Schizophrenia is a chronic, debilitating mental illness that presents with a constellation of symptoms that differ greatly amongst varied individuals. Some experience terrifying symptoms like hearing threatening voices or believing that people are plotting against them. Some even go as far as believing that people are trying to control, modify or extract their thoughts to an extent that their behaviour becomes aggressive towards near and dear ones.

Their speech content and behaviour can be so disorganized and incomprehensible, that dealing with such people can be quite a challenging task. Many find it frightening to live with schizophrenic people due to their unpredictable behaviour.

Schizophrenia involves a disturbance of thought. Not only does it encompass a spectrum of psychotic symptoms but it also covers a range of signs that indicate a diminished expression of emotion.

There are several myths surrounding schizophrenia. Contrary to popular belief, it is not a disease that is passed on in the genes. Many incorrectly think schizophrenia and multiple personality disorder (now called dissociative Identiry disorder- DID) as the same disease.

What proves most crippling for the patient is way their lives are modified in response to this lifelong disease. Although symptoms can be effectively supressed in response to medication and therapy, the opportunities lost, residual symptoms despite treatment and side effects of medication, can leave a tragic scar on the individual’s personality for life.

How prevalent is Schizophrenia?

It is a disorder that mostly affects males in their late adolescence or early adulthood, but it can also occur rarely in old age. The occurrence in females is in their late twenties or thirties. It affects males one and a half times as frequently as women. Around one in a hundred Australians will develop this illness during their lifetime. This alarming prevalence makes it significant to have a baseline knowledge about the symptoms and the treatment options available for this disease.

Symptoms of schizophrenia

Schizophrenia usually starts off when a normal individual starts to exhibit confusing and shocking behaviour, which is sometimes contradictory to his personality. This disorder encompasses a disturbance in thought, behaviour, movement or perceptions.

Some individuals experience only one episode during their lifetime. Others experience a chronic type of illness which requires a rigorous regime of therapy and treatment to control symptoms. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the following symptoms are exhibited:

Positive/ psychotic symptoms

• Delusions: Fixed, false beliefs firmly held in spite of contradictory evidence
• Hallucinations: False sensory perceptions like hearing, seeing, smelling, feeling or tasting
• Disorganized thought and belief
• Disorganized or catatonic behaviour

Negative symptoms:

• Social and emotional blunting
• Apathy
• Lack of speech
• Lack of initiative and self-negligence

Types of schizophrenia

Based on the diversity in the symptoms that schizophrenics present with, it can be classified for convenience of diagnosis into five types:

1. Paranoid schizophrenia: The individual remains preoccupied with one or more delusions or auditory hallucination.
2. Disorganized schizophrenia: The speech and behaviour of this individual is unorganized coupled with a flat or inappropriate affect (outward manifestation of mood).
3. Catatonic schizophrenia: The person experiences symptoms in response to movements. He may exhibit at least two of these symptoms:

• difficulty in movement
• excessive movement, resistance to movement
• abnormal movements
• repeating what others say or do

4. Undifferentiated schizophrenia: The individual may suffer any two of the following symptoms:

• Delusions
• Hallucinations
• Disorganized speech or behaviour
• Catatonic behaviour
• Negative symptoms

5. Residual schizophrenia: This is a less severe form of the disorder and the person suffers from negative symptoms only

Treatment for Schizophrenia

The prognosis of schizophrenia can be variable but based on the assumption of an early diagnosis and treatment, one third progress downhill, another third may experience recurring symptoms and for the unfortunate remaining one third, the symptoms worsen with relapses.

Combination therapy which involves a blend of multiple treatment modalities has proven to be most successful in treating these individuals. The various treatments available are highlighted below:

1. Medications: This remains the cornerstone for curing and supressing the symptoms. Second generation antipsychotics are popularly used for treating the positive symptoms namely olanzapine, aripiprazole, risperidone, quetiapine and ziprasidone. There is a common misconception these drugs work on the principle of sedation, however they function in reality to supress the hallucinations, delusions, agitation and confusion experience by the sufferers. Mood stabilizers like lithium and carbamazepine can also be utilized when the mood disorders are more prominent. To treat the depression caused by the debilitating symptoms, antidepressants like SSRIs (fluoxetine, paroxetine, citalopram etc.) can be effectively employed.
2. Psychosocial therapy: This form of therapy integrates the following components:

• Family psychosocial education, where the family members are not only provided knowledge about the symptoms and course of treatment, but also made aware of the importance of family support and provided problem solving skills to help them deal with the crisis. The awareness lessens the burden of tragedy from the family members and makes the course of treatment easy for the sufferer.
• Assertive community treatment, which involves members of the treatment team meeting up with the patient outside a hospital or workplace setting and has proven to show a reduction in rates of hospitalization.
• Substance-abuse treatment: As 50% of the patients become victims of substance abuse, integrating this measure becomes an essential component of therapy.
• Social skills training: This involves teaching the sufferer basic social skills by the help of role playing and scripting real life situations to ensure stable coping with similar situations in his daily life.
• Cognitive behaviour Therapy (CBT): This involves reality based interventions that focus on the individual’s ability to interact and help them modify patterns to ensure that they act otherwise.

3. Electroconvulsive therapy: Despite its stigmatic reputation, ECT has achieved considerable success in treating schizophrenics refractive to medications and psychosocial therapies.

Research and studies have brought new and safer medications and treatment modalities in the limelight. Scientists have now discovered different patterns that are specific to schizophrenic brains. Ample social support and a compliance of therapy and medications can make this illness run a relatively benign course and enable the sufferers to live a normal life.

If you or someone you know if suffering from a mental health issue or illness such as Schizophrenia, Australia Counselling can link you with professional counsellors and psychologists in Sydney, Melbourne, Canberra, Perth, Brisbane and Adelaide. Search our directory to find a counsellor or psychologist near you today.