Schizophrenia

I find that schizophrenia is a topic that a lot of people don't understand, and think that it's simply hearing voices and such. However, it is apparent that the condition goes much deeper than that.
From what I know, I say one of the most obvious ways of recognising that you have schizophrenia is along the lines of socialising with others. People with extreme mental illnesses tend to be quite reclusive, keeping to themselves and not having many friends, however, if you do know somebody with an illness such as schizophrenia or bipolar disorder, or even just somebody you might believe has problems, then it is important to keep close to them, as it is easier for somebody else to diagnose somebody with a mental illness that the victim themselves.
In the case of schizophrenia, then what you should look for is, of course, odd behaviour, but even slight differences in interpretations can be significant. By this, I mean interpretation of what is seen and heard, as these can be significant if they differ between you and the victim.

I don't know if anyone has seen the film 'A Beautiful Mind', but I think that it is an inspirational film, looking closely at schizophrenia and, in particular, the mathematician John Nash, who won a Nobel Prize in economics. The emphasis of the film, however, is that it is extremely difficult to persuade a victim of schizophrenia that they are actually ill. I suppose that persistence is the key; continually telling someone that their 'hallucinations' are just that. Because of this, I assume that it must be hard to detect that you are actually suffering from the illness. If you have any doubts about your mental stability, don't block out those close to you, as they could be the key to your diagnosis and recovery.

EDIT: Think about it. Would you agree with someone if they stated that everything that you believed in was wrong? Schizophrenia can get so severe that that is the case; it consumes your life, and you no longer know what is actually real and what is not.

In order for somebody to recognize they have schizophrenia I imagine is difficult, because everybody feels righteous of themselves, I'm sure plenty of people don't see themselves as having a "disorder". If a person is unhappy there has to be balance of knowing and accepting who's fault it is of why, in respect to oneself and the "outside"/society.

I'm not a psychiatrist, but I am a physician and I see a lot of schizophrenic patients. Your best sources of medical information on the internet for a layperson are WebMD.com and emedicine.com.

Briefly to answer your questions (in a very general way):

1: How does somebody develop it?
There is a strong genetic component to schizophrenia -- it runs very strongly in families. I am not aware of specific genes associated with it, but there may well be. There are also some interesting studies that associate schizophrenia with being born in the winter and with being born in cities. Who knows.

2. How would you recognize that you have it?
From a purely clinical point of view, I would recommend to you to seek medical attention as soon as possible if you're concerned you might have it. The reason is that the specific diagnosis of schizophrenia is not what's important -- what's important is getting the right diagnosis whatever it is. Diagnosing one's self with anything, let alone a thought disorder, is tricky, and you want someone impartial to figure this out in a systematic way.

There are many different features of schizophrenia, so to answer your question would be very difficult. A common symptom is paranoia (i.e. the suspicion that people are out to get you or hurt you in some way). Other common symptoms are auditory hallucinations (hearing voices) or delusions that the radio or TV or newspaper are speaking directly to you. But there are much more subtle symptoms that someone might not recognize on their own.

3. How would you change somebodies beliefs or delusions or at least convince them that they are absurd?
It's not about convincing someone -- schizophrenia and its related disorders are disorders of thought, and there is no "rational" process that can override this. The delusions and hallucinations often simply go away in people who are treated, and they have normal lives and can accomplish the things they want to in life.

4. Whats the treatment for the disorder?
Generally dopamine-blocking agents. A bunch of (relatively) newer ones include Geodon, Zyprexa, and Abilify, but there are older agents as well. Excess dopamine in certain synapses in the brain is clearly associated with psychotic symptoms (schizophrenia is classified as a psychotic disorder, i.e. a disease of disordered thought), and blocking dopamine with these drugs ameliorates the symptoms.

If other psychiatric disorders or substance abuse problems coexist, these need to be treated too.

5. Whats the difference between schizophrenia and schizoaffective disorder and bipolar?
Schizophrenia is a psychotic disorder, i.e. a thought disorder.
Bipolar is an affective disorder, or a mood disorder. The other major mood disorder is depression. In bipolar there are swings between depression and mania, the latter being a state of grandiosity and euphoria but also associated with self-destructive behaviors (including very risk-taking behaviors, but more typically staying up all night doing things).

There is a spectrum, though, in which one can have a combination of a thought disorder and a mood disorder. Bipolar disorder with psychotic features (or depression with psychotic features) are primarily mood disorders, but may have elements of paranoia or delusions seen in psychotic disorders. Schizoaffective disorder is primarily a thought disorder, but may have affective elements (depressive type or bipolar type).


*** Getting the right diagnosis is CRITICAL because these disorders are all treated differently ***

Thanks, nice response there Aedes,



This really caught my eye. Wow, I wonder how much substance there'd be to this. Assuming a physical/biochemical cause, I wonder just how the environment during birth might affect these processes.

Fascinating stuff, thanks again.

No prob, I can get you some journal references if you're interested.

But don't assume that the time of birth itself is what's the issue. I mean this is a statistical association, but there is a lot implied by the concept "born in the winter". It means being conceived the previous spring. It means gestating during the summer and fall. It means having early infancy during the winter. It means that your mom may have been exposed to certain infections or toxins in a given season during a critical developmental moment. In other words, there may be a REAL environmental influence, but being born in the winter is just a loose marker for it.

My psychiatrist says that I have schizophrenia. Ofcourse most people with the disorder will deny it, like myself. I believe that "death"(who is a person) is trying to find me and kill me. Then I believe that there are these government agents that are trying to find me. Why I don't know yet.

There are different kinds of schizophrenia. There is paranoid, catatonic, disorganized speech, and residual.

The difference between schizophrenia and bipolar is that bipolar is a mood disorder. Bipolar can have psychotic features as well. If there are psychotic features along with a mood disorder they will sometimes diagnose whats called a schizoaffective diorder. There are two types of schizoaffective disorder. bipolar type and major deppressive type.

In my opinion schizoaffective disorder is the most serious from what I have learned but I'm not a psychiatrist yet so.

Yep, that's all accurate. They can all be dangerous, it just depends on how they manifest in someone. And there is overlap between all kinds of disorders, and people with schizophrenia can have features of several kinds.

I highly suggest reading Surviving Schizophrenia for anyone interested in learning about the illness. I've read it about 5 times over. I was skimming over it again the other night.

Oh, and also the forums on Schizophrenia.com, Indepth Schizophrenia Information and Support can be quite interesting.

Bipolar Disorder and Schizophrenia the Same Disorder with the Same Cause?
Here is some new information on schizophrenia and bipolar disorder.
I have bipolar 1-rapid cycling and mixed states with a side order of PTSD.
www.NAMI.org is place that can help you with any mental issues.
I'm always willing to help anyone with mental health issues, PM if you have any further questions.

---------- Post added 07-18-2009 at 02:08 PM ----------

I forgot to add that they are now seeing a tie in and similarities to schizophrenia and bipolar disorder, it's in the article I left the link for.

I have been labeled Schizo Affective. Schizophrenia isnt developed. It is genetic as far as studies have shown so far. There are a few theories out there that it was something that the mother did while she was pregnant, however, I do believe those have been debunked.

Schizophrenia can be described as having hallucinations, auditory delusions. These can be described as hearing voices or other noises that only the person can hear. Schizophrenia is also accompanied by manias due to the imbalance of the chemicals in the brain - not the same as bipolar disorder.

You cannot convince a schizophrenic that something is not there because they are experiencing these things by themselves. They have to come to that conclusion by themselves. The only thing you can do is plant the seed in them that other people do not see/hear what they are seeing/hearing.

The treatment for schizophrenia is psychotropic medications.

Schizo affective disorder vs schizophrenia is complicated. Schizophrenics usually cannot comprehend things the same way that a schizo affective person might, although the schizo affective person can still exhibit the same auditory/visionary hallucinations and delusions as someone with full blown schizophrenia. The schizophrenic has very poor social skills whereas the schizo affective person is able to function in the world without help. The schizophrenic is not in most cases. Let me point out that people such as John Nash were able to function in real life, however, in the end, he needed a support system to help him through what he was going through. Suicide is not uncommon for schizophrenics. Schizo affective persons are more easier rationed with.

Bipolar disorder is a mood disorder caused from a chemical imbalance of the brain.

Jamie

I like the way Aedes has answered to be honest and found the comments and explanations very good So I'll probably recap with some of this but this is the way I have experienced it in my family.

How does somebody develop it?

I am too a believer that Schizophrenia has a genetic component and that it runs in the family, so to speak. Many people do not realise that schnizophrenic symptoms, the illness itself, can be triggered by a huge life event, stress or social change, or can be a part of growing up. My sister in law has Schizophrenia and was diagnosed during school, before that period she was described as a happy and healthy child. So, I guess what I am trying to say is that the illness doesn't manifest itself from birth, it can in fact be triggered by something.


How would you recognize that you have it?

Out of ordinary experiences such as seeing or hearing things (hallucinations) are very common, especially eharing voices and believing that you are being spoken to or taunted. Paranoia and negative suspicions, such as feeling as though someone or something is trying to harm you. Of course extreme anxiety and depression can play a factor. Many schizophrenics also believe themselves to have special powers or paranormal abilities, however not in all cases.

How would you change somebodies beliefs or delusions or at least convince them that they are absurd?

You cannot ''change'' ''delusions'' as such, I like the way Aedes has described it as ''disorders of thought''. You can challenge some of the ''irrational'' situations or experiences but it is very often the case that no matter how much you tell someone that something is ok, they will not believe you - not because they don't trust you but because that's the way they believe it to be.

Whats the treatment for the disorder?

Antipsychotics and antidepressants are medicinal treatments and CBT (cognitive behavioural therapy) is sometimes successful. CBT can be especially good for paranoid thought processes and extreme anxiety.

Skizophrenia means spilt mind. The mind in a Skizophrenic has split from reality. One theroy on the cause of the symptoms of skizophrenia is that there is too much of a certain neurochemical in the brain and it causes the brain to misfire creating hallucinations delusions etc.

Being skizophrenic is somthing like this. Imagine being in a dream knowing that it is a dream. Being perfecly aware that it is a dream you do what you want to in the dream. You react to the dream in the way that you see fit, which often times is not like you would behave when awake. Then somehow a "real person", not a dream image of a real person, but an actual "real person" comes into the dream and tells you that you are no longer dreaming, even though you still know you are. Because you still know you are in a dream you pay that person no mind because you know you are dreaming and they obiously are part of the dream. I mean its obviously a dream. Dead people arent alive in real life, angels dont walk around, this is a dream not reality. You're just another nut ball in my dream telling me that its not a dream... huh...

This is the logical conclusion one would make right.

I have skizoaffective disorder. The result of skizophrena (split mind) is a flatend affect. The means that the person has very little reaction to outside stimuli there is only internal reaction to internal stimuli. The mind is split from the happenings of the present. And the result of this is unpredictabe behavior unreadable expressions and maladaptiveness in general. In skizoaffective (split affect) only the mood is split from reality but not the mind so the mood changes based on the internal stimuli (e.g. hallucinations, delusions, etc.) So the skizoaffective reacts externaly to internal stimuli.

In bipolar (manic depressive) The person has external reactions to external stimuli like a normal person. But because of the overabundance of or lack of a certain neurochemical in the brain the person over or under reacts to the various stimuli. When they are manic they are happy (exuberant) over small occurances and when depressive they are destroyed over insignificant events.

With bipolar just think of how you react to your car getting stolen. And then replace the fact that your car got stolen with the fact that you've misplaced your keys. Or imagine the feeling of hiting loto and relace hiting loto with finding your keys.

With bipolar the moods come and go in cycles sometimes you are privied to loto type reactions (e.g your car actualy got stolen, but you still feel like you just hit loto). And other times you are prone to the car theft reaction (e.g. even though you actualy just hit loto you still feel like your car just got stolen). And the bad thing is that most of the time you dont win loto or get your car stolen. Most of the time you've just lost your keys. And because you lost (or for that mater found) your keys, you're then stuck in loto, or grand theft victm mode for weeks. All of the moods depend on how much of a certain neurochemical is in your system at a given time.

I have skizoaffective (bi polar type) this means that i have a bi polar affect and a skizophrenic mind (e.g. hallucinations, delusions etc.). I react manic depressivly to my skizophrenic delusions and halucinations. Now with skizoaffective my halucinations arent as bad and neither are my moods. But the moods and delusions get together and can make things difficult. I get the best of both the bipolar world and the skizophrenic world. Its lovely sometimes. HAHAHA

The treatment for these disorders usualy consists of med therapy, cognitive therapy, and behavioral therapy and a slew of other depending upon the patients needs. The medications work to balance the neurochemical system decresing symptioms. The cognitive therapy works to help the patient realize the descrepancys in thought and then works to help the patient replace these unhealty abnormal thoughts with more effective ones. And behavioral therapy works to counter the behaviors aquired in the annals of the illness and replace them with more adaptive ones.

The hardest thing about treating skizophrenia in particular is the fact that most skizophrenic patients, by the time they get help, are very immersed in their delusional world. Because of the fact that there mind is split from reality it is difficult to pull them out of their malady. To them we are as much a delusion as their delusions are and in their delusions they tend to be unsure weather their delusions are delusions or not. Because of this they are unsure of us because they cant differentiate delusion from delusion, reality from reality, or any combonation of that in between. So developing trust is very key in any form of treatment for a skizophrenic.

I am lucky that I am skizoaffective. Because my mind is still here on earth for the most part. In skizoaffective the delusions and hallucinations dont convince you of there reality as much as they make you angry, scared, afraid or confused. They do insist upon their existence but they are more of a trouble emotionaly then otherwise.

In general i have found that given my knowledge of reality these cognitive and perceptual distorions can be very enlightening. Not always fun but useful in the end. The biggest benefit is the fact that now i can explain these things first hand to people like you all.

Thanks

Vajrasattva

you must have gotten the right help at a very early age, vaj...i am glad for how well you are able to deal with these things. makes my little troubles seem a lot smaller...

I am not sure if anyone has posted that there are different categories of Schizophrenia:

1. Paranoid Schizophrenia
   
2. Disorganised Schizophrenia
   
3. Catatonic Schizophrenia
   
4. Undifferentiated Schizophrenia
   
5. Residual Schizophrenia
   

For a brief summary of each you can follow this link:
Types of Schizophrenia

Causation is also an interesting point of discussion with regards to Schizophrenia. There are many theorised ways:

• Genetic predisposition or vulnerability that can be activated by: acute or chronic stress (stressful birth etc.), possibly environmental toxins and substance abuse.[1][2]
  
• Infection in early life that lead to higher likelihood of developing Schizophrenia[3]
  

[1] Environmental toxins:
Schizophrenia.com, paranoid schizophrenia - Schizophrenia News, lead risk factor (Feb 04 newsletter)

[2] Genetic predisposition:
Scientists Identify Gene That May Indicate Predisposition To Schizophrenia

[3] Immunology and infection:
Immune system activated in schizophrenia

Sorry this is such a brief post. I was went through all my old textbooks but I cannot seem to find the paper I was going to quote with further information - I hope this ad hoc collection of information is helpful :-) It is very important we discuss mental illness openly and become educated about the matter and I pleased by the comprehensive posts that have already been given. Cheers everyone!

- Minimal.

Hi,

I personally have known a few people (members of my close family) for several years with very extreme mental illness. I have to pick a few of you up on some of the things you have said:



This simply isn't true. The evidence on schizophrenia suggests a possible genetic contributory factor - eg a predisposition, but the genetic factory at the most is contributory.




Once again it's very misleading to state such a thing as a fact. The only evidence is that some sort of chemical imbalance may be contributory... but to my knowledge such evidence is also pretty hazy.


Well my view on mental illness having got to know very intimately some very extreme cases is unconventional to say the least, and in fact often meets with an angry response.

In my view terms like schizophrenia/bi-polar etc are all utterly arbitrary and in fact such labels make the problem of understanding mental illness even harder. I don't believe that the cause of any (or at least most) mental illness is genetic or even physical. Most treatment nowadays involves drugs, and as far as I can see such treatment is not even treatment, but just centred on stopping the patient being able to think to one degree or another thus providing nothing more than an illusion of treatment. Mental illness in my view is a disease of the mind and not the brain - it doesn't matter if you don't believe in any of the dualism between the two (although I do) because even if the mind is just the functions of the brain and nothing more, we can still observe the mental functions from an internalised subjective viewpoint, and it is to the mental functions from this viewpoint that the problems happen (IMO), and so therefore the only treatment can be directed at the mental functions from this same viewpoint. But this is rarely done due to the domination of bio-psychiatry in mental health care.

In my opinion the edifice of thought on mental illness should be razed to the ground and started again from scratch if we want to get to the bottom of it.

In my opinion bio-psychiatry is the single greatest crime of scientism.

The are broad terms, umbrella terms. But if they were utterly arbitrary that would imply that they are applied randomly to people for no reason. That isn't true.

But it isn't really a matter of opinion is it? I don't know man, you criticized Twistedgypsychil for stating things as fact, but you are pretty much just stating opinion as fact. The only difference is you say that it's your opinion before hand.

Things like bi-polar disorder are hard to treat. Drugs don't work all that well. Raze it to the ground? That would require a lot of evidence.

Sofa Sound
'The Insititute of Mental Health, Burning'

Excellent poem, thank you very much!

---------- Post added 03-16-2010 at 12:31 PM ----------



Ok... 'utterly arbitrary' was slightly over the top... but they are certainly VERY arbitrary, I would maintain they are a hinderance to a proper understanding of mental illness, and are generally very misleading to the man on the street.

Im not sure what you mean by your second paragraph. It seems almost common knowledge that mental illness has been proved to be genetic, or caused by brain imbalance etc... and it gets my heckles up whenever I hear it because its just untrue, and I will always challenge that assertion whenever its made... in fact there is to the best of my knowledge zero evidence that it is ALL genetic or biological, at the most it would a contributory factor.