The term “schizophrenia” comes from Greek words meaning “split mind.” This severe psychiatric disorder affects your perception of reality. People with schizophrenia may have visual or auditory hallucinations (seeing or hearing things that aren’t perceptible to others) or delusional thoughts (believing things that aren’t real). They often suffer from paranoia, believing that others are talking about them or plotting to harm them.
They may respond to the instructions of internal voices that tell them how to think or behave. Schizophrenia can cause disorganized thinking and make it hard to communicate your thoughts to others.
These hallucinations and delusions can intrude on daily life, making it hard to hold down a job, maintain a relationship or have a family. However, many people with this disorder are able to lead fulfilling lives with the right psychiatric treatment. There is no permanent cure for schizophrenia; treatment focuses on managing the symptoms that interfere with your everyday activities.
Who Is Affected by Schizophrenia?
About 1 percent of the American population meets the criteria for schizophrenia, according to the National Institute of Mental Health. This psychiatric disorder affects both men and women, and it usually manifests itself for the first time in teenagers or younger adults under the age of 30. It’s unusual for the disorder to appear in middle-aged or older adults who have never had symptoms of schizophrenia before.
This mental illness touches people from all walks of life, in all areas of the world. In some cultures, the visual and auditory hallucinations of schizophrenia have been given a spiritual significance, and schizophrenics have been regarded as visionaries. But in our society, people who suffer from this condition are often feared and marginalized. Schizophrenics are at risk of substance abuse, homelessness, chronic unemployment, incarceration and violence. To make the situation even more challenging, people with severe schizophrenia may be unaware of the need for treatment or the possibility of leading a more rewarding life.
What Are the Signs and Symptoms?
The symptoms of schizophrenia vary from one individual to another. Some individuals display disordered thought patterns, strange beliefs and odd body movements, while others suffer from paranoia, agitation and intense fear. Some schizophrenics remain very still for long periods of time and show no emotional reactions, a condition known as “catatonia.” According to the Mayo Clinic, schizophrenic symptoms can be divided into three basic categories:
- Positive symptoms. Also known as “psychotic symptoms,” these are the obvious signs of a mental split with reality, like hearing voices, seeing things that aren’t there and speaking in odd ways.
- Negative symptoms. These symptoms reflect an absence of a normal behavior, such as social isolation, a flat affect or a lack of decision-making capabilities.
- Cognitive symptoms. These symptoms affect the way you think, remember or process information.
When schizophrenia first appears — often in the teens or early 20s — it may look like typical behavior for a young person. Teens are often moody, withdrawn and quirky by nature, and parents may assume that these behaviors are just an adolescent phase. A few of the red flags of schizophrenia in teens are listed below:
- Social isolation combined with increased suspicion or fear of others
- Responding to voices or sounds that others don’t hear
- Disorganized writing or speech
- Sleep disturbances
Teenagers with a family history of schizophrenia are more likely to develop this psychotic disorder themselves. Parents and teachers shouldn’t be expected to diagnose a complex illness like schizophrenia, but they should be alert to changes in a teenager’s behavior and seek further help from mental health specialists when necessary.
What Causes Schizophrenia?
The exact cause of schizophrenia is still unknown, but according to the National Alliance on Mental Illness, possible causes include:
- Heredity. The incidence of schizophrenia is much higher in close family members.
- Brain chemistry. Imbalances in certain neurochemicals, like glutamate and dopamine, may be partly responsible for schizophrenia.
- Brain structure. Clinical studies indicate that there may be differences in the structural composition of the brain in people with schizophrenia.
- Environmental factors. Social stressors, childhood abuse or viral infections may contribute to the development of schizophrenia.
Schizophrenia isn’t caused by family conflicts, domestic violence or life transitions, but the onset of the illness may appear when the individual is under emotional stress. The death of a parent, a divorce, a severe medical illness or the pressures of college life may trigger an episode of psychosis, or a loss of contact with reality. However, the roots of the disorder probably lie in the individual’s genes or in his or her brain structure.
What About Addiction and Schizophrenia?
Substance abuse is extremely common in people who suffer from schizophrenia. In fact, some of the symptoms of drug or alcohol abuse — delusional thinking, unpredictable behavior, disordered speech, mood disturbances, etc. — closely resemble the symptoms of this mental disorder. Schizophrenics in the midst of a psychotic episode may be arrested or assaulted because of behavior that’s attributed to drugs or alcohol. Because the disorder is not well understood by the general public, it’s often assumed that people who are struggling with the effects of schizophrenia are really just intoxicated.
According to the American Journal of Psychiatry, about half of those who meet the criteria for schizophrenia also have a substance use disorder. Alcohol and marijuana, both central nervous system depressants, are the most commonly abused drugs in this population. Substance abuse increases the risks of poverty, homelessness and social marginalization in schizophrenics. It also increases the danger of medical complications like respiratory infections, communicable diseases, liver and kidney problems, and accidental injuries.
For people who are living with schizophrenia and a substance use disorder, recovery can be extremely challenging.
Schizophrenia poses serious obstacles to treatment, such as:
- Low rates of compliance with treatment plans due to disordered thinking or paranoia
- Difficulty concentrating during counseling sessions or support groups
- Lack of access to affordable rehabilitation facilities
- Lack of convenient transportation
- Low motivation to continue with an extensive rehabilitation plan
Integrated treatment for co-occurring disorders offers hope for schizophrenics who struggle with addiction. In an integrated treatment program, both the symptoms of schizophrenia and the behaviors associated with substance abuse are addressed at the same time. Treatment is provided at a single location by a staff of psychologists, therapists and counselors. Case management services are available for clients who need referrals to community resources like affordable housing, transportation, job placement or medical care.
How Is Schizophrenia Treated?
Like diabetes or heart disease, schizophrenia is a chronic, long-term illness that usually requires lifetime symptom management. Although there’s no “cure” for this psychiatric disorder, many individuals with schizophrenia develop the ability to build meaningful, satisfying lives, notes the U.S. National Library of Medicine. The primary goal of treatment is to help each individual reach his or her full potential, no matter where that point may be.
Psychosocial therapy and medication are the core components of a treatment program for schizophrenia. While symptoms are under control, the client attends counseling sessions with a psychiatrist, therapist, social worker or other mental health professional. Counseling is usually based one or more of the evidence-based treatment models for psychiatric disorders. Popular approaches to treatment include Cognitive Behavioral Therapy (CBT), which helps the client modify negative behaviors, and interpersonal therapy (IPT), which helps the client improve his or her relationships with others. The objectives of talk therapy sessions include:
- Gaining a better understanding of the illness
- Identifying thought patterns and behaviors that are harmful to the clients
- Discussing the stresses and social situations that trigger schizophrenic symptoms
- Developing effective coping skills for dealing with life’s stresses
Along with one-on-one therapy sessions, clients can benefit from counseling sessions with others who are living with schizophrenia. In these sessions, clients talk about their experiences, provide support and encouragement, and discuss coping strategies for the “real” world.
The severity of schizophrenia usually requires lifelong pharmacological therapy. The medications used to treat schizophrenia can cause powerful, possibly dangerous side effects, and they must be managed carefully by medical professionals. The most commonly prescribed medications include drugs in the antipsychotic class. Atypical antipsychotics (aripiprazole, clozapine, olanzapine, risperidone) are newer drugs with fewer debilitating side effects. Typical antipsychotics (chlorpromazine, haloperidol, perphenazine) are older medications that have more serious neurological side effects. Antipsychotic medications can help in the following ways:
- Stabilize emotions
- Reduce the severity of hallucinations
- Minimize destructive behaviors
- Decrease the intensity of delusional thinking
Sedative drugs, antidepressants and anti-anxiety medications may be combined with antipsychotics as part of an overall medication program. Medication therapy requires consistent, careful monitoring and regular assessment by the prescribing physician to make sure that the drugs remain safe and effective.
At times, people with schizophrenia may go through a sudden onset of symptoms, in which their hallucinations, delusions and behaviors become much worse. These episodes can be extremely dangerous — mostly to the individual himself. During a psychotic episode, the risk of self-injury, suicide, assault or incarceration increases dramatically. Hospitalization is usually required to ensure that the individual is safe and well cared for until the episode subsides.
Where Can I Get Help?
There are a wide variety of public and private resources available to individuals with schizophrenia and their families. For those who lack the financial resources to pay for evaluation and treatment, community-based mental health centers can provide valuable interventions. Individual psychotherapy, pharmacological therapy, group support and crisis intervention are available at little or no cost to low-income patients and their loved ones.
At La Paloma, we provide addiction treatment services to individuals with schizophrenia and other co-occurring mental health disorders. Our addiction specialists have specialized training in both substance abuse treatment and the treatment of severe mental illness. Whether you’ve just discovered that a loved one has schizophrenia or you’re already dealing with the serious repercussions of mental illness, we encourage you to contact us to start the process of healing.