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Schizophrenia

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Overview of Schizophrenia

Schizophrenia Meaning in Urdu

شیزوفرینیا دماغ کی دائمی اور شدید بیماری ہے جو کہ انسان کی سوچنے، عمل کرنے، اور حقیقت کو قبول کرنے کے عمل کو متاثر کرتی ہے۔ عام طور پر شیزوفرینیا کو دماغ کی دوسری بیماریوں کی طرح سمجھا جاتا ہے، مگر یہ دوسری بیماریوں کی نسبت زیادہ شدت سے متاثر کرتی ہے۔ اس بیماری کا شکار افراد حقیقت سے دور ہو جاتے ہیں۔ مثال کے طور پر انہیں لگتا ہے کہ انہوں نے ایک کام کر لیا ہے۔ جب کہ حقیقت میں انہوں نے وہ کام نہیں کیا ہوتا۔ اس کے علاوہ شیزوفرینیا کے مریض ایسی چیزوں کو دیکھتے یا سننے لگتے ہیں جن کا حقیقی وجود نہیں ہوتا۔

Schizophrenia is a severe mental disorder that impairs a person to differentiate between reality and thoughts. People with schizophrenia often suffer from delusions, hallucinations, and paranoia, affecting their behaviors and emotional patterns. 

Schizophrenia is the most distinguished form of psychosis, which means your mind does not agree with reality and creates its own scenarios, situations, thoughts, and ideas. If left untreated Schizophrenia can become severe and persistent. 

Effective treatments available, if given on time, can help a person sustain normal behavior at school, work, and in personal relationships. 

Signs and Symptoms of Schizophrenia

Early Onset of Schizophrenia

The onset of schizophrenia ranges from adolescence (late teens) the to early thirties and tends to be more prevalent in males than females. The earliest signs and symptoms occur before the first episode of psychosis. Schizophrenia is rare when it comes to children, which is why the earliest signs begin during late adolescence. Since the process of schizophrenia is very gradual it is often hard to diagnose the disease in its earliest stage of diagnosis. Therefore it is important to be aware of the earliest warning signs of schizophrenia to treat the disease on time. 

1- Psychotic symptoms are the earliest of the symptoms. The patient is unaware of their developing signs and often confuses the developing symptoms with other problems. For example, changing vision, and losing the sense of touch, smell and taste can easily be misunderstood for other forms of disease or seasonal common cold/ flu if in case they are suffering from it. 

The next stage is when abnormal thinking patterns follow without any real basis. These are symptoms that will worsen and take over a person’s conduct emotionally/ behaviourally if left untreated. The typical experience of such symptoms includes;

  • Hallucinations- hearing voices, complaining of some unseen presence, talking about imaginary people. In many cultures including Pakistan, many people confuse it with their understanding of paranormal/ supernatural/ sorcery beliefs, which delays the right medical treatment for schizophrenic patients. 

  • Delusions (holding a strong belief of something which does not exist)- the most common form of delusion is paranoia (extreme irrational fear). For example, a schizophrenic experiencing paranoia will constantly be in fear of ‘being followed’ or ‘having life under threat’ without any obvious evidence. Another form of delusion includes believing an unrealistic news/ show/ drama/ article/ another person’s story and believing it to be their own reality. 

  • Unclear thought patterns- this includes disorganized thoughts and blurry speech. For example, a schizophrenic will not complete their sentences properly and often their narration of any topic or story will be broken down into different other mismatched narrations and stories. 

2- Cognitive symptoms interfere with normal activities which hinder the individual's daily routine, such as low attention span, foggy mind, memory loss, facing difficulty in processing informed decisions, and altered information from reality. As subtle as these signs may be, they can be often confused with being stressed or overworked. Cognitive symptoms can be one of the earliest signs as well for some people (it may vary from person to person). 

3- Other common symptoms include a complete lack of motivation, loss of appetite, losing interest in daily activities, feeling no emotions, finding normal daily tasks hard to complete, withdrawing from social circles and activities, finding no pleasure in everyday life, not being able to sustain daily normal tasks and activities. 

 

Another common symptom present in most schizophrenics is having a ‘flat affect’. Flat affect is a reduced facial expression, meaning gradually they stop showing any emotions through their facial expression or through their speech. 

 

Types of Schizophrenia

Causes of Schizophrenia

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Risk Factors of Schizophrenia

Schizophrenia involves several risk factors. Being mindful of the early risk factors can help in diagnosing the risk of developing schizophrenia. 

  • Genetic: Schizophrenia is a genetic disease that has a high probability of running in the family. Nevertheless, having one schizophrenic family member does not necessarily mean that all family members will develop it as well. According to a genetic study, multiple genes are involved in triggering schizophrenia, yet no single gene has ever been reported to cause the disease. Thus, the genetic information of an individual is not enough to determine whether the disease will develop or not. 

  • Environmental Factors: genetics has a very strong association with the environment. Many environmental factors such as extreme stress, facing abuse in early childhood, poverty, malnutrition, and exposure to viruses can be the contributing factors to triggering schizophrenia disease. Nevertheless, these factors are not the sole reason for developing schizophrenia and require further scientific evidence. 

  • Brain Development: This factor includes the structural and functional development when a child is growing up or before a child is born. The difference in chemical ratios of the brain can be a trigger for schizophrenia. For example, an imbalance of chemical messengers (neurotransmitters)  in your brain (which are responsible for taking brain functions/ commands to the body and other parts of the brain) can result in an imbalance of other brain chemicals that are important for its functioning. This has been reported in the case of abnormal volumes of dopamine (brain chemical) in people who had schizophrenia. For certain schizophrenic people who had different brain circuits and connections were reported to develop these before their birth. People who are vulnerable to the environment or genetics can also experience changes in brain chemical composition during the period of puberty. 

  • Father’s Age: Father’s age is an important risk factor for the disease. The chances of schizophrenia are significantly higher as the father is aged.

  • Pregnancy Complications: Pregnancy complications and exposure to toxins or viral infection either during pregnancy are an important risk factors for the disease.

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Prevention

There are no known ways to prevent the onset of schizophrenia. However, following healthy lifestyle practices and early diagnosis can prevent the worsening of symptoms.

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Diagnosis

Here is how schizophrenia can be diagnosed:

1- Physical Examination: This physical examination helps your physician to know more about your signs and symptoms. 

2- Tests and Scan: Physical examination is followed by diagnostic tests and scans. These scans such as MRI and CT scans can reveal the functioning of organs.

3- Psychiatric Examination: Here your physician tries to get deeper into your apparent signs and symptoms. From your moods to suicidal behavior, they analyze your behavior patterns. Further, questions regarding your medical and family history can help doctors to rule out the possibility of another medical complication.

Treatment of Schizophrenia | When to Consult a Doctor

Schizophrenia varies from person to person. Due to the uncertainty of its root cause, treatments depend on each and every individual case. 

It's always important to immediately consult with a doctor instead of self-diagnosing.

Antipsychotic Medications 

 These medications are there to tame the frequency of psychotic symptoms. In no way, it completely diminishes the disease itself, rather helps the patient in coping better with daily life struggles. 

They are usually taken in the form of pills or as syrup. Some stronger antipsychotic drugs are given in the form of injections at least once or twice a month. Patients whose symptoms do not improve over time are given clozapine in place of antipsychotics. Due to clozapine's side effects, patients have to undergo regular blood screening to see if there have been any side effects. Potentially only a small ratio of people develop any side effects. Some of the side effects include: 

  • Weight gain
  • Dry mouth
  • Restlessness
  • Mild anxiety 
  • Drowsiness 

With regular use of the medicine side effects subside over time, although for some people the side effects continue. Do not ever suspend your prescription due to antipsychotic side effects. Under any circumstances, consult with your doctor first. 

Psychosocial Therapies

Therapies are an important intervention in treating schizophrenia. Mainstream therapies include;

  • Cognitive behavioral therapy, behavioral training skills, emotional regulation control skills, remediations intervention to help improve cognitive and negative symptoms, supported employment therapy along with antipsychotic medication. A mix of these therapies is vital for developing coping skills to manage daily challenges. People who are regular in their therapies and treatment programs are less likely to undergo a relapse of schizophrenia and be hospitalized. 
  •  Coordinated specialty care (CSC)- this is a special recovery-oriented program for people who are undergoing first-stage psychosis. A special team provides a treatment program based on every individual case. CSC is more effective as compared to typical programs of therapies and medications. 
  • Assertive community treatment- this program is designed for patients who are at constant risk of hospitalization. The treatment is specialized with heavy networking of team members working cohesively to reach schizophrenic patients who have been abandoned or are homeless. 

In case of any concerning signs and symptoms, you can consult a medical professional as soon as possible. 

How can you help someone suffering from schizophrenia?

  • If you suspect someone near you or in your community is showing signs of schizophrenia, immediately help them by connecting with a doctor. Usually, you will be met with other alterations such as spiritual treatment as most people are thought to be possessed by the supernatural, whereas in reality delusions and abnormal behavior are foretelling strongly about the development of schizophrenia.
  •  If you know someone who is in treatment and is thinking of dropping out, encourage them to stay in the treatment or provide them financial assistance as certain treatments, medications and treatments can be costly. 
  • You can also connect them with foundations that finance patients with less financial means. 
  • Acknowledge and respect their delusion as ‘their reality'. Understanding that their actions and thoughts are not in their power, is why the least you can do is be supportive and encouraging toward a patient. 
  • Try finding a support group near you, so to help the individual understand that he/she is not alone. 

Please understand that regardless of your belief system or pocket, schizophrenia requires immediate medical emergency care. Do not delay the matter and assist your loved one in finding a suitable doctor.

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