SchizophreniaSchizophrenia is a challenging disorder that makes it difficult to distinguish between what is real and unreal, think clearly, manage emotions, relate to others, and function normally. But that doesn't mean there isn't hope. Schizophrenia can be successfully managed. The first step is to identify the signs and symptoms. The second step is to seek help without delay. With the right treatment and support, a person with schizophrenia can lead a happy, fulfilling life. What is schizophrenia? Schizophrenia is a brain disorder that affects the way a person behaves, thinks, and sees the world. People with schizophrenia often have an altered perception of reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. This can make it difficult to negotiate the activities of daily life and people with schizophrenia may withdraw from the outside world or act out in confusion and fear. Although schizophrenia is a chronic disorder, there is help available. With support, medication, and therapy, many people with schizophrenia are able to function independently and live fulfilling lives. Common misconceptions about schizophrenia MYTH: Schizophrenia refers to a "split personality" or multiple personalities. FACT: Multiple personality disorder is a different and much less common disorder than schizophrenia. People with schizophrenia do not have split personalities. Rather, they are “split off” from reality. MYTH: Schizophrenia is a rare condition. FACT: Schizophrenia is not rare; the lifetime risk of developing schizophrenia is widely accepted to be around 1 in 100. MYTH: People with schizophrenia are dangerous. FACT: Although the delusional thoughts and hallucinations of schizophrenia sometimes lead to violent behaviour, most people with schizophrenia are neither violent nor a danger to others. MYTH: People with schizophrenia can’t be helped. FACT: While long-term treatment may be required, the outlook for schizophrenia is not hopeless. When treated properly, many people with schizophrenia are able to enjoy life and function within their families and communities. warning signs Early warning signs of schizophrenia In some people, schizophrenia appears suddenly and without warning. But for most, it comes on slowly, with subtle warning signs and a gradual decline in functioning long before the first severe episode. Many friends and family members of people with schizophrenia report knowing early on that something was wrong with their loved one, they just didn’t know what. In this early phase, people with schizophrenia often seem eccentric, unmotivated, emotionless, and reclusive. They isolate themselves, start neglecting their appearance, say peculiar things, and show a general indifference to life. They may abandon hobbies and activities, and their performance at work or school deteriorates. The most common early warning signs of schizophrenia include:
Signs and symptoms of schizophrenia There are five types of symptoms characteristic of schizophrenia: delusions, hallucinations, disorganized speech, disorganized behaviour, and the so-called “negative” symptoms. However, the signs and symptoms of schizophrenia vary dramatically from person to person, both in pattern and severity. Not every person with schizophrenia will have all symptoms, and the symptoms of schizophrenia may also change over time. Delusions A delusion is a firmly-held idea that a person has despite clear and obvious evidence that it isn’t true. Delusions are extremely common in schizophrenia, occurring in more than 90% of those who have the disorder. Often, these delusions involve illogical or bizarre ideas or fantasies. Common schizophrenic delusions include:
Hallucinations Hallucinations are sounds or other sensations experienced as real when they exist only in the person's mind. While hallucinations can involve any of the five senses, auditory hallucinations (e.g. hearing voices or some other sound) are most common in schizophrenia. Visual hallucinations are also relatively common. Research suggests that auditory hallucinations occur when people misinterpret their own inner self-talk as coming from an outside source. Schizophrenic hallucinations are usually meaningful to the person experiencing them. Many times, the voices are those of someone they know. Most commonly, the voices are critical, vulgar, or abusive. Hallucinations also tend to be worse when the person is alone. Disorganized speech Fragmented thinking is characteristic of schizophrenia. Externally, it can be observed in the way a person speaks. People with schizophrenia tend to have trouble concentrating and maintaining a train of thought. They may respond to queries with an unrelated answer, start sentences with one topic and end somewhere completely different, speak incoherently, or say illogical things. Common signs of disorganized speech in schizophrenia include:
Disorganized behaviour Schizophrenia disrupts goal-directed activity, causing impairments in a person’s ability to take care of him or herself, work, and interact with others. Disorganized behaviour appears as:
Negative symptoms (absence of normal behaviour's) The so-called “negative” symptoms of schizophrenia refer to the absence of normal behaviour's found in healthy individuals. Common negative symptoms of schizophrenia include:
Causes of schizophrenia The causes of schizophrenia are not fully known. However, it appears that schizophrenia usually results from a complex interaction between genetic and environmental factors. Genetic causes of schizophrenia Schizophrenia has a strong hereditary component. Individuals with a first-degree relative (parent or sibling) who has schizophrenia have a 10 precent chance of developing the disorder, as opposed to the 1 precent chance of the general population. But schizophrenia is only influenced by genetics, not determined by it. While schizophrenia runs in families, about 60% of schizophrenics have no family members with the disorder. Furthermore, individuals who are genetically predisposed to schizophrenia don’t always develop the disease, which shows that biology is not destiny. Environmental causes of schizophrenia Twin and adoption studies suggest that inherited genes make a person vulnerable to schizophrenia and then environmental factors act on this vulnerability to trigger the disorder. As for the environmental factors involved, more and more research is pointing to stress, either during pregnancy or at a later stage of development. High levels of stress are believed to trigger schizophrenia by increasing the body’s production of the hormone cortisol. Research points to several stress-inducing environmental factors that may be involved in schizophrenia, including:
Abnormal brain structure In addition to abnormal brain chemistry, abnormalities in brain structure may also play a role in schizophrenia. Enlarged brain ventricles are seen in some schizophrenics, indicating a deficit in the volume of brain tissue. There is also evidence of abnormally low activity in the frontal lobe, the area of the brain responsible for planning, reasoning, and decision-making. Some studies also suggest that abnormalities in the temporal lobes, hippocampus, and amygdala are connected to schizophrenia’s positive symptoms. But despite the evidence of brain abnormalities, it is highly unlikely that schizophrenia is the result of any one problem in any one region of the brain. Effects of schizophrenia When the signs and symptoms of schizophrenia are ignored or improperly treated, the effects can be devastating both to the individual with the disorder and those around him or her. Some of the possible effects of schizophrenia are:
Diagnosing schizophrenia A diagnosis of schizophrenia is made based on a full psychiatric evaluation, medical history, physical exam, and lab tests.
Conditions that can look like schizophrenia The medical and psychological conditions the doctor must rule out before diagnosing schizophrenia include
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