One person acting in totally opposite ways is what most of us imagine when we think of schizophrenia. But, in reality, schizophrenia is very different from these Dr. Jekyll-and-Mr. Hyde conceptions. Here is what some persons with schizophrenia have reported about their experiences:
“I started to play checkers but could not go on. I was too much absorbed in my own thoughts, particularly those regarding the approaching of the end of the world.”
“I have never had a single moment in which I did not hear voices. They accompany me to every place…they continue even when I am in conversation with other people.”
These people are describing some of the symptoms of schizophrenia: trouble controlling their thoughts; difficulty concentrating; hallucinations–hearing voices or seeing things that aren’t there. They also have delusions–believing something not based in reality, thinking, for example, that you can control the weather, that you are God, or that aliens from outer space are trying to put a drug into your food through a special machine. A person with schizophrenia may show no emotion or may react very inappropriately (for example, laughing when told that someone died). Patients with schizophrenia seem to lose their energy, their ambition, their will; nothing seems to be important. They often withdraw from people and stay fairly isolated.
You’ve probably had some experiences like these at one time or another–a hard time concentrating on a test; feeling lazy, empty, or low; mistakenly hearing someone calling your name. These are not signs of schizophrenia. it is the combination and severity of several symptoms at one time–the delusions and hallucinations, the way the disease can totally incapacitate emotions, desires, and ability to function on a day-to-day level for many months–that tells a doctor a person may have schizophrenia.
Devils, Witches,, Madmen
Like other forms of mental illness, schizophrenia has been around throughout history. As recently as 100 years ago, many who undoubtedly had schizophrenia were treated as simply odd or, if too disruptive, locked up. In other times and different cultures, many were persecuted as witches or madmen controlled by the devil or evil spirits.
Our knowledge of schizophrenia has grown with our understanding of the brain and personality. In 1896, Emil Kraepelin developed the term dementia praecox to describe several illnesses that had schizophrenic-like symptoms. He thought that dementia was caused by an irreversible deterioration of the brain. In 1911, Eugene Bleuler coined the term schizophrenia, which means splitting of the mind, to describe the way persons with schizophrenia seemed to separate their thoughts, feelings, and behaviors from each other. He believed it was a psychological rather than a physical problem and thought it could be treated by counseling.
This question of physical vs. psychological causes continues to this day. Most experts now feel, however, that it is both. New research suggests that those with schizophrenia have problems with the chemicals that affect the nerves in their brain and find that these problems may be genetically passed on in families. But like an unhealthy heart that is more likely to have an attack from too much cholesterol, it is theorized that the schizophrenia is triggered by a certain amount or type of psychological stress.
Schizophrenia is found all over the world. There are many different types of schizophrenia. In the United States schizophrenia affects about 1 percent of the population, most commonly starting between the ages of 16 and 25. Of those who develop symptoms of schizophrenia, roughly one-third will recover completely. Another one-third will improve but not fully recover (they may continue to have symptoms like hearing voices or fears of people that interfere with their ability to function). The final one-third may stay the same or get worse.
There is no known cure for schizophrenia. In 1952, however, it was discovered that certain drugs used for physical ailments could control hallucinations and other symptoms of schizophrenia. Today medications are the primary means of helping the person with schizophrenia. Many patients need to take some medication all the time; others, only when the disease is most active.
Counseling with patients and their families helps to reduce stress, educate patients and family members about the disease, and help the patients keep up their social skills so that they are not so alone. There are self-help organizations in many communities that support family members.
Medications have allowed most persons with schizophrenia to remain in their own communities rather than in mental hospitals. How independently a schizophrenia patient can live depends upon the severity of his or her disease. Some patients can work and live on their own with minimal support. Others may work part time at supervised jobs and live at home with family. Others who cannot work may attend a social and recreational treatment program during the day and live in a supervised group home with other patients.
A Hopeful Future
There is still much to learn, but we have come a long way since the time of witches and devils. New forms of imaging (CT scans, MR scans) are helping us understand how the brain works. Studies in genetics may help us predict who may be vulnerable to the disease, and new forms of medication may help us treat schizophrenia more effectively. The future for those with schizophrenia and their families looks more hopeful than ever before.