Schizophrenia – Maligned and Misunderstood
How many times have you watched television and the villain has schizophrenia? Or worse (cue drum roll here) he has paranoid schizophrenia.
Sheesh, get a grip and find an illness that is somewhat probable. Schizophrenia occurs in less than 1% of the population worldwide. I’m not saying that people with this illness don’t get violent. Some do, the same as pastors, ministers, doctors and shrinks. But it’s not nearly as common as writers would have us believe.
The illness usually begins in the teens or early adulthood, although a later onset is not impossible. (My girlfriend’s daughter, a professional woman, was diagnosed in her 40’s.
I think because this illness is so grossly misunderstood, it is frightening. Hopefully I can shed a little light on the disease and its symptoms.
First of all, Schizophrenia does NOT mean split personality. There’s another illness to account for multiple personalities residing in the same body. Schizophrenia is a chronic illness that will affect an individual’s functioning in many areas of life. I say likely because this disease, like any other, occurs on a continuum from very mild to very serious. The severity of the illness is a major factor in determining if or what medications are given and what support is required.
Schizophrenia is characterized by serious disruption in thinking and feeling, affecting the basic elements of human experience: language, thought, perception, affect (expression of emotion), and our sense of self.
Diagnosing this illness requires a look at the symptoms it adds (for example hallucinations) and the symptoms that remove a slice of ‘normal’ behavior (this could be the facial and physical expression of emotion). In shrink language, these are called positive and negative symptoms.
Scizophrenia requires a multi-level diagnosis, but to ensure I don’t write a book, I’m going to talk about the first level today. Diagnosis requires that two or more of the following must be present for a significant part of a month. Additionally, at least one of the first three must be included.
What are the symptoms of this illness? Just reading them sounds scary, so bear with me:
Delusions are, quite simply, false beliefs, or beliefs that appear false to the majority of the culture. This is where many people indulge in discussions of what is normal. Perhaps the person is ‘seeing’ the truth and the rest of us can’t see that because a part of our brain isn’t evolved enough or we’re not spiritual enough or whatever…take your pick of reasons. Those possibilities are true. But since many people share similar delusions this doesn’t seem likely. Although, I have to admit the delusion that the government is watching me and tracking my movements may have some validity in this post 9/11 world.
Are these spiritual experiences? Could be but remember the diagnosis of Schizophrenia is multi-tiered and must be accompanied by more than the presence of delusions.
Hallucinations can occur for many reasons other than Schizophrenia. For example, fevers, stress, and medications can all contribute to them. What are they? They are the presence of visions, voices or sounds, touch, smells or tastes that are not present to anyone else. Did you notice the five senses? Give yourself a gold star. Hallucinations can occur as any or all of the senses.
I used to wonder why a person having an auditory hallucination wouldn’t simply look around. I mean if you’re hearing voices and no one is there, isn’t that a clue that this is a mind problem? A client once explained it to me this way: hallucinations are processed through the same physiological mechanism that the real thing is processed through. So for someone having an incident, he ‘hears’ voices through his auditory nerves, and ‘sees’ angels through the optic nerve. He can’t tell the difference. Imagine a life where you really didn’t know if anything was real? Absolutely terrifying, in my opinion.
3. Disorganized Speech
Disorganized speech is often considered to be a reflection of the thoughts of the individual. It includes speech that is garbled, erratic jumping from topic to topic and using made up words. These make the individual hard to understand.
4. Grossly abnormal psychomotor behavior, including catatonia
Abnormal psychomotor behavior manifests in a number of ways. For example, it might show up as inactivity as a result of being in a stupor. Or as mania. Or it might show in the body as extreme flexibility or rigidity of the limbs.
5. Negative symptoms
Negative symptoms include a wide array of behaviors that psychiatrists look for to diagnose Schizophrenia.
These might include any of the following:
- lack of emotion – the inability to enjoy regular activities (visiting with friends, etc.) as much as before
- Low energy – the person tends to sit around and sleep much more than normal
- lack of interest in life, low motivation
- Affective flattening – a blank, blunted facial expression or less lively facial movements, flat voice (lack of normal intonations and variance) or physical movements.
- difficulty or inability to speak
- Inappropriate social skills or lack of interest or ability to socialize with other people
- Inability to make friends or keep friends, or not caring to have friends
- Social isolation – person spends most of the day alone or only with close family
This is a complicated illness. Diagnosis is complicated (more on this in a subsequent post) and getting the right medication in the right dosage can be a nightmare. Additionally, people with Schizophrenia are highly vulnerable to stress, which can make a managed illness unmanageable, seemingly overnight.
Imagine this: you’ve been diagnosed with Schizophrenia and you’re coping. Your meds are working and all is well. But then something happens: a parent gets sick, you get evicted from your apartment, someone starts to bully you. That additional stress is enough to push hormones and chemicals into the brain at an astounding rate. When that happens, usually the medications stop being effective and you are back to square one, often hospitalized for treatment of an illness you no longer know you have.
This is an insidious disease. My friend’s daughter, who was diagnosed in her 40’s is very astute. And she has coped with Schizo-affective disorder (schizophrenia and bi-polar affective disorder together) extraordinarily well. But she told me a story that happened to her late one night that I’d like to share:
She was sitting in the kitchen, drinking coffee and talking with her boyfriend. They put the cigarette butts in a ‘can’ and put water in it, to ensure there was no risk of fire. Then they dumped the can in the toilet and flushed it. Tidied u the kitchen and he went on his way.
An hour later, she was sound asleep when she dreamed she smelled smoke. She jumped out of bed and went running to the kitchen, the only room she smokes in. Searching frantically, she didn’t see a cigarette burning anywhere. The ‘smoke can’ was under the sink, empty and washed out as it should be and their coffee cups had been washed and put away. But the voices took over and told her that a butt was burning in her apartment and if she didn’t find it, the entire ten storey apartment building would burn down and everyone would die.
So she tore her apartment apart. Finally five hours later, with every drawer emptied, the frig and stove pulled out, she accepted that this was a hallucination and called 911. Clearly, for no reason she’s been able to discern, the illness had taken a turn and she needed her meds adjusted.
So let’s stop making people with Schizophrenia the likely suspect for everything imaginable. Violent tendencies in this group are no higher than in the rest of the population. I think they’ve been maligned enough.
For more information, please visit:
www.schizophrenia.com which also provided the list of negative symptoms.
Do you know anyone with Schizophrenia? Have any experience with the illness? What do you think?