Schizophrenia, The Great PuzzleAt first glance, schizophrenia may seem like a great puzzle.
Its causes are still uncertain
Its symptoms, variable.
Striking most often in the 16 to 30 year age group, affecting an estimated one person in a hundred, it is youth's greatest disabler. But if it is a puzzle, it's one that is slowly being solved. New pieces are continually falling into place. Consider what we have learned about its symptoms.
Schizophrenia often starts slowly. When the symptoms first appear, usually in adolescence or early adulthood, they may seem more bewildering than serious.
In the early stages, people with schizophrenia may find themselves losing the ability to relax, concentrate or sleep. They may start to shut long-time friends out of their lives. Work or school begins to suffer; so does their personal appearance. During this time, there may be one or more episodes where they talk in ways that may be difficult to understand and/or start having unusual perceptions.
Once it has taken hold, schizophrenia tends to appear in cycles of remission and relapse. When in remission, a person with schizophrenia may seem relatively unaffected and can more or less function in society. During relapse, however, it is a different story.
People with schizophrenia may experience one or all of these main conditions:
• delusions and/or hallucinations
• lack of motivation
• social withdrawal
• thought disorders
Delusions are false beliefs that have no basis in reality. People with schizophrenia may think, for example, that someone is spying on them, listening to their thoughts, or placing thoughts in their minds.
Hallucinations most often consist of hearing voices that comment on behaviour, are insulting or give commands. Less often, people with schizophrenia may see or feel things that aren't there.
Disorganized thinking makes some people with schizophrenia feel mixed up. In conversation, they may jump randomly from one unrelated topic to another. Depression and anxiety frequently accompany these feelings.
The symptoms of schizophrenia vary greatly from person to person, from mild to severe. A specialist is needed to make the diagnosis, especially because there are no diagnostic tests.
Theories About the Causes of SchizophreniaWe know that schizophrenia is a biological disorder of the brain. The causes are not yet known, but there are several theories. There is strong evidence of important inherited factors. Many researchers are looking for genetic causes of schizophrenia that runs in families. Success may become more likely as genes for complex illnesses are found.
The characteristics of schizophrenia, along with its tendency to ebb and flow in cycles, makes it similar to auto-immune diseases.
New technology has provided some recent clues to the causes of schizophrenia. Computer images of brain activity show that the part of the brain that governs thought and higher mental functions behaves abnormally in persons with schizophrenia. Magnetic Resonance Imaging, or MRI, has shown that the same area in the brain of some people with schizophrenia appears either to have deteriorated or not to have developed normally. Computed Axial Tomography (popularly known as CAT scans) show that the fluid-filled spaces within the brains of people with schizophrenia tend to be larger than those in people without the illness.
Even the treatments physicians use today are giving scientists much-needed pieces to the puzzle. For example, some people with schizophrenia respond well when they are given medication that interferes with their body's production of the brain biochemical dopamine. This fact is leading researchers to speculate that either an over-production of dopamine or an over-sensitivity to it has something to do with the illness.
TreatmentsA number of medications have been found that help bring biochemical imbalances in many people with schizophrenia closer to normal. These medications can help a great deal in lessening hallucinations and delusions, and in helping maintain coherent thoughts. But, they usually have serious side effects contributing to non-compliance with medication and relapse.
Psychotherapy for individuals, groups or families is possible, and can mean a lot to people with schizophrenia and their loved ones. Psychotherapy can offer understanding, reassurance, insights and suggestions for handling the emotional aspects of the disorder and providing less stressful living situations.
Families can be a big help. Working closely with health care professionals, family members can learn about the illness. Families can also provide useful information to the health care professionals. They can find ways to support people with schizophrenia and provide a nurturing environment that encourages communication.
To the Future With proper and improved medication, extensive community support (especially in housing) and skilled psychotherapy, many people with schizophrenia will be able to function in the community. With these resources to draw from, many people with schizophrenia could live independently, work, enjoy family and friends.
The search for a cure continues with hope for success increasing every day.
Brochure produced through a health education grant from: Eli Lilly Canada Inc., Pfizer Canada Inc., and SmithKline Beecham Inc.