs block the action of dopamine in the brain (Chapman). These drugs can help
a great deal in lessening hallucinations and delusions, and in helping to maintain
coherent thoughts. But, they usually have serious side effects that contribute to people
not taking their medication, and relapse (Long).
Haldol is the most commonly prescribed antipsychotic drug to treat schizophrenia. Abbott
Laboratories is presently in the process of testing the safety and efficiency of a new
drug, sertindole (Torrey 8). Nearly ten years ago the first studies of clozapine opened
up a new line of medical research and it was hailed as a miracle drug. Unfortunately, a
small percentage of patients on clozapine develop a blood condition known as
agranulocytosis and have to stop taking the medication (Long). Agranulocytosis is a
disorder noted by a massive reduction in the number of white blood cells which usually
results in the occurance of infected ulcers on the skin and throat, intestinal tract, and
other mucous membranes. Agranulocytosis may cause a bacterial infection to become fatal
since white blood cells are an important defense against microorganisms (Chapman). A new
medication, olanzapine, may be the next miracle drug on the market. Recent studies have
shown that olanzapine offers many of the same benefits of clozapine but apparently
without the side affects (Torrey 8-9).
Hospitalization is often necessary in cases of acute schizophrenia to ensure safety of
the affected person, while also allowing initiation of medication under close supervision
(Torrey 10-11). In milder cases, family therapy has been to be found helpful. With
this type of therapy, family members learn to live with the person in an understanding
and accepting manner (Chapman).
In the following excerpts from her life story, Esso Leete describes her 20-year battle
with schizophrenia and her growing
acceptance of her illness. She has committed herself to leading the fullest life her
disease will allow and to educating others
about mental illness. She's employed full time as a medical records transcriptionist at
a hospital where she was once committed (Long).
"It has been 20 years since I first became mentally ill. As I approach 40, I find myself
still struggling with the same symptoms, still crippled by the same fears and paranoia.
I am haunted by an evasive picture of what my life could have been, whom I might have
become, what I might have accomplished. My schizophrenia is a sad realization, a painful
reality, that I live with every day.
Let me tell you a little about my history. I probably inherited a predisposition to
mental illness; my uncle was diagnosed as having dementia praecox", an earlier term for
schizophrenia. In my senior year of high school, I began to experience personality
changes. I did not realize the significance of the changes at the time, and I think
others denied them, but looking back I can see that they were the earliest signs of
illness. I became increasingly withdrawn and sullen. I felt alienated and lonely and
hated everyone. I felt as if there were a huge gap between me and the rest of the world;
everybody seemed so distant from me.
I reluctantly went of to college, feeling alone and totally unprepared for life away from
home. I was isolated and had no close friends. As time went on, I spoke to virtually no
one. Increasingly during classes I found myself drawing pictures of Van Gogh and writing
poetry. I forgot to eat and began sleeping in my clothes. Performing even the most
routine activities, such as taking a shower, rarely even occurred to me.
Toward the end of my first semester, I had my first psychotic episode. I did not
understand what was happening and was extremely frightened. The experience left me
exhausted and confused, and I began hearing voices for the first time.
I was admitted to a psychiatric hospital, diagnosed as having schizophrenia, treated with
medications and released after a few months.
During my late teens and early 20s, when my age demanded that I date and develop social
skills, my illness required that I spend my adolescence on psychiatric wards. To this
day I mourn the loss of those years.
It was not until much later that I made a conscious effort to develop a sense of control,
realizing that I had the power to decide what form my life would take and who I would
be.
For the next ten years, I did not require hospitalization. During that time, I was
divorced from my first husband and married a community mental health center psychiatrist.
Although I experienced some acute flare-ups of symptomatology during that period, I had
no recurrence of persistent, disabling symptoms.
When more serious symptoms returned about ten years later, I denied their existence.
Having discontinued medications years earlier and now withdrawing from other forms of
support, I experienced more symptoms.
I decided to investigate a private psychiatric residential halfway house that one of the
nurses at the hospital had told me about. I sought and gained admission to the program.
Staff at this facility believed in my potential, and I began to develop confidence in
myself.
I was now ready to take control of my life. My estranged second husband and I moved into
an apartment together, and I threw myself into the task of finding employment. None of
these steps were accomplished easily, but the pieces of my periodically disrupted life
were coming back together.
Like those with other chronic illnesses, I know to expect good and bad times and to make
the most of the good. I take my life very seriously and do as much as I can when I am
feeling well, because I know that there will be bad times when I am likely to lose some
of the ground I have gained. Professions and family members must help the ill person set
realistic goals. I would entreat them not to be devastated by our illnesses and transmit
this hopeless attitude to us. I would urge them never to lose hope, for we will not
strive if we believe the effort is futile."
As one can see, schizophrenia is a highly disruptive disease that has no regard for who
it affects. Researchers and mental health professionals are committing vast amounts of
time and energy to finding its cause and refining its treatment. Health care and lost
resources cost approximately $33 billion per year in the United States alone (Torrey 2).
Organizations of schizophrenic patients and families across the country offer their
members support and comfort. Schizophrenia doesn't affect one person-it affects whole
families.
Works Cited
Arieti, Silvano. "Schizophrenia." Encyclopedia Americana. 1992 ed.
Baruk, Henri. Patients Are People Like Us. New York: William Morrow and Company,
1978.
Chapman, Loren J. Grolier Multimedia Encyclopedia. Release 6. Computer Software.
Creative Technology, 1993. IBM PC-DOS 3.3, 4MB, CD-ROM.
Eysenck, H., W. Arnold, and R. Meili. Encyclopedia of Psychology. New York: Continuum
Publishing Company, 1982.
Hoffer, Abram and Osmond, Humphrey. How to Live with Schizophrenia. Secaucus: Carol
Publishing Group, 1992.
Honig, Albert. The Awakening Nightmare. Rockaway: American Faculty Press, 1972.
Long, Phillip W. Schizophrenia: Youth's Greatest Disabler. Internet: Internet Mental
Health, 1996.
Sinclair, Lawrence. High Performance Consultants. Psyrix Corporation, 1995.
Torrey, E. Fuller. Surviving Schizophrenia: A Family Manual. National Alliance for
the Mentally Ill Pamphlet. Arlington, VA: Wilson, 1993.
Walsh, Maryellen. Schizophrenia: Straight Talk for Family Friends. New York:
William Morrow and Company, Inc., 1985
Willwerth, James. "The Souls that Drugs Saved." Time Oct. 1994: 78-81.
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