Behind the Diagnosis...
Miia Novak, Psy.D
Schizophrenia is a scary, daunting word. When we hear it, most people immediately fall onto the assumption of a sufferer having lost their marbles. However, that is not the case. When it comes to schizophrenia, there is a lot of misconceptions about what it truly is. It is a scary and frightening condition in its own right, as it can manifest and develop equally amongst men and women. About 1 in 100 people will have one episode of schizophrenia, with two thirds of these developing further episodes at some point. At least 26 million people worldwide are living with schizophrenia, 2.6 million being Americans, according to the World Health Organization - with many more indirectly affected by it.
In this series, I’m going to be divulging into the inner workings of various mental conditions that are very much present in everyday life. We’ll be looking into the mind of those affected by such conditions, as well as the treatments available today with the wonders of modern medicine, therapy and support. We’ll also be debunking the myths and misconceptions behind these disorders, which negatively impact the support people suffering from these conditions get, affecting their path to helping combat their condition, or cause them to not seek support at all.
Behind the Diagnosis of Schizophrenia.
The Symptoms of Schizophrenia.
When it comes to symptoms of schizophrenia, there is actually quite a few. Schizophrenia changes how a person thinks and behaves. The condition may develop slowly. The first signs can be hard to identify as they often develop during the teenage years. With young people, some symptoms can be mistaken for normal adolescent behavior. For example, becoming socially withdrawn and unresponsive or changes in sleeping patterns. Many believe it is just one ‘symptom’ with underlying behaviors. This is simply not true. As a matter of fact, in the world of psychiatry, it is accepted there is actually and called Positive and Negative symptoms of schizophrenia. One might ask, how could there possibly be a positive and negative to such a condition? Well, it basically means what you would see in a normal person, would be considered abnormal. It breaks it down, and groups the symptoms to make it easier to understand the inner workings behind schizophrenia on a simpler level.
So, what would these positive and negative symptoms look like? Well, for starters;
Hallucinations are positive.
Hallucinations are when you see, smell, hear, taste or even feel things that do not exist. The most common being the hearing of voices. For a person experiencing a schizophrenic episode, these hallucinations can and are very real to the person. Even though the people around them can’t hear, or experience the same sensation, the person affected takes it as fact.
Psychiatrists and mental health professionals have done research into the hallucination factor. Brain-scanning shows there is a change in the speech area in that sector of our brain to those hearing voices for example. The brain mistakes the thoughts for real voices, as if they truly are hearing voices as fact. Often enough, it is not always experienced as a ‘one on one’ talk so to say - the voices can originate from different places, for example the television or car radio. Some people describe the voices they hear as friendly or even pleasant, however more often they’re rude, critical and abusive to others.
Hallucinations like this also factor into the next symptom;
Delusions are positive.
By definition, a delusion is a belief held with a very strong conviction despite contradicting reality, even if this belief is based on strange or unrealistic views. It can affect the way a person suffering from schizophrenia behaves. Delusions can also begin suddenly, or develop over weeks, months or even years. Schizophrenics may develop a delusion to explain the hallucination they are experiencing. For example, one might describe their actions of hearing voices as someone trying to monitor them, such as the police or media. They may experience a paranoid delusion, one where they believe they are being harassed or persecuted over their choices. May believe they are being followed during their daily life, or being plotted against which often tends to be a family member or friend. Other such delusions might be believing the media, newspapers and TV are relaying and communicating messages to you personally. These delusions are present in a lot of cases of schizophrenia, however many do say it is not as prevalent to them personally, like the extreme cases provided above.
Changes in behavior and thoughts
This is another ‘positive’ symptom that’s listed. What this means is, a person’s behavior may become more disorganized and unpredictable in what they do. Their appearance may seem unusual to others they come across. People with schizophrenia may also behave inappropriately to their surroundings, they become agitated or shout or swear for no apparent reason. May also believe that their thoughts are not their own, or being controlled by someone else, or even disappearing as if someone removed a certain thought from their mind.
Negative symptoms of schizophrenia often appear several years before the first acute episode. Normally psychiatrists and mental health professionals call this the ‘prodromal period’ of schizophrenia. These symptoms usually appear to gradually and slowly get worse as time progresses. This might include the person becoming more socially withdrawn, lose interest in appearance or personal hygiene. However, these symptoms can be very difficult to tell if they are related to the development of schizophrenia, it could possibly be caused by something else. Other symptoms that people living with the condition they said affected them was the likes of losing interest in activities and life itself, like forming relationships. This could also contribute to another condition known as depression which is why it can be hard to tell. Lack of concentration and changes to their sleeping patterns is another. Such symptoms can and do lead to problems with friends and family. It can be mistaken for deliberate rudeness, for instance.
The First Episode
When dealing with schizophrenia, what often follows at some point in the condition’s lifetime is psychosis. When it’s time comes around, the very first episode of acute psychosis can be extremely difficult to cope with - for the person who is affected with the condition and for their family and friends. It’s frightening for those exposed to it, and can last for several weeks. People often have episodes of schizophrenia when their symptoms are severe. This is acute schizophrenia. They can then go through periods with few or no symptoms. Thoughts can still be confused or muddled. Even when there are no obvious external symptoms. Drastic changes in their behavior can occur, becoming extremely upset, anxious, angry or confused with those around them. They may grow wary and suspicious of friends and family. They may not think they need help, or find it very hard to persuade them to visit a professional. Losing touch with reality is a big symptom in an episode of psychosis. Disturbed thoughts become the forefront of psychosis, they may believe an organization or someone is out to get them. This ties in with the delusions spoken about earlier, however more rampant during an episode.
Misconceptions about schizophrenia
When it comes to the topic of schizophrenia, there is quite a lot of misinformation regarding it. It’s more misinformed than any other mental health condition out there. A diagnosis of schizophrenia does not mean the person affected has a ‘split personality’ or mean that the person will be calm for one minute, and out of control the next. That is not what schizophrenia as a whole does. It often gets confused with psychopathic tendencies, or bi-polar disorder. Stories, movies and other forms of media often tend to present people with schizophrenia as dangerous and unhinged, even though most people diagnosed with the condition do not commit any violent crimes. Another misconception is that those affected upon who hear voices are dangerous and tell the person to commit a violent crime. This is not the case, in fact the voices are more likely to suggest they harm themselves than someone else and actually do have a choice in what the voices say to them.
Another misconception being that schizophrenia only involves delusions and hallucinations. This is incorrect. Psychosis is unusual and frightening, and its popular culture in media so it naturally associates schizophrenia with delusions and hallucinations more than any other symptom. This causes the misinformation with the positive and negative symptoms. Another big myth and misconception is that schizophrenia cannot be treated. Again, untrue. In older movies, or older generations in general, people suffering from the condition were taken away to institutions and left there for the rest of their lives in isolation. This obviously caused the condition to worsen and made people believe it was lost hope. It was often seen as receiving a life sentence in prison. Although it’s true it cannot be cured, it can be successfully treated with rehabilitation, psycho-social therapies and medication. Proper treatment however requires the person to come to terms with the condition, and seek the help they need, Institutions are there to help one another, not lock them away like the olden times. With the proper treatment from said professionals and institutions.. People with schizophrenia can start being themselves again and become completely healthy.
If you or someone you know and care for, are experiencing the symptoms of schizophrenia - you may wish to contact your GP or reach out to psychiatric professionals who can steer the affected in the right direction. If you do not feel comfortable approaching it that way, speaking to social services or a local community health team can also support you.
As you need urgent support, or feel like harming yourself or anyone else for that matter, head to the nearest hospital emergency department, or dial 911.
As scary as the condition might sound, getting the help you or someone you know, needs, is the first step to overcoming it.
Next week, Behind the Diagnosis will focus on the topic of Borderline Personality Disorder