Schizophrenia is a chronic brain condition whose main symptoms are delusions and hallucinations, along with trouble speaking in a coordinated manner, difficulty thinking, and lack of motivation.
Although there is no cure, there are effective pharmacological treatments that, together with therapy, allow the person to lead a normal life.
A form of schizophrenia used to be called paranoid schizophrenia. Now, paranoia is considered to be a symptom of this condition, but not a condition in itself.
Causes of schizophrenia
Science has not yet been able to determine what causes schizophrenia.
A consensus has been reached that it can be triggered by a combination of genetic alterations, chemical alterations that occur at the brain level, and a specific environment.
MRIs and other imaging studies of people diagnosed with schizophrenia show differences in the structure of the brain and central nervous system.
These characteristics make schizophrenia to be defined as a brain disease, under the medical field and not exclusively psychological.
Many times, schizophrenia affects generations of the same family. However, if a family member, such as a parent, has a diagnosis of schizophrenia, that does not mean that the child will have it.
Specialists divide the symptoms of schizophrenia into three categories.
They include perceptual disturbances such as changes in vision, hearing, sense of smell, touch, and taste. The person may have a distorted sense of reality, as if they perceive an alternate reality. Among these perceptions can be listed:
- Hallucinations. Such as hearing voices or seeing people or objects that are not actually present or do not exist.
- Delusions. When the person is convinced of a belief that is not based on facts, such as paranoia that someone is after them, or that the internet or television sends them messages of missions that they must complete.
- Thought disorders. The person cannot organize their ideas or their speech.
- Lack of motivation. The person loses interest in things that previously interested him.
- Distancing from friends and family. The person no longer participates in social gatherings or does not seek the affections that were previously part of his life.
- Inability to feel affection. The person does not show feelings or emotions.
- Dramatic mood swings. From a near catatonic or comatose state to irrational hyperactivity.
- Difficulty completing tasks. Work, school, are now difficult burdens to bear.
- Difficulty processing information. It is difficult for the person to coordinate or organize their knowledge and that builds barriers to making decisions.
- Difficulty focusing. The person loses the ability to concentrate, which also complicates academic and work processes.
Globally, the World Health Organization (WHO) reports that some 20 million suffer from schizophrenia.
The same source indicates that the incidence of this condition is higher in Asian countries: Indonesia is the nation with the most cases. In Latin America, the 10 countries with the most cases are Uruguay, Nicaragua, Cuba, Honduras, Brazil, Mexico, the Dominican Republic, Guatemala, El Salvador and Chile, in that order.
In the United States, for example, 2.6 million adults are living with schizophrenia, 40% of whom often do not receive treatment.
Diagnosis of schizophrenia
The onset of schizophrenia does not happen overnight. It is a process that can take time, generally about six months, during which the person shows a progressive deterioration of their social, logical and cognitive functions, among others.
That is why the diagnosis is made when the symptoms are already unquestionable, and cannot be confused with something temporary.
To reach a diagnosis of schizophrenia, the doctor will evaluate the patient: he will do a physical exam, review his medical history and order radiological studies.
The person must have presented at least two of the most characteristic symptoms (described at the beginning of the article) for a period of at least one month.
Difference with dissociated identity disorder
Although some of the signs may appear similar on the surface, schizophrenia is not a dissociated identity disorder (which used to be called multiple personality disorder or split personality).
People with dissociative identity disorder have two or more distinct identities that are present and alternately take control of them.
Genetic: schizophrenia is sometimes hereditary. However, the fact that one family member has schizophrenia does not mean that other family members will also have it. Studies suggest that many different genes can increase a person’s chances of developing schizophrenia, but that no single gene causes the disorder.
Environmental: Research suggests that a combination of genetic factors and aspects of a person’s environment and life experiences may play a role in the development of schizophrenia. These environmental factors may include living in poverty, stressful or dangerous environments, and exposure to viruses or nutritional problems before birth.
Brain structure and function: Research shows that people with schizophrenia may be more likely to have differences in the size of certain brain areas and in the connections between brain areas. Some of these brain differences may develop before birth. Researchers are working to better understand how brain structure and function may be related to schizophrenia.
Antipsychotic medications can help reduce the intensity and frequency of psychotic symptoms. They are usually taken daily in pill or liquid form.
Newer generations of medications allow some drugs to be given as injections once or twice a month, which for some people is more convenient than daily oral doses.
Patients whose symptoms do not improve with standard medication are usually given clozapine, with close medical monitoring and frequent blood tests due to complex side effects. These side effects usually develop between 1% and 2% of patients receiving this medication.
Many people who take antipsychotic medications have side effects such as weight gain, dry mouth, restlessness, and sleepiness when they start taking these medications. Some of these side effects go away over time, but others may persist, which may cause you to stop your medication.
Stopping medication suddenly can be dangerous and can make schizophrenia symptoms worse. People should not stop taking antipsychotic medications without first talking to a health care provider.
Cognitive and behavioral therapy helps the person living with schizophrenia to be able to have a normal social, work and family life.
The person who consistently stays in therapy is less likely to have seizures due to schizophrenia.
Experts say that this consistency is essential for people with this diagnosis to meet life goals such as finishing school, having a job and a relationship.
The importance of family support
Special programs help the relatives of the person with schizophrenia to support them and act in times of crisis.
This support is essential especially at times when the patient loses awareness of reality.
Family members are trained in the knowledge of the symptoms, actions and reactions of the person with schizophrenia in order to help them without fear of symptoms that are strong to observe.
Sources: American Psychiatry Association, Mayo Clinic, NIMH, WHO, NY Langone Health.