Schizophrenia: Causes, Symptoms & Treatment

Schizophrenia is a mental illness that completely affects the personality of the sufferer. Often, those affected have a disturbed relationship with reality, which manifests itself, for example, through delusions and hallucinations. Most often, schizophrenia first appears in the years between puberty and a maximum of 35 years.

What is schizophrenia?

Schizophrenia is a mental disorder that affects all perceptions of the sufferer. Both internal and external perceptions change, sometimes significantly. This affects the emotional life and thinking of the sufferer. The drive and motor function also change. Schizophrenia usually occurs in episodes. An episode is also called a psychosis. The affected person can completely lose touch with reality. Psychiatry distinguishes between different forms of schizophrenia depending on the symptoms. In paranoid-hallucinatory schizophrenia, hallucinations and delusions occur. Catatonic schizophrenia is characterized by symptoms in the motor system. If mainly the emotional life is disturbed, it is a hebephrenic schizophrenia. If there is a lack of drive, social withdrawal, and lack of emotion, it is called residual schizophrenia.

Causes

Several factors probably play a role in the causes of schizophrenia. A genetic predisposition is thought to be the central factor in this process. However, other factors must be added as triggers. These can be, for example, stress, drug use or drastic events in life. Psychosocial factors could also be a cause of schizophrenia. However, it has not yet been scientifically proven that problems in the family, partnership or profession are causally responsible for the outbreak of schizophrenia. Biochemical causes have not yet been conclusively scientifically proven. However, it has been proven that in the brain of a schizophrenic the docking sites for dopamine react hypersensitively. Dopamine is a messenger substance that transmits nerve impulses. Neuroanatomical causes are also thought to be the cause of schizophrenia. For example, some sufferers have been found to have a dilated chamber in the brain filled with cerebrospinal fluid. In addition, cerebral blood flow is altered in the presence of schizophrenia.

Symptoms, complaints, and signs

A prominent symptom of schizophrenia is delusion. Sufferers suffer from absurd delusions that have no basis in reality. Nevertheless, these ideas appear realistic to people with schizophrenia, so even logical reasoning cannot change their minds. An example of a delusion is the persecution delusion. Sufferers think that they are being persecuted and threatened. In a relationship delusion, on the other hand, they relate all possible events to their person. The thinking changes significantly in the course of the disease. The trains of thought suddenly break off and/or are disjointed. Another symptom of schizophrenia is ego disorder. The boundary between one’s self and the outside world is blurred, and parts of one’s body or thoughts are perceived as foreign. Likewise, people with schizophrenia often suffer from hallucinations. These usually manifest themselves in an auditory form and are perceived by patients as extremely threatening. People with schizophrenia are often listless, feeble, or [apathy|apathic]]. They have little interest in social contacts or leisure activities. Emotions are flattened, and sufferers are irritable, suspicious, or depressed. Not all signs of schizophrenia are always present to the same degree. They vary both in the course of the disease and from patient to patient.

Course of illness

The course of the disease of schizophrenia is different for each individual affected. In many sufferers, the first signs of schizophrenia appear months or even years before the actual onset. However, these first signs do not yet clearly indicate schizophrenia. For example, the affected persons distance themselves and withdraw. They are often depressed and perceive reality in a distorted way. This preliminary stage of schizophrenia is called the prodromal phase. If schizophrenia breaks out acutely, hallucinations, delusions (e.g., persecutory delusions) and ego disorders occur. In addition, there are thought disorders, lack of emotion and lack of drive.However, the severity and combination of symptoms are different for each patient. An acute phase can last from a few weeks to a few months. Afterwards, it subsides again. The course of schizophrenia can occur in episodes. It can happen that after each new outbreak, some of the symptoms remain permanently. This is called chronification of schizophrenia.

Complications

One possible complication of schizophrenia is worsening of symptoms. This is the case in about one-third of those affected, while another third each experience improvement or no significant change

Many schizophrenics suffer from a chronic physical illness. Neuroleptics and antipsychotics, respectively, are medications that may be used for schizophrenia. These psychotropic drugs can also cause complications. Some agents in the atypical antipsychotic group appear to increase the risk for diabetes mellitus. Other neuroleptics increase the likelihood that the person will develop a parkinsonoid. A parkinsonoid is a drug-induced parkinsonian syndrome that resembles neurodegenerative disease. However, the symptoms are not due to atrophy of the substantia nigra, as in Parkinson’s, but to the use of a medication. Other potential side effects of antipsychotics include seizures, movement disorders, and/or an increase in body weight. A serious but rare complication of neuroleptics is malignant neuroleptic syndrome, which occurs in 0.2 percent of patients taking antipsychotics. Typical symptoms include fever, rigor and clouding of consciousness. Malignant neuroleptic syndrome is life-threatening and therefore must be treated. On a case-by-case basis, the treating physician weighs whether the benefits or risks of a drug outweigh the risks for a particular patient. Complications are also possible at the psychological level. One in two schizophrenics suffers from another mental illness. The most common comorbidities are anxiety disorders, affective disorders, and psychotropic substance disorders.

When should you see a doctor?

Consultation with a physician is indicated as soon as the individual exhibits abnormal behavior that is described as being off the norm. Hallucinations, seeing and perceiving imaginary entities, or intuitions with calls to action are worrisome. The clarification by a physician is necessary as soon as it comes to voice hearing, an aggressive appearance or a danger for the concerning itself as well as humans of the direct environment. If social rules are not observed, emotional injuries to relatives occur, or parts of the patient’s own body are perceived as strange, a visit to the doctor is necessary. Many patients justify their actions by being convinced that thoughts have been transmitted to them from an external source and are controlled from there. Religious or spiritual inspirations without an illness value are to be distinguished from schizophrenia. If the patient is unable to cope with everyday life without help, if their personalities change, or if their behavior triggers fear in those around them, action is required. A doctor is needed, as patients with schizophrenia require drug therapy. Withdrawal from social life, isolation or a strong distrust of all people are characteristic of the disease and should be monitored by a doctor. Medical help is also needed for depressive behavior.

Treatment and therapy

Because many different factors may be responsible for the development of schizophrenia, multidimensional therapy is used in treatment. It consists of treating patients with psychotropic drugs, psychotherapy, and sociotherapy. In the field of psychotherapy, supportive psychotherapy is sometimes used. This therapy gives the patients support in dealing with their illness. In addition, all methods of behavioral therapy are applied. The therapy always depends on the individual clinical picture of the patient. Sociotherapy supports the affected person in all skills that are important for everyday life. Sociotherapies can be, for example, work or occupational therapies. But rehabilitation services may also be part of sociotherapy.Treatment for schizophrenia usually begins with inpatient treatment in a clinic. This is followed by treatment in a day clinic. In most cases, the patient then moves to a therapeutically supervised residential community, where he or she can lead an independent life despite schizophrenia.

Prevention

Because hereditary factors play a major role in schizophrenia, general prevention of the disease is not possible. However, if there is a hereditary predisposition, it is advised to avoid any stress and to refrain from drug use, as these factors can promote an outbreak of schizophrenia.

Follow-up

Because schizophreni is a serious

mental illness, aftercare is often difficult for those affected. Therapy to treat the illness is a lengthy process, the duration of which is often unpredictable. After initial therapy, patients are recommended further psychiatric care and support. This should reduce and contain the occurrence of possible secondary symptoms. A complete cure of the disease is rarely possible. Patients must therefore work constantly on their well-being. Aftercare

is therefore primarily concerned with the patient’s environment. Friends,

family members and companions should therefore work closely with the therapists and

and physicians in order to actively support those affected in their aftercare. Due to the complex nature of the disease, most patients are not able to actively

due to the complex nature of the disease. The ongoing effects make the possibility of insight almost impossible. Filtering out bad behavioral habits is an almost insurmountable task for sufferers. Affected persons can hardly manage positive changes and measures on their own, which is why the aforementioned support of the environment is of massive importance. In addition, in most cases, further medical treatment in the form of medication cannot be dispensed with. Therapeutic measures can immensely increase the well-being of the affected person and prevent complaints.

What you can do yourself

Many sufferers and relatives experience schizophrenia as a disease that can only be influenced by medication. Although medication plays an important role in therapy, self-help forms another important component. To facilitate treatment and minimize limitations, it is important to detect the recurrence of symptoms as early as possible. Therefore, an important component of self-help is to be aware of one’s own schizophrenia symptoms and to see a doctor or therapist if they recur. Family members can also assist schizophrenic individuals in this task. Critical life events and high levels of stress can re-emerge or exacerbate psychotic symptoms. However, not all schizophrenics react negatively to stress – their own experience can help assess future reactions to stress at work or conflicts in the family and prepare accordingly. If a patient’s psychotic symptoms are exacerbated by stress, general stress-reducing measures in daily life may be helpful. It should be noted, however, that relaxation techniques such as autogenic training and progressive muscle relaxation, which are otherwise popular, are not recommended for psychotic symptoms. Instead, it may be useful to plan sufficient breaks in everyday life, for example, and to ask for help in good time if problems arise.