Schizophrenia Clinical Management: Your Path To Real Mental Strength


Schizophrenia is a chronic, severe, and disabling brain disorder.

Define: Schizophrenia

  • People suffering from schizophrenia often hear voices in an absence of a stimulus or have false beliefs known as delusions.
  • People suffering from schizophrenia might have difficulty in differentiating reality from the delusions and hallucinations.
  • Expressing a normal range of emotions may be difficult for them.
  • Patients aren’t often violent and almost never pose any danger to anyone.
  • Schizophrenia does not develop due to childhood experiences or poor upbringing or even an absence of willpower.

Schizophrenia and the loss of brain cells

New research by Yale University has revealed that brain loss happens due to neuroinflammation causing psychotic episodes. The condition of the patients improves with medications. Their efficacy is well-documented since patients may suffer relapses of the positive symptoms of schizophrenia-like delusions and hallucinations.

Types of schizophrenia

  • Paranoid schizophrenia — in this type of schizophrenia, patients may believe that a person or agency may be taking special interest in them, that they are being followed or watched and someone wants to harm them.
  • Disorganized schizophrenia — Speech, behaviour and thoughts in this sort of disorder are often incoherent, disorganized and bizarre.
  • Catatonic schizophrenia — Catatonic features include, staying silent and maintaining abnormal postures for hours. This can be severe enough to lead to exhaustion and death.
  • Residual schizophrenia — Though these patients don’t necessarily suffer from hallucinations or delusions, yet they have some leftover symptoms of schizophrenia.
  • Schizoaffective disorder — Psychiatric symptoms of schizoaffective disorder are a combination of schizophrenia and a major mood disorder like depression or bipolar disorder.

Causes

Heredity and Environmental

  • Scientists recognize that schizophrenia tends to run in families. Less than 1 percent of the population develops schizophrenia. But, 10 percent of the people with first-degree relation to patients suffering from schizophrenia do report similar symptoms. For example, parents, brothers or sisters. Even people having second-degree relation like aunts, uncles, cousins or grandparents are also at significant risk of developing the condition than the general population.
  • Risk of schizophrenia is at its highest in case of identical twins as compared to the general population.
  • Scientists believe that certain genes increase the risk of schizophrenia. Studies suggest that patients suffering from schizophrenia are at increased rates of rare genetic mutations. These mutations probably hamper normal brain development in multiple ways with minor effects.
  • To scientists, both genes and environmental aspects of a person is necessary to develop schizophrenia. Therefore, several environmental factors do play a role for the psychiatric disorder to manifest in a healthy person. For example, viral infections, stressful situations; prenatal (before birth) and postnatal (after birth) malnutrition, besides other factors like psychosocial ones.

Chemistry

  • Chemical imbalances of neurotransmitters (serotonin and dopamine) are found in patients. Chemical imbalances affect behaviour and emotional processing leading to symptoms.
  • Hallucinations or delusions can happen because of the problems in processing various sights, smells, sounds, and tastes. Early warning of schizophrenia

Patients hear or see that are not there

  • They constantly feel followed and monitored
  • They may have a strange or absurd way of speaking or writing
  • They may show abnormal body posture
  • Their emotions may be dulled or they may show a minimal emotional range
  • Due to schizophrenia, their academic or work performance often suffers
  • Personal hygiene and appearance of the patients often undergoes a significant decline

Positive symptoms

  • Delusions or false fixed beliefs
  • Hallucinations or to see, feel, taste, hear or smell something that is not there
  • Disorganized thoughts and speech

Negative symptoms

  • Social isolation
  • Extreme apathy or indifference
  • Lack of motivation or initiative
  • Emotional dormancy

Recovery and Rehabilitation

  • Psychosocial Rehabilitation Programs may help people regain their skills like employability, cooking, cleaning, budgeting, shopping, socializing, problem solving, and stress management.
  • Through housing programs, a range of support and supervision such as 24 hours supervised living support may be provided an on-need basis.
  • Many employment programs can help mentally-ill people to get employed or to gain skills that are necessary to re-enter the workforce.
  • Therapy or counseling including different types of “talk” therapy, both in-person and in groups can help the patients and their family members to understand the illness better and share their concerns.

Antipsychotic medications

  • Traditional antipsychotics may effectively control the “positive” symptoms of schizophrenia-like hallucinations and delusions.
  • New Generation (also called atypical) antipsychotics can treat both the positive and negative symptoms of schizophrenia and with fewer side effects.

Antipsychotic medications

Example of typical antipsychotics-

  • Chlorpromazine (Thorazine)
  • Haloperidol (Haldol)
  • Perphenazine (Etrafon, Trilafon)
  • Fluphenazine (Prolixin).

Example of atypical antipsychotic are:

  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)
  • Aripiprazole (Abilify)
  • Paliperidone (Invega).

Side effects

  • Drowsiness
  • Dizziness when changing positions
  • Blurred vision
  • Rapid heartbeat
  • Sensitivity to the sun
  • Skin rashes
  • Menstrual problems for women
  • Rigidity
  • Persistent muscle spasms
  • Tremors
  • Restlessness
  • Weight gain
  • Cholesterol problems
  • Blood sugar changes

Patient support

  • Greater awareness may motivate the patient to follow the treatment plan and to combat a mental disorder as severe as schizophrenia.
  • Educating family members, friends, and caregivers to understand the patient’s mental condition can be of great help.
  • Patients can participate in a support group with other people suffering from schizophrenia can interact with each other.
  • Patients should be taught ways to beat stress and relax. There are many stress management techniques like yoga, tai chi or meditation.

Prevention

  • There’s no surefire way to prevent schizophrenia.
  • Early onset of treatment can keep the symptoms under control and avoid serious complications later on.
  • Persistent treatment can help to prevent worsening of the patient’s symptoms.

Though long-term treatment may be required, yet the outlook for people with schizophrenia isn’t hopeless. Many patients can enjoy life and function normally within their families and communities through proper treatment.

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