All Things Schizophrenia

Schizophrenia is a disorder that affects around 20 million people worldwide. It is both widespread and hard to cope with, especially when it comes to everyday tasks. This article will delve deep into its symptoms, causes, and potential treatments. 

Symptoms

Psychosis is often a trait of those who have contracted Schizophrenia. This is a disruption in the way the brain is supposed to function and further, a lack of truthful perception. It means that sights and sounds become unclear and indiscernible, and disorganized behavior may arise in response; this is otherwise known as a psychotic period. Additionally linked to Schizophrenia is delusion, in which false beliefs are held as true despite empirical or legit evidence against it. A person might believe, for instance, that their coffee is poisoned or that their neighbor is an enemy spy. Behavior is more cautious because of this. Appealing more to the senses though, to have Schizophrenia could also mean hallucinating, where sight, hearing, and smelling occur in the absence of a stimulus, or in simpler words, feeling things that aren’t actually there. 

Abnormal motor behavior (AMB) is slightly more interesting. While psychosis, delusion and hallucination are akin in their distortion of reality, AMB differs in its more direct relation to action. Sporadic and unpredictable, someone could behave in a way that isn’t what they are usually like; increased movement and a child-like demeanor are just two examples of the abnormalities that may occur. Catatonia is a third abnormality, where there is a lack of movement and general interest. In its most extreme cases, a person could maintain a rigid and strange posture, and stay stagnant for a long period of time. Similar to this, in terms of its close influence on behavior, is yet another symptom: disorganized thinking as well as the disjointed communication that stems from it. Blatant and illogical remarks are made amidst conversations, with most of it being off topic. A person with Schizophrenia may be asked about their pets, in one instance, only to justify their ownership with dislike; ‘I hate cats, therefore I own one’. To them, the connection between a contrasting cause and effect suffices an appropriate response. 

Negative symptoms are those that reflect noticeable decreases and absences in certain behaviors, emotions or drives. Avolition refers to a lack of motivation to engage in self-initiated and meaningful activity; Alogia is the lack of speech where someone prefers not to say much; Asociality entails social withdrawal and a lack of interest in talking to others; and finally, Anhedonia is the lack of interest in hobbies, recreation, and sexual activity. Clearly such symptoms exhibit one commonality - the ‘lack of’ something, which plays a role in the way a Schizophrenic person sees the world around them, or more specifically, how they struggle to forge connections with their surroundings. 

Causes

Schizophrenia is partially caused due to genetics. Someone with a parent who has Schizophrenia is 6 times as likely to contract the disease than someone with no family history at all. From here, likelihood is further dependent on how closely related, in terms of genes, family members are to each other. The closer the relation, the greater the risk. 

Though there are numerous studies considering the above, perhaps the conclusions made from those that are based on twins are the most criticized. This is because twins normally share the same environment and that there could be possible effects of this; also, identical twins may be deemed more ‘similar’ than fraternal twins which encourages a bias. However, with every problem comes a potential solution: adoption studies, where rather unethically, children are separated from their parents at a young age. 

In an adoption study conducted by Heston (1966), over a 36 year period, 97 adoptees were surveyed and 47 our of them were born to mothers with Schizophrenia. 5 of them (11%) were then diagnosed with Schizophrenia while there were no cases detected among the 50 in the control group, which ultimately proves that the disease does arise in nature (ie. genetics). Yet, it takes two to tango; could the surrounding environment play an equally important factor in the development of Schizophrenia? Yes, is the short answer. In an examination of 303 adoptees (Tienari et al 2004), 145 had biological mothers with Schizophrenia while the rest had no psychiatric history in their bloodline. The adoptees were then classified, in terms of the environment they had been raised in, as either ‘healthy’ or ‘disturbed’ (‘disturbed’ adoptees were those that had been brought up in an unstable family setting). It turns out that those who had mothers with Schizophrenia and demonstrated the latter were more likely to develop Schizophrenia (36.8%) than in cases where the two were mutually exclusive (ie. Schizophrenic mother but ‘healthy’, no psychiatric history but ‘disturbed’, and no psychiatric history but ‘healthy’). The fact that adoptees at higher genetic risk had a higher likelihood in the condition that they are ‘disturbed’ exemplifies that genes do not provide a full picture independent of nurture (ie. environment).

Looking more closely at the brain, a number of neurobiological factors have been found in relation to Schizophrenia, one of which being the neurotransmitter dopamine. Interest in it was first stimulated by 2 distinctive findings: drugs that increase dopamine cause Schizophrenia-like symptoms, while those that block its production result in the opposite. Only then was it identified that an overabundance was responsible for both onset and maintenance, and it was further discovered an optimal level is needed; too much in the limbic system may lead to symptoms such as hallucinations and delusions, while low levels in the prefrontal cortex may lead to negative symptoms. 

Treatment

There is no definite cure for Schizophrenia, and because of this, there are more efforts to alleviate its symptoms instead. 

One way is through cognitive behavioral therapy (CBT), a chance to identify thoughts or feelings that need to be expressed. Its aims are to cope with delusion and psychosis, ease stress, and to manage any social anxiety. Recently researchers have suggested that an additional reason for Schizophrenia is trauma from a young age, so CBT could also be crucial in allowing patients to explore and then to come to terms with their deep experiences. 

Another relief is medication, although it affects people differently. Some find the medication useful, while others don't feel much better. Patients are commonly prescribed with antipsychotics when first diagnosed in order to control symptoms such as anxiety and hallucination. There are several reasons behind why they do so, but an important one is by blocking dopamine, an alleged cause of Schizophrenia (see ‘Causes’). 

Finally, arts therapy encourages creative expression in contrast to the verbal CBT. Patients will often find that relieving in a non-verbal way helps to bridge their miscommunications, but more importantly, helps them to let their consciousness out in a way that is comprehensible to themselves and doesn't need to be to others. 

References:

creatcareinc (2020). How Schizophrenia Affects Your Daily Life. [online] Creative Care Inc. Available at: https://www.creativecareinc.com/how-schizophrenia-affects-your-daily-life/. 

Mayo Clinic. (2024). Schizophrenia - Symptoms and causes. [online] Available at: https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443#:~:text=Schizophrenia%20is%20a%20serial%20 

Miles, L. (2018). LibGuides: PSY 142 - Abnormal Psychology - Textbook: Schizophrenia - Part 1. [online] guides.hostos.cuny.edu. Available at: https://guides.hostos.cuny.edu/psy142/6-2. 

NHS (2023). Treatment - Schizophrenia. [online] NHS. Available at: https://www.nhs.uk/mental-health/conditions/schizophrenia/treatment/.