Schizophrenia - Types, Symptoms, and Medication

What is Schizophrenia?

Schizophrenia definition states that it is a chronic brain disease in which a person interprets reality abnormally. It is a severe long-term brain disorder that affects how a person thinks, behaves, acts, or feels. Schizophrenia meaning: “it is a mentality or approach characterized by inconsistent or contradictory elements.”

It is a mental disorder that involves the relationship breakage between emotions, thoughts, and behavior. It leads to the wrong perception and inappropriate actions. It is a mental fragmentation in which a person withdraws from reality and personal relationships into delusion and fantasy.

People with schizophrenia require lifelong treatment even if their symptoms get better. They need to take the antipsychotic medication their entire life. Psychosocial therapy can also help in managing the symptoms. However, in a few cases, hospitalization may be required.

What Causes Schizophrenia?

The exact cause of schizophrenia is still unknown. However, the known causes include brain chemistry, genetics, and various environmental traits. The nature of schizophrenia causes is complex, and they are not fully understood. Therefore, the treatment is focused on managing the symptoms and normalizing the day-to-day functioning rather than curing the disease.

Schizophrenia research studies are looking into new ways to detect, treat, prevent, and mitigate the disease. Research on the causes of schizophrenia strongly suggests that a little brain’s chemical balance disorder will be heavily implicated.

It is associated with an excess of receptors for dopamine. Dopamine is a type of neurotransmitter that our body makes, and our nervous system uses to send messages between nerve cells. The dopamine hypothesis of schizophrenia states that hyperactive dopamine transmission results in schizophrenia symptoms. Researchers are still not sure about these significant causes, but they indicate it is a brain disorder.

Schizophrenia Symptoms

Symptoms of schizophrenia may vary from person to person. Usually, it involves distorted thoughts, paranoia, hallucination, delusion, disorganized speech, and impaired ability to function. The signs of schizophrenia fall into four different categories:

Positive Symptoms of Schizophrenia

Positive symptoms or psychotic symptoms are such symptoms that are abnormally present. They include hallucination, delusion, and thought disorder. People with positive symptoms may not be able to distinguish reality from imagination. They may experience the world in a distorted way.

Psychotic disorder indicates the altered perception, i.e., changes in smell, taste, touch, hearing, and vision.

• Hallucination: It is a state in which a person hears voices or sees things that don’t exist in reality.
• Delusion: A schizophrenic person held beliefs that are not based in reality.
• Thought Disorder: It is a state in which a person experiences unusual thinking, which is inferred from disordered speech.

Negative Symptoms of Schizophrenia

Negative symptoms are such kinds of symptoms that are abnormally absent. They include loss of motivation, decrease or loss in the ability to initiate a plan, etc. It is basically the lack of ability to function properly.

Lack of emotions, negligence of personal hygiene, or unable to make eye contact are a few examples of negative symptoms. Moreover, an individual experiences the following things:

• Reduced or loss of interest in daily activities
• Lack of the ability to experience pleasure
• Lack of motivation to begin, plan or sustain activities
• Reduced or disordered speaking
• Inability to express emotion

Cognitive Symptoms of Schizophrenia

Cognitive symptoms include problems with paying attention to something, inability to concentrate, and difficulty memorizing. Some individuals show very mild schizophrenia cognitive symptoms. But, mostly, these symptoms are very prominent and interfere with normal activities. Usual or normal activities include remembering, learning, or having conversations, etc.

Individuals specifically experience the following things:

• They have difficulty in memorizing things.
• They have difficulty paying attention or focusing.
• They have a problem with processing information immediately after learning it.
• They cannot make decisions.
• They can’t have a normal conversation with anyone.

Disorganized Symptoms of Schizophrenia

A person who is diagnosed with schizophrenia usually has trouble with logical thinking. Disordered symptoms include bizarre behavior, disordered speech, confused thinking, abnormal behavior, and logical thinking problems. An individual with disorganized symptoms usually show the following signs:

• They lack the motivation to do anything.
• They experience bizarre behavior and do not want to be a part of any social gathering.
• Useless or excessive movements.
• They can’t think logically or have difficulty in logical thinking.
• They may behave like a child or show unpredictable agitation.
• Lack of response or resistance to instructions.

The most common early signs of schizophrenia include insomnia or oversleeping, depression. Lack of feeling emotions, social withdrawal, ignorance of personal hygiene, and disordered speech also included. These warning signs may be the result of various reasons, not just schizophrenia. However, these are the signs that a person is having some mental problem, and he needs help.

Moreover, men and women both are equally likely to get this disorder. But, men tend to get the early onset of schizophrenia. The ages of onset usually tend to hold after puberty.

Individuals are usually diagnosed in their late teens to early 30s. People less than age 12 and more than 40 rarely or hardly develop this disorder.

Schizophrenia Types

It is a mental disease that indicates a brain disorder. It affects an individual's behavior and thoughts. Schizophrenia affects how a person thinks, behaves, feels, or acts. It affects the sense of what is real.

Experts are now considering it a spectrum disorder related to various mental disorders that share some symptoms. There are five different types of schizophrenia:

1. 1. Paranoid Schizophrenia: It is the most common type of schizophrenia and is usually characterized by positive symptoms. The symptoms include delusion and hallucination. But, it does not include a lack of emotion or disorganized speech.
2. 2. Residual Schizophrenia: An individual who has a history of schizophrenia positive symptoms. But now, only has lingering negative symptoms fall under this category.
3. 3. Catatonic Schizophrenia: It is characterized by catatonia. An individual experiences catatonic excitement, i.e. excessive movement, or catatonic stupor, i.e. decreased movement.
4. 4. Disorganized Schizophrenia: Disorganized or hebephrenic schizophrenia is characterized by disorganized behavior or speech. Individuals experience an inappropriate or lack of emotional response.
5. 5. Undifferentiated Schizophrenia: An individual who doesn’t fit into any category because he shows symptoms of more than one kind. This individual exhibits both positive and negative symptoms.

People with schizophrenia have any of these subtypes of schizophrenia for at least six months. The early schizophrenia onset is usually paranoid schizophrenia symptoms. However, there could be a time when people did not have any symptoms at all. But the first one started six months ago, and people have continuously experienced it for a month.

Schizophrenia Diagnosis

Schizophrenia can be diagnosed if you are experiencing one or more of the symptoms mentioned above. A mental health professional needs to check your complete medical history and perform physical examination. There is no laboratory testing available for this disorder. But, doctors use various diagnosis tests like CT scans, MRIs, or blood tests.

For diagnosis purposes, the doctor does the physiological evaluation to eliminate any physical illness as a symptom. If no physical illness symptom is found, the doctor refers the patient to the psychologist or psychiatrist. Psychiatrists and psychologists are professionally trained to diagnose and treat schizophrenia.

Psychiatrists or psychologists use various assessment tools and design interviews to evaluate the patient for schizophrenia. They need the patients’ complete medical history and want to know if any of his family members is suffering from schizophrenia. They will closely observe the patient’s behavior and attitude. They need to determine if the symptoms are pointing to a specific disorder outlined in DSM-5.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is a standard reference book for recognized mental illnesses. It is published by the American Psychiatric Association (APA). According to DSM-5, a person who has schizophrenia must continuously show two or more symptoms for one month.

One of the symptoms must be delusion, hallucination, or disorganized speech. Other core symptoms may include loss of emotional expression and gross disorganization. Some other criteria for the diagnosis of schizophrenia include:

• Lack of motivation to perform any task.
• Sign of disturbance that lasts for at least six months.
• Negligence of self-care and personal hygiene.
• Behavior and thoughts are disturbed because the patient experiences psychotic episodes.
• Difficulty in understanding what is real or what is not.

Diagnosing schizophrenia involves ruling out stress, depression, bipolar disorder, or any other mental disease. It involves determining that the symptoms are not due to any medical condition, medication, or substance abuse.

Schizophrenia in Children

Schizophrenia is very rare in children. It usually starts from mid to late teens. There are very few chances that a child younger than age 12 gets this disorder. Childhood schizophrenia is rare and hard to spot.

The following key symptoms may help in diagnosing schizophrenia in children. The early onset symptoms may include:

• Unusual or late crawling
• Late talking
• Late walking
• Abnormal motor behavior

A few of these symptoms are also related to autism and other pervasive spectrum disorders. Therefore, ruling out the development disorder is the first step in the diagnosis. However, the late onset of schizophrenia symptoms in childhood may include:

• The child becomes shy and withdrawn.
• Talk about odd or unusual ideas.
• Trouble distinguishing dreams from reality.
• Fear that someone is going to harm them, so they start to cling to their parents.
• Bizarre mood, thoughts, and ideas.
• Listening to voices, watching, or feeling things that do not exist in reality.
• Anxiety, confused thinking, lack of emotional expression, extreme mood swings, or sudden agitation.
• Having difficulty in doing homework and learning.
• Trouble making and keeping friends.

Teens and children experience almost the same symptoms, but hallucination is more commonly experienced by children. Other symptoms like delusion or thinking disorder are more common in adults. These symptoms are the warning signs, so make sure you consult your child’s healthcare provider.

Diagnosing schizophrenia as early as possible may improve your’s or your loved one’s chances of managing the symptoms. If proper medication, care, therapy, and treatment is provided in time, the patient can have a normal and better life.

Schizophrenia Treatment

Schizophrenia requires lifelong treatment. It is not curable, but proper care and medication can help manage the disorder. Treating such disorders is very complex, but the right medication and therapy, self-care can help a patient have a better life. There are very few cases when hospitalization is required; most of the patients get better with medication.

The national institute of mental health suggests the following schizophrenia medication and treatment options.

Medication

The most common treatment for schizophrenia is medication. Medicines are used to control the symptoms by targeting the brain neurotransmitter dopamine. The goal of treating schizophrenia with medicine is to manage the symptoms at the lowest possible dose effectively. Different medicines, dosage amounts, or combinations over time, achieve the required results.

Medications may take several weeks before they show effective and noticeable results. There are many side effects of using schizophrenia medication that is why people may be reluctant to take them. The following medication is used for schizophrenia treatment:

• First Generation Antipsychotic

  The first generation antipsychotic are cheaper, specifically used for long term treatment. These medicines increase the risk of neurological side effects. First-generation antipsychotics include Perphenazine, Haloperidol, Fluphenazine, and Chlorpromazine.

• Second Generation Antipsychotic

  The second-generation antipsychotics are more expensive than first-generation antipsychotics. However, they are still preferred over the first generation because they have a low risk of serious side effects. Second-generation antipsychotics include Ziprasidone, Iloperidone, Cariprazine, Asenapine, Aripiprazole, etc.

• Long-Acting Injectable Antipsychotic

  Many patients are reluctant to take solid medication; for them, injectable antipsychotics were developed. They are given every two to four weeks, depending on the prescribed dosage. The common injectable antipsychotics include Risperidone (Risperdal Consta, Perseris), Paliperidone (Invega Sustenna, Invega Trinza). Haloperidol decanoate, Fluphenazine decanoate, and Aripiprazole (Abilify Maintena, Aristada) are also included.

Psychosocial Treatments

The other treatment is a psychosocial treatment that is more effective than medication. Supportive psychotherapy, cognitive behavioral therapy, behavioral skill training, or cognitive remedy may help address the disorder. Schizophrenia treatment is complicated; misuse of any substance may result in severe disorder.

Therefore, psychosocial treatment is preferred over medication. Psychosocial treatments include:

• Therapy

  Individual or family therapy helps in normalizing thought patterns. They help to improve life skills i.e. communication, socialization, etc. They also help in managing stress and handling personal relationships. Therapies are effective to identify the warning signs and tackle them effectively.

• Social Skill Training

  Social skills are focused on communication and interaction skills. It works on improving the ability to participate in daily routine activities. Staying involved with others helps in keeping the symptoms under control.

• Self Help

  Self-help may take time to take full effect, but they play a vital role in managing the symptoms. Do exercise regularly, get plenty of sleep, eat healthy meals, avoid drugs and alcohol to keep yourself protected.

• Family Support

  Family support gives a sense of protection. Educational programs can be designed for family members to teach them how they should live with schizophrenia patients.

• Vocational Rehabilitation

  These programs are designed to help people prepare for, find, and keep jobs. These programs provide a supported employment environment. Many support groups are designed to help people find jobs, housing and managing their illness.

Hospitalization

There are very few cases when hospitalization is required. It is only required when the disorder takes severe shape, and no treatment is making an effect. Hospitalization becomes essential to ensure proper hygiene, adequate sleep, proper nutrition, and ensure safety.

The most effective strategy for treating schizophrenia is the combination of medication, therapy strategies, social support, and lifestyle changes.

Schizophrenia Facts and Myths

Schizophrenia is a chronic mental disease, but most people fear that this disorder is not based in reality. It is a kind of disorder that makes it challenging to distinguish between what is real and what is not. The actual cause of schizophrenia is not discovered yet, which is why there are many misconceptions about it.

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