Adam "was a wonderfully,
sweet young man," his mother said. He was a high school athlete
and captain of his team, active in his college fraternity, a good student.
He had graduated from college and started working while studying for
a professional certification exam when something inside him changed.
. . Adam stopped being careful about his personal appearance. He told
his parents he suspected them of communicating with each other in secret
ways, such as in sign language which he couldn't understand. He began
to hear his mother's voice in his head and he asked her why she was
sending him messages. . . he was diagnosed with schizophrenia.
What is schizophrenia?
Schizophrenia, a disease
of the brain, is one of the most disabling and emotionally devastating
illnesses known to man. But because it has been misunderstood for so
long, it has received relatively little attention and its victims have
been undeservingly stigmatized. Schizophrenia is not a split personality,
a rare and very different disorder. Like cancer and diabetes, schizophrenia
has a biological basis; it is not caused by bad parenting or personal
weakness. Schizophrenia is, in fact, a relatively common disease, with
an estimated one percent to one and a half percent of the U.S. population
being diagnosed with it over the course of their lives. While there
is no known cure for schizophrenia, it is a very treatable disease.
Most of those afflicted by schizophrenia respond to drug therapy, and
many are able to lead productive and fulfilling lives.
What are its symptoms?
Schizophrenia is characterized
by a constellation of distinctive and predictable symptoms. The symptoms
that are most commonly associated with the disease are called positive
symptoms, that denote the presence of grossly abnormal behavior. These
include thought disorder, delusions, and hallucinations. Thought disorder
is the diminished ability to think clearly and logically. Often it
is manifested by disconnected and nonsensical language that renders
the person with schizophrenia incapable of participating in conversation,
contributing to his alienation from his family, friends, and society.
Delusions are common among individuals with schizophrenia. An affected
person may believe that he is being conspired against (called "paranoid
delusion"). "Broadcasting" describes a type of delusion
in which the individual with this illness believes that his thoughts
can be heard by others. Hallucinations can be heard, seen, or even
felt; most often they take the form of voices heard only by the afflicted
person. Such voices may describe the person's actions, warn him of
danger or tell him what to do. At times the individual may hear several
voices carrying on a conversation. Less obvious than the "positive
symptoms" but equally serious are the deficit or negative symptoms
that represent the absence of normal behavior. These include flat
or blunted affect (i.e. lack of emotional expression), apathy, and
Who gets it?
While schizophrenia can
affect anyone at any point in life, it is somewhat more common in
those persons who are genetically predisposed to the disease. The
first psychotic episode generally occurs in late adolescence or early
Genetic Link -- The probability
of developing schizophrenia as the offspring of two parents, neither
of whom has the disease, is 1 percent. -- The probability of developing
schizophrenia as the offspring of one parent with the disease is approximately
13 percent. -- The probability of developing schizophrenia as the
offspring of both parents with the disease is approximately 35 percent.
Onset by Age -- Three-quarters
of persons with schizophrenia develop the disease between 16 and 25
years of age. -- Onset is uncommon after age 30, and rare after age
Onset by Sex -- In the
16-25 year old age group, schizophrenia affects more men than women.
-- In the 25-30 year old group, the incidence is higher in women than
What is the course of the
Studies have shown that
some persons with schizophrenia recover completely, and many others
improve to the point where they can live independently, often with
the maintenance of drug therapy. Fortunately, this accounts for the
majority of cases. However, approximately 15 percent of people with
schizophrenia respond only moderately to medication and require extensive
support throughout their lives, while another 15 percent simply do
not respond to existing treatment. New therapies may offer hope for
the treatment of these most seriously affected sufferers.
How is it treated?
Hospitalization is often
necessary in cases of acute schizophrenia. This ensures the safety
of the affected person, while allowing for observation by trained
mental health professionals to determine whether schizophrenia is
the appropriate diagnosis. Hospitalization also allows for the initiation
of medication under close supervision. Antipsychotic drugs (also called
neuroleptics), available since the 1950s, can dramatically improve
the functioning of people with schizophrenia. Once the most troubling
symptoms are controlled by medication, the person often does not require
hospitalization. Depending on the seriousness of the disease, the
person may utilize day programs, rehabilitation facilities, and be
treated in an outpatient setting. This allows the psychiatrist to
adjust medication dosages as necessary over the course of the disease.
The person may also need assistance in readjusting to society once
his or her symptoms are controlled. Supportive counseling or psychotherapy
may be appropriate for these individuals as a source of friendship,
encouragement, and practical advice during this process. Relatives
and friends can also assist in rebuilding the person's social skills.
Such support is very important.
What can/should I do if
a loved one is sick?
Because an individual with
schizophrenia may not be aware that he is ill, it is often necessary
for a friend or relative to make certain that proper treatment is
sought. A good doctor is critical; it helps to find one through the
recommendation of other families or healthcare professionals. Once
the person is released from the hospital, families are often left
with the responsibility of ensuring that the person is taking medication
and is continuing to receive whatever other treatment is necessary.
The best way to treat a friend or relative with schizophrenia is with
compassion, understanding, and support. The person should not be made
to feel as if the disease is his or anybody's fault. As Dr. E. Fuller
Torrey has stated, "People do not cause schizophrenia; they merely
blame each other for doing so." Learning about the disease and
its treatment will help to avoid the temptation to blame. In addition
to seeking help for the person afflicted with the disease, loved ones
often find mutual support to be invaluable. AMI/FAMI is a grassroots,
self-help organization of families and friends of people with serious
mental illnesses. Members meet regularly to share practical information
and common experiences.
Mental Illness Terminology
emotional feeling, tone and mood attached to a thought, including
its external manifestations. Bipolar disorder: a periodic, recurrent
mood disorder with intervening periods of complete normalcy. Not
to be confused with schizophrenia.
- Blunted affect:
(see flat affect)
- Deficit symptoms:
(see negative symptoms)
- Delusion: fixed,
irrational ideas not shared by others and not responding to reasoned
- Flat affect:
absence of or diminution in the amount of emotional tone or outward
emotional reaction typically shown under similar circumstances.
- Grandiose delusion:
a delusion in which subject believes himself possessed of great
wealth, intellect, importance, power, etc.
perceptions that occur without any external stimulus.
- Inappropriate affect:
emotional tone or outward reaction out of harmony with the idea,
object, or thought accompanying it.
- Manic depressive
as bipolar disorder)
- Negative symptoms:
are absent among individuals with schizophrenia but present among
- Neuroleptic drugs:
the standard drugs currently used to treat the symptoms of schizophrenia.
Positive symptoms: behaviors which are absent among healthy individuals
but present among individuals with schizophrenia.
a mental disorder causing gross distortion or disorganization of
a person's mental capacity, emotional response, and capacity to
recognize reality, communicate, and relate to others to the degree
of interfering with his or her capacity to cope with the ordinary
demands of everyday life. Schizophrenia: the most common type of
psychosis characterized by a disorder in the thinking processes,
such as delusions and hallucinations, an extensive withdrawal of
the individuals's interest from other people in the outside world,
and the investment of it in his own. Schizophrenia is now considered
to be a group of mental disorders rather than a single entity.
- Thought disorder:
a symptom of schizophrenia. Clear, goal-directed thinking becomes
increasingly difficult, as shown in a diffuseness or "woolliness"
and circumstantiality of speech.
- Withdrawal: the
process of retreating from society and relationships with others.
Usually indicated by aloofness, lack of interest in social activities,
and difficulty in communicating with others.