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A mental disorder is a pattern of psychological symptoms or behavioural symptoms that impact quite a few areas of a person’s life. Mental disorders often create severe distress for the person experiences these symptoms (Tracey, 2018). One particular disorder that I’m interested in is schizophrenia. In this assessment, I will give provide a description of schizophrenia as well as some of the treatment options and the effectiveness of these treatment options. I will also reflect on my own findings of this disorder.
A Description of Schizophrenia
Schizophrenia is a mental disorder which is serious and affects a person’s emotions as well as the way they think and behave (Swingler, 2013). A person diagnosed with schizophrenia often experiences psychotic symptoms like hallucinations and delusions and they can lose touch with reality with no knowledge or understanding of the fact that they actually have an illness (Tracey, 2018). Investigations of schizophrenia began in 1896. Dr Emil Kraeplin, a Psychiatrist, termed the condition Dementia Praecox. His research was the basis of all future research and this led to Dr Eugen Bleuler’s work in 1911 that called it schizophrenia (Tsuang & Farone, 1997). Statistics revealed that at some point, about one in 100 people could possibly be diagnosed with schizophrenia beginning between age 16 and 25 years.
Men and woman could be diagnosed with Schizophrenia but men are more likely to get it at a younger age and the effects of it might be more serious (National Schizophrenia Fellowship, 1996). In quite a few cases, Schizophrenia develops slowly, that people might not even be aware that they actually have had it for a while. However, in other cases, it sometimes suddenly strikes and develops quickly (Swingler, 2013). The causes of schizophrenia are not entirely known but experts in this field say that there are many contributing factors that are usually involved in the onset of schizophrenia (Swingler, 2013). Evidence shows that genetic and environmental causes work hand in hand to bring on schizophrenia (Swingler, 2013).
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The causes that are said to contribute to triggering Schizophrenia are things like relationships, genetics, drug abuse and an imbalance of chemicals in the brain (Tracey, 2018). Genetic inheritance applies when there is a history of schizophrenia in the family; there is a less than 1% chance of being diagnosed with schizophrenia if there is no history of it in the family. However, if there is a history, the risk rises to 10% (Tracey, 2018). Experts also believe that an imbalance of chemicals in the brain such as dopamine, a neurotransmitter, plays a role in the onset of schizophrenia (American Psychiatric Association, 2013).
Experts believe that stressful experiences or traumatic events play a key role in triggering the onset of schizophrenia. Drugs are also known to cause schizophrenia relapses, particularly marijuana. The abuse of marijuana could possibly trigger the first episode of schizophrenia (American Psychiatric Association, 2013). Some say that certain prescription drugs, for example, stimulants and steroids, can also cause psychosis (American Psychiatric Association, 2013).
The Symptoms
There is a theorized 3 factor model with regards to the symptoms of schizophrenia. The 3 factors recognised are positive, negative and disorganised symptoms. The positive symptoms are symptoms that are ‘added’ to the patient’s experience of life. Even though they are named ‘positive symptoms’, it does not mean that they are ‘good’ symptoms. One of the positive symptoms is hallucination which is hearing or seeing something that isn’t there. The most common hallucinations in schizophrenia are the hearing of voices. The other positive symptom of the disorder is delusions which are unusual or odd beliefs that are normally seen to be incorrect by others.
A schizophrenic person usually holds onto their belief even when it is proven to be untrue. The most common delusion is paranoia which is when they believe that someone is out to get them or is trying to harm them (Mueser et al, 2013). People with schizophrenia frequently have a hard time functioning at school or work and find it difficult relating to others. This may be because of negative symptoms. A negative symptom refers to certain abilities that have been lost and does not necessarily mean ‘bad’ symptoms. Negative symptoms include; no desire in activities that were enjoyed before, self-neglect, lack of interest in relationships or socialising, not wanting to talk and a lack of emotion or incorrect emotions (Mueser et al, 2013).
There are also symptoms of disorganised schizophrenia which are caused by confusion in the brain, these include; trouble with making decisions or planning, using words in unusual ways, like jumping from one topic to another, out of place emotions like laughing at sad news, as well as finding it hard to understand other people’s emotions feelings or actions. A person with schizophrenia may also have thoughts of suicide or self-harm (American Psychiatric Association, 2013).
The Treatment
The normal way of treating schizophrenia is through medication and therapy. Medication is believed to be the key treatment method for Schizophrenia, however; various therapeutic methods do benefit schizophrenic patients (Mueser et al, 2013). Antipsychotic medication is used to treat Schizophrenia and it is designed to lessen the psychosis symptoms (hallucinations and deletions) with the hope of improving the way they function on a day to day basis (Mueser et al, 2013). The procedures with regards to schizophrenia treatment are not very clear and it does not give any suggestions of what type of antipsychotics should be tried first. However, certain factors like the availability of medication, the price of it and the side effects determine the choices that are made (Mueser et al, 2013).
When it comes to important choices in antipsychotic schizophrenia treatment, the challenge is in whether to administer first or second choice medication. Doctors are often likely to choose an atypical antipsychotic which is a second-generation antipsychotic (conventional or typical antipsychotics). Normally the first generation antipsychotics have severe side effects that could affect a patient’s body movement and cause movement disorders (tardive dyskinesia) which might just end up being permanent even after the patient’s stops administering it (Swingler, 2013). This is the probably the reason why they are not the first choice. Most often, those who do not respond well to second-generation antipsychotics will probably respond well to the first generation antipsychotics.
It is vital to treat schizophrenia together with therapy because the medication on its own isn’t usually adequate enough to improve on the everyday functioning of a schizophrenic patient. Psychosocial mediation is becoming an important function in the treatment of people with serious mental illnesses especially schizophrenia (Menear & Briand, 2014).
A study was done on merging CBT together with family psychoeducation which proved to show significant improvements in schizophrenic patients (Lecomte et al, 2014). An evaluation of the psychosocial treatment for schizophrenia revealed that long-term family psychoeducation actually decreases the patients’ “chance of a relapse over a period of 1–2 years (Lecomte et al, 2014).
Other research stated the long-term success of psychoeducation (a blend of individual and family approaches). Patients suffering from schizophrenia, who had completed a brief program of eight psychoeducational sessions, had considerably lower hospitalization ratings after 12 and 24 months compared to the standard treatment without the psychoeducation. (Lecomte et al, 2014).
There are also other large-scale research studies that confirmed the value of psychoeducational family interventions. They revealed that the interventions had led to a 20% decrease in relapse rates with the results being particularly clearly due to family interventions which lasted over 3 months (Lecomte et al, 2014). A recent evaluation of 50 patients revealed that family interventions were highly effective in several areas. (Lecomte et al, 2014).
There are approximately 23 trials and quite a lot of literature reviews that have been issued about the influence of social skills training (Morin & Franck, 2017). They reveal that patients with schizophrenia are able to learn a range of skills like problem-solving strategies in social interactions and that the developed skills are generally still existent even after 2 years, which is the period of the studies (Morin & Franck, 2017). A review of a four meta-analyses of skills training established that social skills training has an important effect on behavioural skills and social functioning, but not so much on relapse and symptom reduction.
The results of numerous meta-analyses came to a similar conclusion (Morin & Franck, 2017). Kurtz and Mueser studied 1,521 schizophrenic patients and concluded that skills training programs create significantly adequate improvement in social functioning and the negative symptoms and decrease hospitalization rates over a 1- to 2-year period (Morin & Franck, 2017). Equally, the results were compared and concluded that social skills training can improve the social skills of schizophrenic patients and lessen relapse rates but currently, the evidence is sadly very limited (Morin & Franck, 2017).
My Own Reflection
Schizophrenia affects millions of people around the world. Yet, there are still so many common misperceptions about schizophrenia. People assume it means different things or they think this illness could only happen to certain people. An improved understanding of what it actually means to have schizophrenia is essential to ensure that people who have the disease get the treatment they require and the respect they deserve.
The most common perception people have is that schizophrenia means having ‘split personalities’. There is such a thing as ‘split personalities” however, it is called dissociative identity disorder, which is completely different and is not connected to schizophrenia. Dissociative identity disorder is not as common as Schizophrenia (Menear & Briand, 2014).
Most people also think that all schizophrenic people are violent and are likely to be involved in criminal acts. You find that if there is a schizophrenic person living in the community, most people in that community are afraid of that person who is schizophrenic. One of the reasons for this is the media because they will take the stories of a few criminals who happen to be schizophrenic and repeat their stories over and over which creates that stigma around schizophrenic people. People don’t understand that the delusions that occur in a schizophrenic person mind, sometimes triggers violent behaviour but this is usually not a long-term behavioural change and can usually be managed together with other symptoms. (Menear & Briand, 2014).
Lots of people think schizophrenia is uncommon. I was one of these people but I have come to realise that this is simply not true. Although it is not nearly as common as cancer or heart disease, schizophrenia still affects millions of people around the world. One estimate proposes that approximately one percent of the world’s population—which is about 70 million people—have schizophrenia, which makes it just as common as HIV/AIDS (Varcarolis, 2000). People also think that children cannot have schizophrenia. This is actually truer than the other beliefs.
Children as young as five years old seldom can show symptoms of schizophrenia, but there is no evidence that shows that schizophrenia cannot affect the very young. When communities misunderstand an illness, like schizophrenia, it creates a stigma, weighing them down with discrimination, accusations and unrealistic expectations. By familiarizing myself with schizophrenia and the perceptions about the disorder, I have become more supportive of it because I now understand the challenges faced by schizophrenics.
Aspects of Schizophrenia that interest me
The aspect of schizophrenia that interests me most is the fact that people living with schizophrenia can live normal lives. Schizophrenics are quite capable of working and holding on to their jobs for a long duration. Most people assume that a diagnosis of schizophrenia means you’ll never achieve professional success because it affects the brain and behaviour, as well as the fact that people with the illness can lose touch with reality (Swingler, 2013).
I find it interesting that there are famous people living with schizophrenia who battled the disease throughout their lifetime. If there was more awareness in the media about the people who are living normal lives after being diagnosed with schizophrenia, it would minimise the stigma around the disorder. Unfortunately, many people living with it that are employed often do not want to reveal their mental health status because they are afraid of losing their jobs and because of the stigma around the illness.
In my view, the harshest aspect of the illness is the fact that those suffering from schizophrenia are often in denial of their diagnosis, which robs them of the ability to accept treatment that will reduce their symptoms. This can actually lead to many unnecessary years of pain and suffering for them (American Psychiatric Association, 2013).
Conclusion
Currently, there is no cure for schizophrenia because of the severity of the symptoms experienced by a person with schizophrenia. Even though Schizophrenia is a chronic condition and symptoms may actually never go away for some people, it is possible for schizophrenics to experience long-lasting remission that permits long-term employment, strong social relationships and an independent lifestyle. Though the common stigma among South Africans that people with schizophrenia cannot expect a lasting recovery, several studies have revealed that a considerable portion of schizophrenia patients do recover.
The key is to give them the medical support they need and the flexibility to control their schedules and environments. Recovery can mean different things for different people — for some people, it may involve the decrease or elimination of symptoms, whereas, for others, it may mean learning to find happiness and be productive, finding fulfilment, and a sense of belonging in spite of the schizophrenia symptoms.
