Managing Schizophrenia: Insights into Medication, Therapy, and Community Support

What is Schizophrenia?

Schizophrenia is a chronic mental health condition characterized by symptoms persisting for at least one month, often requiring lifelong treatment. Except for times when the individual is experiencing delusions or acting according to delusions, they may not seem to have any issues with functioning or behavior. Schizophrenia is categorized into various types based on the symptoms that manifest:

• Catatonic schizophrenia: Characterized by prolonged periods of immobility and unresponsiveness in psychomotor state.
• Paranoid schizophrenia: The most common type of schizophrenia where individuals experience hallucinations and delusions.
• Disorganized schizophrenia: In this type, individuals tend to exhibit incoherent responses.
• Hebephrenic schizophrenia: A subtype where individuals experience mood disorders such as depression, mania.
• Residual (Residual type) schizophrenia: A phase where symptoms have decreased to almost none in individuals showing symptoms of schizophrenia. Symptoms have diminished, but the individual lacks positive thoughts towards life.
• Undifferentiated schizophrenia: When the type of schizophrenia cannot be determined despite the diagnosis, it is categorized as undifferentiated schizophrenia.

What Causes Schizophrenia?

The exact cause of schizophrenia is unknown, but it is believed to result from a combination of genetic and environmental factors. The interaction between genes and a range of environmental factors can lead to schizophrenia. Additionally, psychosocial factors can also influence the onset and course of schizophrenia. Both men and women have an equal likelihood of developing schizophrenia. However, men may begin to show symptoms of schizophrenia at an earlier age. Symptoms of schizophrenia can start suddenly or become more pronounced over time. While there is no known definite cause of schizophrenia, several conditions are associated with it, including:

• Being born in winter months
• Very low birth weight
• Complications during birth
• Recreational substance use
• Genetic factors
• Brain structure

How is Schizophrenia Diagnosed?

Diagnosing schizophrenia requires multiple tests and assessments. Therefore, individuals are initially referred to a psychiatrist for evaluation of symptoms. Evaluation involves questioning about current symptoms, medical history, family history, and any substance abuse issues. It may also require talking to a family member for more information about the individual's symptoms. The doctor may then conduct a physical examination and may request blood tests or brain scans to rule out underlying causes.

Doctors may order various imaging techniques such as CT or MRI to ensure that symptoms suggestive of schizophrenia do not stem from issues like stroke, brain injuries, tumors, or other structural changes in the brain. Electroencephalography (EEG) may also be used to evaluate brain electrical activity if necessary. By observing the individual's described symptoms or behaviors, doctors can diagnose schizophrenia or related disorders. Subsequently, the identified symptoms are compared with the necessary criteria for schizophrenia diagnosis. Symptoms must have persisted for at least six months for a diagnosis. Symptoms can be severe enough to cause impairment in the individual's work, school, home, or social functioning.

What are the Symptoms Associated with Schizophrenia?

Individuals with schizophrenia often experience persistent difficulties in cognitive abilities such as memory, attention, and problem-solving skills, or thinking skills. Some individuals with schizophrenia may experience periodic exacerbation and remission of symptoms throughout their lives, while others may see symptoms gradually worsen over time. The severity, duration, and frequency of symptoms can vary from person to person; however, as individuals age, the frequency of severe psychotic symptoms generally decreases. Noncompliance with prescribed medications, alcohol or substance use, and stress can exacerbate symptoms.

Negative Symptoms

Negative symptoms denote what is missing or lacking abnormally in individuals experiencing schizophrenia. Negative symptoms include loss of interest and motivation in life and activities, lack of concentration, reluctance to leave home, changes in sleep patterns, among others. The first appearance of negative symptoms constitutes the prodromal phase of schizophrenia. Symptoms in the prodromal phase typically emerge gradually and worsen over time, often involving increasing social withdrawal. Additionally, individuals may lose interest in their appearance or personal hygiene. Negative symptoms may include:

• Impairment in emotional expression
• Speech abnormalities
• Decreased desire to initiate social contact
• Decreased motivation to engage in daily activities

Positive Symptoms

Positive symptoms of schizophrenia typically manifest before acute mood changes by several years. Positive symptoms can include:

• Hallucinations: Defined as seeing, hearing, smelling, tasting, or feeling things that are not real. Auditory hallucinations, hearing voices, are the most common type.
• Psychosis: Defined as a disruption in the brain's processing of information leading to a loss of contact with reality. Psychotic experiences are vivid and clear impressions resembling normal perceptions. Severe psychosis can interfere with an individual's ability to perform daily life activities. Thoughts and speech can become confused due to psychotic symptoms, making it difficult for others to understand the individual's speech. This can lead to difficulties in communication.
• Changes in behavior and thoughts: The individual's behaviors may become disorganized and unpredictable. Their appearance or clothing may seem unusual to others. Schizophrenia patients may become agitated for no apparent reason, shout, or curse. They may believe that their thoughts are being controlled by someone else, are not their own, or are being inserted into their minds by someone else, as if someone is removing their thoughts from their minds.

Treatment of Schizophrenia

Treatment should be under the supervision of a psychiatrist, but it may involve a team of different mental health professionals, including a doctor, mental health nurse, social worker, occupational therapist, and clinical psychologist. Treatments are tailored to the individual's needs. Schizophrenia is typically treated with a combination of medication and therapy, customized to each individual's needs. Medication and cognitive-behavioral therapy (CBT) are commonly preferred in treatment. While there is no permanent treatment option available for schizophrenia, various antipsychotic medications are effective in reducing acute psychotic symptoms and may also help reduce the likelihood and severity of future acute episodes. Additionally, treatment can contribute to reducing stress, supporting employment, or developing social skills. Schizophrenia patients are at higher risk of substance abuse compared to the general population. Treatment options are further elaborated below.

Medication

Medication use is the mainstay of treatment for schizophrenia. Antipsychotic medications can alleviate main symptoms such as hallucinations and delusions. However, it may take up to 6 weeks for the medication to take effect. Some individuals may develop side effects from medication, so regular follow-up is essential.

Psychotherapies

Psychotherapies can help individuals understand, manage, and learn new coping mechanisms for their symptoms. Psychotherapy methods such as cognitive-behavioral therapy can help schizophrenia patients cope with their illness and manage their condition. Other techniques that can be used in treatment include art and drama therapy, which can help individuals overcome motivation loss and recognize their symptoms. Health care providers may also recommend techniques focusing on social skills development, reducing stress, and establishing personal care routines.

Community Support

Mental health services can also provide practical support for schizophrenia patients. A stable living environment, supportive relationships, and meaningful work or activity are essential components for recovery. Some individuals with schizophrenia may require rehabilitation and skills training to return to work or education.

Hospital Treatment

Some individuals with schizophrenia may require occasional hospital treatment. Hospitalization is preferred to help when symptoms become unmanageable, or when the individual is at risk of harming themselves or others.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a treatment option used when specific medications fail to improve symptoms, and the individual is at risk of self-harm or harm to others. This treatment involves applying an electric current to the scalp to stimulate specific parts of the brain. If you are experiencing some mental health issues, do not hesitate to seek support from a healthcare institution.

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Disclaimer:
The information provided in this article is for educational purposes only and should not be considered medical advice. If you have any health concerns or are experiencing symptoms, it is important to consult with a healthcare professional, such as a doctor or clinic, for proper diagnosis and treatment. Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read in this article.