Despite all the awareness about mental disorders, disorders like schizophrenia are still perceived to be in the same category as “insanity” or “madness”. And sadly, as long as headlines like “mental patient kills family” exist, this will stay the case.
Not everyone with mental illnesses like schizophrenia are dangerous. Let’s educate ourselves a little bit.
So what is Schizophrenia?
Schizophrenia is a mental disorder that is characterized by symptoms that affect thinking, emotions, behavior, and perception. It alters an individuals perception of reality, and how they interact with the world.
It is relatively rare, and is only present in an estimated 1% of the population. Onset typically occurs in late adolescence or early adulthood, although it can develop at any age.
Three types of symptoms exist for schizophrenia - positive, negative, and cognitive.
Positive symptoms
Positive symptoms are things that are added on to the normal human condition. This includes the following -
1. Delusions -
An irrational belief that is evidently not true.
Delusions of Persecution-
This is the most common type of delusions in schizophrenia patients. This is when they believe someone is trying to harm them (simply put : paranoia)
Delusions of Grandeur-
Believing that they are a person of extreme importance, fame, or status.
Delusions of Reference-
Believing that messages are meant specifically for them. Example - reading the news and thinking the person that wrote it is trying to say something to them.
Delusions of control-
Believing that someone else is controlling their thoughts and actions.
Erotomania -
Believing a person of a higher status is in love with them.
2. Hallucinations -
Hearing, seeing, feeling things that only exist in your reality.
Auditory -
The most common type of hallucinations to occur. When people hear voices or other types of sounds.
Visual -
Seeing things that are not real.
Tactile -
Feeling like something is touching them or crawling on them.
Gustatory -
Tasting weird or unpleasant tastes in your mouth.
Olfactory -
Smelling odors or smells that are not real. These smells are usually extremely unpleasant.
3. Disorganized speech-
Jumping from sentences, saying things that make no sense, or stopping abruptly while speaking.
4. Disorganized behavior-
Weird, unusual, or inappropriate behavior. This usually manifests as inappropriate affect (emotion). Example - crying or laughing randomly in inappropriate situations.
5. Catatonia -
Being awake but not responding, or moving. Catatonic behavior can manifest as weird abnormal movements, or no movement at all.
Catatnoic behavior can look like-
Sitting very still and not responding.
Repeating the same movements for a long time.
Mimicking someone’s speech or movement.
Becoming agitated all of a sudden.
Holding an extremely abnormal or unusual pose.
Negative symptoms -
Things that are taken away from the normal human condition.
Blunted & Flat Affect -
Blunted affect is a reduction in emotional expression, feeling emotion but only expressing some of it.
Flat Affect is when there is no emotional expression at all.
Alogia -
A lack of content in speech. Saying fewer words, or only speaking when spoken to directtly.
Anhedonia -
The reduction or inability to feel pleasure.
Avolition -
The lack of overall motivation
Asociality -
The lack of desire to interact in social settings or make friends.
Cognitive symptoms -
Impaired Memory -
Individuals with schizophrenia may have difficulty with both short-term and long-term memory. This can affect their ability to remember recent events and make it challenging to plan for the future.
Attention and Concentration Problems -
Schizophrenia can cause difficulties in sustaining attention and focusing on tasks. This may lead to distractibility and decreased productivity.
Executive Function Impairment -
Executive functions encompass higher-level cognitive abilities such as problem-solving, decision-making, and planning. People with schizophrenia often struggle with these skills, making it difficult to set and achieve goals.
Processing Speed -
There is often a decrease in processing speed, making tasks that require quick thinking or decision-making more challenging.
Verbal Memory and Language Problems -
Some individuals with schizophrenia may experience difficulty in understanding complex language or expressing themselves clearly. They might also have difficulty with word-finding and organizing their thoughts coherently.
Visuospatial Abilities -
Problems in perceiving and understanding spatial relationships can lead to difficulties with tasks that require these skills, such as navigation or reading maps.
Cognitive Flexibility -
Cognitive inflexibility makes it difficult to adapt to new situations or to switch between tasks. This can lead to perseveration or getting stuck on one idea or task.
Insight and Awareness -
Some people with schizophrenia may have limited insight into their condition or its implications. This lack of insight can affect their ability to manage their symptoms and engage in treatment.
What causes it?
Genetic Factors -
Genetic Predisposition -
Genetic factors are a significant contributor to the development of schizophrenia. Having a family history of the disorder increases an individual's risk. It's not caused by a single gene but rather by multiple genetic variants that collectively contribute to susceptibility.
Schizophrenia is considered a polygenic disorder, meaning that it arises from the interaction of various genes. These genes are involved in functions such as neurotransmitter regulation (particularly dopamine), brain development, and the immune system.
Epigenetics -
Beyond the DNA sequence, epigenetic factors can influence gene expression. These modifications can result from environmental stressors, potentially impacting an individual's susceptibility to schizophrenia.
Neurobiological Factors -
Dopamine Dysregulation -
One of the key neurological theories of schizophrenia involves the dysregulation of dopamine, a neurotransmitter that plays a role in mood, motivation, and pleasure. Overactivity of dopamine receptors is believed to contribute to positive symptoms like hallucinations and delusions.
Structural Brain Abnormalities -
Brain imaging studies have revealed structural abnormalities in individuals with schizophrenia, such as enlarged brain ventricles and reduced gray matter volume. These anomalies may be associated with both genetic and environmental factors.
Environmental Factors -
Prenatal and Perinatal Factors -
Exposure to prenatal stressors, like maternal malnutrition, viral infections during pregnancy, or birth complications, has been linked to an increased risk of schizophrenia. These early environmental stressors may interact with genetic susceptibility. Mothers that were exposed to influenza during the second trimester of pregnancy were found to be more likely to have schizophrenia than others.
Childhood Adversity -
Early childhood stress, abuse, or trauma can influence brain development and emotional regulation, potentially increasing the risk of schizophrenia in susceptible individuals.
Psychosocial Factors -
Stress and Trauma -
Chronic psychosocial stressors, such as unemployment, financial difficulties, and social isolation, can exacerbate the risk of schizophrenia and contribute to relapses in individuals with the disorder.
Substance Abuse -
Cannabis and Other Substances -
Excessive cannabis use, can increase the risk of developing schizophrenia, especially in individuals with a genetic predisposition. Cannabis has been associated with the onset of the disorder in vulnerable individuals.
These factors don't operate in isolation. The most sensible theory of mental illnesses says that all of these factors interact in a complex web, with genetic predisposition being triggered by environmental stressors and substance use to influence the development and course of schizophrenia.
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