What is Schizophrenia?

Schizophrenia is a serious and disabling brain disorder that may cause people affected with this condition to hear voices the rest of do not hear or to see things we do not see. A person with schizophrenia may believe that others are attempting to control their mind or that others are plotting to hurt them.

These symptoms are very real to the person with this illness and because of this, they may become very agitated for no apparent reason, they may say things which do not seem to make sense, and they may withdraw from those around them.

While schizophrenia develops equally among men and women, the onset of symptoms of schizophrenia is different for men and women. For men, typically symptoms begin to appear during late adolescence and early adulthood. For women, the symptoms typically begin a little bit later, usually early 20s to early 30s. Although some children have been diagnosed with symptoms of schizophrenia, it is rare that symptoms would appear before puberty, and equally rare that symptoms would begin after age 40.

There is a genetic component to schizophrenia. People with a relative, especially a first degree relative (parent or sibling), who has the disorder are at greater risk of developing the disorder too. Despite this, scientists believe that more than genetics plays a role in whether someone with a genetic pre-disposition will develop the disorder. Severe stressors early in a person’s life (severe abuse, malnutrition or viruses) even during gestation, may play a significant role.

Signs and Symptoms

The symptoms of schizophrenia can be placed into three categories:

Positive Symptoms – These are usually easy to spot as they are not common among the general population, and typically they involve losing touch with reality.

  • Hallucinations
    1. Seeing, hearing, smelling or feeling something that is not really there
    2. Voices are the most common hallucination
      1. The voices might make comments about the person with schizophrenia or they might give the person commands
      2. The voices might warn the person with schizophrenia of impending danger
      3. The voices might also talk to each other
  • Delusions
    1. Holding false, often illogical beliefs, that are not part of the person’s culture
    2. Believing that their mind is controlled by magnetic waves
    3. Believing that people on television or radio are speaking directly to them
    4. Believing they are a famous person or a person of historical significance.
    5. Believing that others are deliberately poisoning or cheating them
  • Thought Disorders
    1. Difficulty organizing thoughts or connecting them
    2. Garbled speech or unintelligible words
    3. Stopping in the middle of a thought
  • Movement Disorders
    1. Clumsy or uncoordinated behavior
    2. Involuntary movements
    3. Unusual mannerisms
    4. Catatonia

Negative Symptoms – These usually refer to a reduction in normal emotional and behavioral states.

  1. Immobile facial expressions
  2. Monotone voice
  3. Lack of pleasure
  4. Speaking less
  5. Lack of attention to personal hygiene or needing assistance with personal care

Cognitive Symptoms – These typically refer to a person’s ability to think. Impairment in these areas may make it difficult or impossible for a person to work or lead a normal life.

  1. Difficulty absorbing information to make decisions
  2. Inability to remain focused
  3. Difficulty retaining and using recently learned information

Forms of Treatment

Since no one yet knows what causes schizophrenia, it cannot be cured. The treatment for this disorder is mostly organized around treating and managing the symptoms, and since it cannot be cured, a person with Schizophrenia will need treatment throughout his/her life.

Anti-psychotic Medication

There are a number of medications that are used mostly to treat the positive symptoms of schizophrenia. When the correct medication combination has been identified, a person with schizophrenia may be able to live a relatively normal life with few recurrences of symptoms. Unfortunately, the side effects of some of the medications are themselves unpleasant, and people with schizophrenia may stop taking them because of this. Additionally, the nature of the disorder is such that once the person experiences fewer symptoms, they believe themselves to be cured, and stop taking the medication.

Illness Management Skills

People with schizophrenia can take an active role in managing their own illness. Once they learn basic facts about schizophrenia and the principles of schizophrenia treatment, they can make informed decisions about their care. If they are taught how to monitor the early warning signs of relapse and make a plan to respond to these signs, they can learn to prevent relapses. Patients can also be taught more effective coping skills to deal with persistent symptoms.*

Family Education and Family Therapy

The involvement of person’s family and support network is often critical to the success of a person with schizophrenia. When family and friends understand the illness they are less likely to judge or misinterpret the person’s behavior. Whey they are able to recognize uncontrolled symptoms they may assist the person in obtaining medical care sooner so that hospitalization can be avoided or minimized.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is useful for patients with symptoms that persist even when they take medication. The cognitive therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to “not listen” to their voices, and how to shake off the apathy that often immobilizes them. This treatment appears to be effective in reducing the severity of symptoms and decreasing the risk of relapse.*

Self Help Groups

Self-help groups for people with schizophrenia and their families are becoming increasingly common and can be especially helpful. Group members are a continuing source of mutual support and comfort for each other. People in self-help groups know that others are facing the same problems they face and no longer feel isolated by their illness or the illness of their loved one. The networking that takes place in self-help groups can also generate social action. Families working together can advocate for research and more hospital and community treatment programs, and patients acting as a group may be able to draw public attention to the discriminations many people with mental illnesses still face in today’s world. The National Alliance on Mental Illness (NAMI) is a good resource for those looking for support groups.

Catholic Charities Behavioral Health Services does not currently provide psychiatric services so prescribing anti-psychotic medications is not something our staff is able to do. As such, it would be irresponsible to provide therapy services to people with schizophrenia unless the person is under the care of a psychiatrist or medication professional who monitors his/her medications and his/her symptoms are well controlled with the medication.