Schizophrenia is a mental illness that impairs one’s ability to perceive reality. It is often confused with split personality, to which it is not at all similar. Rather, those with schizophrenia can suffer from delusional thinking that can impair behavior and ability to live a normal and functional life.
Schizophrenia most often develops in young adults in their late teens. It is equally prevalent among males and females. Very rarely, the illness may occur in early childhood. Additionally, the late onset variety may occur in the elderly, possibly tied to dementia from Alzheimer’s disease, though this is not always the case. Most often, however, an older teen that has seemed relatively fine and healthy will begin to exhibit symptoms of the illness. Symptoms vary in prevalence and in persistence, and are a way of diagnosing different types of the illness.
Symptoms are organized into three classes, positive, disorganized, and negative. Positive does not refer to “good” in this case. Positive symptoms include delusions and hallucinations. Delusions usually separate into those of grandeur and those of persecution. Those suffering from this illness may believe that they are invincible or all-powerful and thus cannot be hurt. This can cause them to act in ways that are dangerous to themselves or others. Conversely, those affected may believe that others are plotting against them, or that there is a subversive tendency by those around them to somehow harm the person.
Hallucinations are often present and fuel delusions. The schizophrenic may hear voices that are not there. They may also see things that don’t exist. These additional voices or visions may cause the person to feel helplessly trapped, as he or she cannot distinguish between what is real and what is not real.
Disorganized symptoms of schizophrenia include difficulties communicating. Speech may be impaired or unintelligible. The affected person may have conversations with someone only he or she can see. Impaired vocal expression is often accompanied by repetitive movements, pacing, or walking in circles.
Negative does not really mean “negative” but rather "not present." A patient may have a flat tone that expresses no interest whatsoever in conversation. Speech may be very trite, and really mean little. Inability to follow through with activities and a persistent disinterest in life may exist.
There are five subtypes of schizophrenia, based on the severity or lack of the above symptoms. Catatonic patients seem to move very little, and mostly exhibit what we would term disorganized symptoms. Disorganized schizophrenia tends to have primarily negative and disorganized symptoms. Paranoid schizophrenia is characterized by positive symptoms and lack of disorganized or negative symptoms. The residual kind has positive symptoms at low intensity. Undifferentiated schizophrenia shows positive symptoms, but does not show total negative or disorganized symptoms.
In many cases, the illness can respond well to drug therapy. Often, when people are first diagnosed, they may require psychiatric hospitalization to start a medication regimen and help stabilize their condition. Medication, like anti-psychotics, can help alleviate some but not all symptoms. The patient is also taught to recognize that the brain will still produce some positive symptoms, and that these should be ignored.
Once some of the symptoms are under control, those with the illness need ongoing therapy and support, often employing cognitive behavioral techniques to help cope with what will be a lifelong illness. There is no specific cure; there are simply methods to help reduce symptoms and cope with the condition. For about 1/3 of all patients, even these methods may not provide enough relief to function in society, and some people with very severe forms will require lifelong care or hospitalization.
Unfortunately, most anti-psychotic medications can have significant long-term side effects, causing obesity, difference in gait, and Parkinson like symptoms after a long period of use. Researchers are attempting to develop new medications and delivery methods that may prove more effective, yet this illness remains a challenging one to treat and to live with.
