Schizophrenia – Everything You Should Know

What is Schizophrenia?

Schizophrenia is a chronic brain or psychiatric condition in which a person feels disconnected from reality. Affected individuals may experience delusions or hallucinations, feel suspicious or paranoid, and not care about their hygiene and appearance. While some may even exhibit highly disorganised thinking and behaviour and face cognitive issues, others may find it challenging to do well at school or work.

The condition can happen to men and women of all ages; some teenagers as young as 13 years old can also be diagnosed with schizophrenia. Although schizophrenia has no cure, it can be managed with behavioural therapy and medication.

Also, schizophrenia is often confused with split or multiple personality disorder. However, these conditions are different. A person who has schizophrenia will not necessarily have multiple personalities.

Now that you know about schizophrenia, read about the different types, symptoms, and treatments. 

Schizophrenia: Types

1. Paranoid Schizophrenia

This is the most common type where the affected individual usually experiences hallucinations and delusions. However, paranoid schizophrenia does not affect speech and emotions.

Symptoms

• Auditory hallucinations or hearing voices
• Obsession with certain delusions

2. Disorganised Schizophrenia

Also known as hebephrenic schizophrenia, it usually develops when a person is about 15-25 years old. The affected individual finds it difficult to do regular work correctly. They may also exhibit childlike behaviour and forget or misplace things.

Symptoms

• Withdrawing socially
• Communication issues
• Difficulty with simple routine tasks, such as self-care and personal hygiene
• Misusing words
• Placing words in the wrong order
• Difficulty in thinking clearly
• Responding inappropriately
• Giving wrong and unrelated answers to questions
• Repeating the same things multiple times
• Difficulty in making eye contact

3. Catatonic Schizophrenia

This type primarily affects movements. It may cause limited, unusual or sudden movements in some people. People with this condition may switch from being still and mute to hyperactive and vice versa. 

Symptoms

• Not moving and maintaining a rigid posture
• Moving excessively, without any purpose
• Grimacing
• Hand waving
• Staring
• Mimicking someone’s speech or movement

4. Undifferentiated Schizophrenia

This type has some signs of paranoid, catatonic and disorganised schizophrenia. Affected people usually experience disorganised speech and behaviour, hallucinations, agitation and social withdrawal.

Symptoms

• Unusual behaviour
• Abnormal movements
• Lack of sleep or excessive sleeping
• Distorted beliefs and behaviours
• Neglecting personal hygiene
• Emotional issues

5. Residual Schizophrenia

Affected individuals may not exhibit typical symptoms of schizophrenia, such as hallucinations, delusions, disorganised speech and strange behaviour. However, they do have some negative symptoms but in a milder form.

Symptoms

• Social withdrawal
• Odd beliefs
• Unusual perceptions
• Difficulty in expressing emotions

6. Cenesthopathic Schizophrenia

This type causes unusual bodily sensations that are medically unexplainable.

Symptoms

• Cold and moving sensations in the body
• A part of the body feels stretched or detached
• A part of the body feels hollow
• A creepy sensation in the mouth
• Excess mucus secretion in the mouth

Schizophrenia: Symptoms

Schizophrenia can cause a range of symptoms in different individuals. However, as per experts, experiencing excessive mental stress or not taking prescribed medications correctly can worsen the signs and symptoms of schizophrenia over time and make it challenging to manage the condition.

Early signs and symptoms of schizophrenia

This includes:

• Social withdrawal
• Feeling different from others
• Concentration issues
• Anxiety
• Sleeping problem
• Irritability and bad temper
• Moving slowly
• Repeating movements and gestures
• Odd ideas

Advanced symptoms of schizophrenia

These are divided into three categories - positive, negative and cognitive. 

1. Positive symptoms

In schizophrenia, ‘positive’ symptoms mean added throughs or actions that are not real. These include:

• Delusions: Affected people have delusions or false beliefs that they refuse to give up. For instance, someone with this symptom may think other people are plotting against them.
• Hallucinations: These are sensory experiences that look real but are created by the mind. These include hearing voices or seeing things that are not there. Some may even smell weird odours, feel sensations on their skin or have a strange taste in the mouth.
• Paranoia: This causes schizophrenia patients to believe that they are being followed or victimised, and they always doubt the actions of others.
• Catatonia: People experiencing this symptom may either stop speaking or speak unreasonably. In some cases, catatonia can also cause a person to stop moving or move excessively.

2. Negative symptoms

 Negative symptoms of schizophrenia affect the emotions and behaviours of a person. These include:

• Lack of emotions
• Unusual emotional responses to certain situations
• Loss of excitement in life
• Social isolation
• Difficulty in completing everyday activities
• Speaking less
• Not initiating or following through with plans

3. Cognitive symptoms

Some people with schizophrenia experience trouble with certain mental functions. Hence, they are called cognitive symptoms. Some of these symptoms are:

• Forgetfulness
• Disorganised thinking
• Trouble with focusing
• Disorganised speech
• Forgetting and losing things
• Moving slowly
• Finding it difficult to learn and use information

What Causes Schizophrenia?

While the exact causes are unknown, experts believe that certain psychological, genetic and environmental factors are responsible. The leading causes and risk factors of schizophrenia are:

1. Genetics

 While genetics play an essential role, a single gene is not responsible for the condition. Schizophrenia happens due to different combinations of genes. However, not everyone with those genes develops schizophrenia.

2. Neurotransmitters

 These chemicals are responsible for carrying messages between brain cells. Schizophrenia can happen due to a change in the level of serotonin and dopamine neurotransmitters. 

3. Brain development

 Differences in the brain structure and central nervous system can cause schizophrenia. 

4. Psychological reasons

 Increased stress levels due to different personal or professional reasons is a psychological trigger for schizophrenia.

5. Birth complications

 Premature labour, low birth weight and lack of oxygen during birth can increase the risk of schizophrenia.

6. Drug abuse

 Taking mind-altering drugs during adolescence or young adulthood can also cause schizophrenia.

How is Schizophrenia Diagnosed?

Schizophrenia diagnosis is not easy. Doctors often opt for a complete psychiatric examination to diagnose the condition. They usually ask specific questions to know the symptoms a person is experiencing, and they observe their actions to check for signs of schizophrenia. 

1. Checking Symptoms

 Doctors check if the concerned person is exhibiting at least two of the five main symptoms of schizophrenia:

• Delusions
• Hallucinations
• Disorganised movements
• Incoherent speaking
• Negative symptoms

2. Duration and Symptoms

Doctors check if the concerned person has been experiencing two or more symptoms for over a month.

3. Effect on Work and Relationship

 Schizophrenia often disrupts a person’s personal and professional life. Hence, doctors check for these symptoms as well.

The following tests are also done to diagnose schizophrenia:

• Physical examination
• Imaging tests, such as CT scan and MRI, to check for changes in the brain’s structure
• Blood test, urine test and spinal tap test to check if there are any notable chemical changes in bodily fluids 
• Brain activity test, such as EEG, to check the brain’s electrical activity

Schizophrenia: Complications

Complications related to schizophrenia are:

• Depression
• Anxiety disorders 
• Obsessive-compulsive disorder (OCD)
• Aggressive behaviour
• Social isolation
• Inability to attend school or work
• Financial issues
• Health issues
• Self-injury
• Suicide or thoughts of suicide

Schizophrenia: Treatment

There is no cure for schizophrenia. However, it can be treated or managed with a combination of medications and therapies. The sooner the condition is diagnosed, the better the treatment outcome.

1. Medications

• Typical antipsychotics: These block dopamine type 2 receptors in the brain as the presence of too many dopamine receptors in certain parts of the brain can cause hallucinations, delusions and psychotic symptoms associated with schizophrenia.
• Atypical antipsychotics: These block dopamine and serotonin, two communication chemicals in the brain. This allows antipsychotic medications to manage the positive and negative symptoms of the condition more effectively. 

2. Psychotherapy

 This can help affected people cope with the condition and manage it more effectively. Psychotherapy can ease depression, anxiety, stress and substance use disorder too. 

3. Electroconvulsive therapy

 When none of the prescribed medications works, doctors often suggest electroconvulsive therapy (ECT). This treatment is crucial for those who exhibit signs of harming themselves and others.

4. Vocational rehabilitation

 This can help schizophrenia patients develop skills they may require to return to employment and maintain a regular job.

5. Family support

If someone is diagnosed with schizophrenia, support from family members and friends can help them feel better and regular. Family members can even go to schizophrenia educational programs.

Conclusion

Schizophrenia is a chronic condition that has no cure. While some people live with the symptoms all their life, others may experience them on and off. Talk to a healthcare practitioner without delay if you or a loved one have schizophrenia symptoms. Early diagnosis and timely treatment can help keep the symptoms in check and manage the condition better.