Schizophrenia is the name given to a group of psychotic disorders associated with significant disturbances in thought, emotion and behaviour.
A person with untreated schizophrenia can experience sequences of ideas that do not logically relate to one another, disorganised speech, a faulty perception of reality, and unusual motor activity or body movements.
Someone who is experiencing untreated schizophrenia will often withdraw from the people around them into what most people would consider a land of fantasy.
Schizophrenia does not mean someone has more than one personality or a “split” personality.
What causes schizophrenia?
The causes of mental health problems have been linked to several factors:
- biological factors like the body’s chemistry, genetic make-up and physical health
- psychological factors influenced by the person’s upbringing, emotional experiences and interactions with other people
- social factors to do with the person’s current life situation and the cultural and social environment they are influenced by.
There seem to be several factors which have to be present in order for schizophrenia to develop. Often it’s the interaction, or the combination of all those factors, which cause its development.
So, for example, there might be an interaction between a person’s biological make-up, a stress or change in their environment and the person’s ability to deal with this stress or change.
This can be more likely to occur if a person doesn’t have good relationships with friends and family and therefore possibly less support.
Genetic factors and schizophrenia
People in the general population have a very small chance of developing schizophrenia in their lifetime. This chance gets bigger when family members have a history of experiencing schizophrenia.
Genetic factors seem to play a very important role in determining whether someone will develop schizophrenia. For example, a child of one parent with schizophrenia has a greater chance than the general population of developing schizophrenia.
If both parents have schizophrenia the risk increases. The causal relationship is not well defined e.g. the extent to whether this is nature or nurture.
It has been suggested that stress and/or trauma can be one of the things that may cause schizophrenia. Family factors causing stress may affect the course of the illness, in terms of how severe the symptoms are and how long they last.
There is no convincing evidence to say that a person’s family situation causes schizophrenia.
Some research suggests drug misuse is related to the development of schizophrenia. It is likely that substance misuse may bring on or worsen the symptoms and get in the way of the treatment of a person with schizophrenia.
It has been thought for a long time that the neurotransmitters (the chemicals in the brain that allow nerve cells to talk to each other) are involved in the development of schizophrenia.
There are no definite answers about this or the rest of the theories yet, but there is lots of research going on in this area.
Positive symptoms of schizophrenia
Positive symptoms are additional experiences or excessive behaviours that are not usual for that person to go through, and are considered by the general population to be unusual.
These are things like hallucinations, delusions and thought disturbances/disorganised speech.
Hallucinations can be in a few different forms. The most commonly experienced are auditory hallucinations where the person can hear voices talking, laughing or making noise.
The voices can comment on the person’s activities, can issue instructions, they can argue, or it may be just that the person can “hear” their own thoughts being repeated or commented on.
Noises around them may also become too much and hearing them could be painful. Don’t confuse this description however with your own general thoughts inside your head that everyone has.
Other sensory hallucinations can occur where the person can feel sensations that do not exist, such as burning, tingling or stinging sensations.
They may experience sensations of not feeling “real” or feeling machine-like. Or, they do not feel connected to their body. Their bodies or a particular body part may feel and/or look strange to them.
Visually they may imagine that they see things that aren’t there, or find that visual stimulus in an extreme form such as light could be almost blinding.
The hallucinations may be accompanied by a delusion that may confirm and encourage the hallucination. Delusions are thoughts held by a person which most people would disagree with.
An example of a common delusion is where a person believes they’re someone other than who they actually are, usually someone famous. Paranoid delusions can be experienced where the person believes that they are being watched or persecuted.
Disorganised speech (thought disorder)
This means a person has difficulty in organising their thoughts and communicating them in an order that a listener would understand.
Random words or new topics are injected into the conversation which will not make any sense to a person listening.
Negative symptoms are the absence of thoughts and behaviours that are normally present in people in the general population.
These symptoms are often very stable and affect the person throughout their life.
If you’re experiencing negative symptoms, they might include:
Lack of expression – also referred to as blunted affect. Sometimes people who are psychotic find their expressions are diminished. Their face, tone of voice, and gestures may seem flat, and they may seem uninterested in their surroundings – which is not necessarily the case.
Unmotivated – also called apathy. People often feel unmotivated and sometimes sleepy. They might have trouble doing even simple things, and feel like there is nothing they are interested in.
Lack of pleasure – also referred to as Anhedonia. A psychotic illness often affects a person’s ability to feel pleasure. Sometimes the person may no longer feel enjoyment like they used to be it from things like going to the movies, or sharing a close relationship.
Difficulty speaking – sometimes called poverty of speech. Sometimes the person can find it hard to speak. Often their conversations are short and uncomfortable. This can make conversation with them difficult, and frustrating for both the person experiencing this symptom, and anyone else in the conversation.
Inattention – this is when the person can often be easily distracted and this can make work, school or any activity very difficult and often highly frustrating.
Catatonia and inappropriate affect
People with schizophrenia can also experience other symptoms that don’t fit into the categories of ‘positive’ or ‘negative’.
Catatonia – grimaces, strange facial expressions, repeated gestures, manic gestures.
Catatonic immobility – strange positions that a person with schizophrenia will hold themselves in for a long time.
Inappropriate affect – A person with schizophrenia may express a response to some news that does not match, or is not appropriate. For example, some sad news may cause them to smile and laugh.
Treatment for schizophrenia
The most common form of treatment is a combination of medication and support. Support means things like individual counselling, information and support from the person’s family and friends.
People with schizophrenia can also benefit a lot from a stable living environment, structure, a meaningful job/study/hobby and being kept from as much stress as possible.
Medication will usually be prescribed by a GP or psychiatrist. A psychologist, social worker or psychiatric nurse can also help you to manage your symptoms and get on with your life.