Understanding Schizophrenia

Schizophrenia is a severe mental illness marked by characteristic changes in thinking, emotions and behavior. It affects about 1% of Americans and occurs at equal rates in men, women and all ethnic groups. A person with the illness experiences delusions and hallucinations and finds it difficult to organize thoughts and behaviors, making it hard to carry out daily activities. Symptoms typically begin to appear between the ages of 16 and 30.

Mental health professionals aren’t certain what triggers schizophrenia, but it is believed to be caused by a combination of genetics, brain structure and environmental factors. As is the case with all mental illnesses, early diagnosis and treatment greatly enhances the chance of a better outcome. If it’s identified in the early stages, future psychotic episodes can be greatly reduced.

Watch this clip of Anderson Cooper try to go through a normal day while using a schizophrenia simulator.

Symptoms
Even the symptoms of schizophrenia are complex. The symptoms are broken down into three categories: positive symptoms, negative symptoms and cognitive symptoms.
Positive symptoms are psychotic behaviors that can be severe at times. Positive symptoms include:

• Hallucinations: Things that a person sees, hears, smells or feels that nobody else can. Hearing voices is one of the most common hallucinations.
• Delusions: False beliefs that a person believes to be true even if proven wrong or illogical by others. Some people may believe the TV or radio is sending messages to them. Others have paranoid delusions, in which someone is out to get them (violence, cheating, poisoning, etc.).
• Thought Disorders: Disorganized thinking, difficulty connecting thoughts, talking in a way that is hard for others to understand, stops speaking abruptly mid-sentence, making up meaningless words.
• Movement Disorders: Agitated body movements, such as repeatedly tapping a foot or bouncing a leg. Sometimes a person can also become catatonic (doesn’t move or respond to others). This is less common now that there is more effective treatment.

Negative symptoms can be hard to recognize because they can be mistaken for depression or other mental illnesses. Negative symptoms include:

• Flat affect (speaking in a monotone voice, not moving face when speaking)
• Lack of pleasure in life
• Inability to carry out planned activities
• Speaking very little in social settings, even if forced

Cognitive symptoms are subtle and can also be difficult to recognize. Tests are often the only way to identify problems. Cognitive symptoms include:

• Difficulty understanding information and making decisions
• Trouble focusing and paying attention
• Problems remembering and using information right after learning it

An evaluation by a mental health professional is needed to make an accurate diagnosis. The first step is ruling out any other medical conditions or substance abuse. A person must have at least two symptoms, one being hallucinations, delusions or disorganized speech, for the majority of time during a one month period in order to consider a schizophrenia diagnosis.

Treatment
Treating schizophrenia can be challenging because most people with the illness don’t believe they have it. Since there isn’t a known cause, the goal of treatment is to alleviate symptoms. A combination of antipsychotic medications and psychosocial treatments are often used. Psychosocial treatments are appropriate for people who are stabilized on medication. The treatments teach skills needed to live independently, such as communication skills, social skills and time and money management.
Vocational training is often recommended to help a person live well outside of a hospital environment.

While schizophrenia can be a debilitating mental illness, it is possible to live a full life with proper treatment. Read about Elyn Saks, who was diagnosed with schizophrenia in her twenties. She was told by her doctor that she should get a part-time cashier job, but Elyn had higher aspirations and went on to become a law professor at the University of Southern California and she even received a MacArthur Foundation genius grant.