Schizophrenia

Mental illnesses and disorders have been representing a sort of fogginess for all people relating to them in a way or another. Schizophrenia was, and to some extent is still, vague and perplexing because it has common aspects with other mental illnesses and disorders. And as it varies in intensity from one person to another, its symptoms “are so varied and numerous” that it is difficult and time-consuming to diagnose it or have prognoses for it; (Pratt, Gill, Barrett & Roberts, 2007). However, thanks to the great efforts of researchers, psychologists, psychiatrists and therapists, schizophrenia is no longer a horrifying abyss because we can know a lot about it. In this paper light will be shed on the definition of schizophrenia, its causes, and ways of diagnosing it through a variety of symptoms. Also means of treatment through rehabilitation, medications and family training in dealing with persons with schizophrenia are highlighted.

Schizophrenia is simply defined as a mental multi illness of unknown causes; (Burke, Gates & Hammond, 1995) and (Null, 1995). To make it simpler schizophrenia is a mental complex confusing illness that can have varied aspects most of which are featured with/by “disorders of perception and emotion”; (Null, 1995) and characterized by social functioning problems, self-care skills difficulties and inability to discern reality from unreality or fantasy; (Mueser & Gingerich, 2005). To distinguishes it from dissociative identity disorder (multiple-personality disorder), Swiss Psychiatrist Eugen Bleuler (1857-1939) in 1908 defined what he thought as the essential characteristic of the illness, compiling it from Greek where (schizo) means (a split) and (phren) means (in the mind); i.e. “a split in the mind between perception and reality”; (Mueser & Gingerich, 2005), or “a splitting of the mind” where “schizophrenic language, thoughts, and feelings are often disconnected or split from each other”; (Burke, Gates & Hammond 1995).
Schizophrenia, like any illness, must have some causes or factors, among which are biological causes entailing some sort of “disturbance in the brain”; yet which biological factors are responsible for the illness are still undefined; (Mueser & Gingerich, 2005). Anatomical studies of the brains and pharmacological experiments pointed out some genuine brain abnormalities in those who had the illness”. Nasrallah (1990) and others proved that according to electrophysiological rhythms, variability is greater in the brains of the people with schizophrenia. Also, current studies connote schizophrenic effects to temporal and front lobe dysfunction of the central nervous system, which play a crucial role in “self-monitoring, emotional processing, and willed activity”; (Burke, Gates & Hammond 1995). A second theory of biological causes is the “dopamine hypothesis” which attributes schizophrenia to an imbalance in brain chemicals that play a vital part in all its functional aspects such as “the ability to think, feel, perceive, and act in a planned, goal-directed” style; (Mueser & Gingerich, 2005). An imbalance in dopamine neuron transmitter in excess relates to schizophrenia. It is believed that schizophrenia has also genetic and environmental factors that raise a person’s probability of developing the illness by 10% in first degree kinship (like parents or siblings). Finally, it is thought that biochemical and nutritional factors can account for some mental illnesses including schizophrenia; (Null, 1995). Because of pollution, toxic particles of pollutants, whether chemicals or heavy metals, are ingested and over time get into the brain affecting its chemistry, hence mind and behavior. Dr. Hal Huggins has shown that many people with mental illnesses are suffering from different types of toxins, such as mercury, lead, copper, iron, and aluminum poisonings.

Schizophrenia diagnosis means recognizing and classifying the illness through a spectrum of symptoms, according to one of the two diagnostic systems, which are widely used throughout the world; one is the “Diagnostic and Statistical Manual of Mental Disorders” developed by the American Psychiatric Association 4th edition (DSM-IV), and the other is the “International Classification of Diseases” developed by the World Health Organization 10th edition (ICD-10. “A diagnosis of schizophrenia must be based on interviews with the person, relatives and others who know the person well,” and medical tests are made to exclude physical symptoms (Mueser & Gingerich, 2005).

Schizophrenia symptoms mean signs or indications of the illness. They are complex as the illness is not a unitary disease and it covers a number of disorders. According to the American psychiatric Association, symptoms are classified as positive and negative. Positive symptoms, (abnormal experiences), manifest an excess or distortion of normal functions; (Pratt, Gill, Barrett & Roberts, 2007). They are characterized by the manifestation of patently absurd or false thoughts, behaviors, or feelings. Hallucination and delusions are the most common and intensely-mildly fluctuating two types of psychiatric symptoms; (Mueser & Gingerich, 2005). Hallucinations are false perceptions-sensations including hearing, seeing, feeling, tasting and smelling things that are not present in the environment. Delusions are false or not shared beliefs. Delusions include other types such as persecutory (paranoid) delusions, delusion of reference, delusion of control, grandiose delusion. Also, thought disorders associated with cognition or thinking, or the way the mind and brain process information are other types of delusions such as thought broadcasting, thought insertion, racing thoughts, somatic delusion, and delusions of guilt; (Mueser & Gingerich, 2005), and (Pratt, Gill, Barrett & Roberts, 2007).

On the other hand, negative symptoms are abnormal behaviors that denote the diminution or loss of normal functions; (Pratt, Gill, Barrett & Roberts, 2007). They are harder to identify as indications to illness because they are characterized by the absence of normal thought, behavior or feelings, and they tend to be fairly stable over time, whereas psychotic symptoms may fluctuate more. Negative symptoms include blunted/flat affect which means lack of noticeable facial or vocal expressiveness of emotion, alogia, apathy reflecting discouragement or hopelessness about the future, little energy, easy fatigue, and finally anhedonia; (Mueser & Gingerich, 2005).

Various ways of schizophrenia treatment include medication, rehabilitation, and educating family members, relatives and even friends. They all aim at giving the persons with schizophrenia the most opportunities to live, to work and to enjoy until recovery takes place. While recovery means eliminating the vulnerabilities and symptoms or related problems of the illness, ((Mueser & Gingerich, 2005), rehabilitation means the available services and technologies that help the disabled to adapt to their world; (Deegan, 1988 journal). Recovery, as a process rather than an outcome, streams in line with rehabilitation; (Mueser & Gingerich, 2005). Thus treatment is classified into two categories: biological or somatic and psychological. Somatic category means medication but also electroconvulsive therapy while psychological category refers to efforts to reduce symptoms and to improve functioning by using interventions that affect social or psychological factors; (Pratt, Gill, Barrett & Roberts, 2007).
Medications such as the major tranquilizers and neuroleptics, Stelazine and Chlorpromazine, are for the positive symptoms of schizophrenia; while mood-related drugs such as the antidepressants are for negative symptoms. Two new effective antipsychotic drugs, Risperidone and Clozapine, have been developed for the two types of symptoms; (Burke, Gates & Hammond 1995) & (Pratt, Gill, Barrett & Roberts, 2007). Orthomolecular treatment means putting the basic bodily constituents (proteins, amino acids, carbohydrates, fats, vitamins, minerals, oxygen, enzymes, nucleic acids, water, and electromagnets and biomagnetic energy forms) into balance. Nutrients such as vitamins B3, B6, C and minerals such as zinc and manganese have proved very influential; (Null, 1995).

Rehabilitation means the available services and technologies that help persons who are disabled with schizophrenia or any psychiatric illness to adapt to their world and to their environment involving programs, relatives, colleagues, coworkers, peers, mates and friends. Rehabilitation aims at helping the disabled “to meet the challenge of disability” and to achieve a novel and appreciated “sense of integrity”. There are some principles for creating good environments in rehabilitation programs such as flexibility of guidelines for acceptance, amendments of their linear designs, change of their absolute definition of failure into a relative and proportional one, creation of fail-proof programs models, and finally, conductivity of rehabilitation environment to the recovery process; (Deegan, 1988 journal).

To overcome problems of communication, high levels of stress, frequent arguments, not talking to each other, and hurtful misunderstandings, and to achieve effective communication and positive relationships between family members and the person with schizophrenia, the family members must work closely to manage the disorder and prevent conflicts. Knowing and recognizing the positive and negative symptoms of schizophrenia can help setting tolerance and patience with the persons with schizophrenia, hence lowering the amount of stress and conflict. This can be achieved by getting to the point directly and simply, expressing one’s feelings directly, straightforwardly and clearly, giving lots of positive feedback, making positive and nondemanding requests, expressing upset feelings constructively, always checking out what the disabled thinks or feels, and finally by suggesting taking a break from stressful situations; (Mueser & Gingerich, 2005)

In conclusion, schizophrenia is no longer a horrifying illness once its precise and compiling definitions that distinguish it from other psychiatric disorders are already known. Identifying its symptoms, whether positive or negative, gives, deepens and highlights our insights in recognizing and diagnosing the illness, moreover, helps us to make prognoses of the development of the illness. This will consequently result in selecting the most suitable type of treatment, whether by using somatic (biological) type which means (pharmacological) medication and orthomolecular treatment (that is balancing body constituents by giving vitamins and minerals), or/and psychological treatment that sets a symptom-reducing and function-improving environment by creating rehabilitation programs and training the family members and relatives in how to deal with the individual with schizophrenia.

References:
1- Null, G. (1995). Nutrition And The Mind. New York, NY: Four Walls Eight Windows.
2- Burke, D. R.(1995). When The Music Is Over: My Journey into Schizophrenia. New York, NY: BasicBooks
3- Barrett, M. N. Gill, J. K., Roberts, M. M., Pratt, W. C. (2007). Psychiatric Rehabilitation. Burlington, MA: Elsevier Academic Press.
4- Gingerich, S., Mueser, T. K. (2006). The Complete Family Guide to Schizophrenia. New York, NY: The Guilford Press.
5- Deegan, P. (1988). Recovery: The Lived Experience of Rehabilitation. Psychological Rehabilitation Journal, 1988.

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