Schizophrenia

What Is Schizophrenia?

Schizophrenia is a chronic, severe, and disabling brain disorder. It affects about 1 percent of people all over the world.

People with schizophrenia may hear voices other people don't hear or believe that others are reading their minds, controlling their thoughts, or plotting to harm them. These experiences are terrifying and can cause fearfulness, withdrawal, or extreme agitation. People with schizophrenia may not make sense when they talk, may sit for hours without moving or talking much, or can seem perfectly fine until they talk about what they are really thinking. Since many people with schizophrenia have difficulty holding a job or caring for themselves, the burden on their families and society is significant as well.

Schizophrenia is a major mental illness characterized by persistent defects in the perception or expression of reality. A person suffering from untreated schizophrenia typically demonstrates grossly disorganized thinking, and may also experience delusions or auditory hallucinations. Although the illness primarily affects cognition, it can also contribute to chronic problems with behavior or emotions.

Schizophrenia may develop so gradually that the family and even the person with the disease may not realize that anything is wrong for a long period of time. This slow deterioration is referred to as gradual-onset or insidious schizophrenia. A gradual build-up of symptoms may or may not lead to an acute or crisis episode of schizophrenia. An acute episode is short and intense, and involves hallucinations, delusions, thought disorder, and an altered sense of self.

Sometimes schizophrenia has a rapid or sudden onset. Very dramatic changes in behaviour occur over a few weeks or even a few days. Sudden onset usually leads fairly quickly to an acute episode. Some people have very few such attacks in a lifetime; others have more. Some people lead relatively normal lives between episodes. Others find that they are very listless. depressed, and unable to function well.

In some, the illness may develop into what is known as chronic schizophrenia. This is a severe, long-lasting disability characterized by social withdrawal, lack of motivation, depression, and blunted feelings. In addition, moderate versions of acute symptoms such as delusions and thought disorder may be present in the chronic disorder.

There are 5 recognized types of schizophrenia: catatonic, paranoid, disorganized, undifferentiated, and residual. Features of schizophrenia include its typical onset before the age of 45, continuous presence of symptoms for 6 months or more, and deterioration from a prior level of social and occupational functioning.

Schizophrenia Symptoms & Signs

People with schizophrenia may show a variety of symptoms. Usually the illness develops slowly over months or even years. At first, the symptoms may not be noticed. For example, people may feel tense, may have trouble sleeping, or have trouble concentrating. They become isolated and withdrawn, and they do not make or keep friends. As the illness progresses, psychotic symptoms develop:

• Delusions - false beliefs or thoughts with no basis in reality
• Hallucinations - hearing, seeing, or feeling things that are not there
• Disordered thinking - thoughts "jump" between completely unrelated topics (the person may talk nonsense)
• Catatonic behavior - bizarre motor behavior marked by a decrease in reactivity to the environment, or hyperactivity that is unrelated to stimulus
• Flat affect - an appearance or mood that shows no emotion

No single characteristic is present in all types of schizophrenia. The risk factors include a family history of schizophrenia. Schizophrenia appears to occur in equal rates among men and women, but women have a later onset. For this reason, males tend to account for more than half of patients in services with high proportions of young adults. Although the onset of schizophrenia is typically in young adulthood, cases of the disorder with a late onset (over 45 years) are known.

Childhood-onset schizophrenia begins after the age of 5 and, in most cases, after relatively normal development. Childhood schizophrenia is rare and can be difficult to differentiate from other pervasive developmental disorders of childhood, such as autism.

No one symptom positively identifies schizophrenia. All of the symptoms of this illness can also be found in other brain disorders. For example psychotic symptoms may be caused by the use of drugs, may be present in individuals with Alzheimer’s Disease, or may be characteristics of a manic episode in bipolar disorder. However, when a doctor sees the symptoms of schizophrenia and carefully asseses the history and the course of the illness over six months, he or she can almost always make a correct diagnosis.

The symptoms of schizophrenia are generally divided into three categories, including positive, disorganized and negative symptoms.

• Positive Symptoms, or "psychotic" symptoms, include delusions and hallucinations because the patient has lost touch with reality in certain important ways. "Positive" as used here does not mean "good." Rather, it refers to having overt symptoms that should not be there. Delusions cause the patient to believe that people are reading their thoughts or plotting against them, that others are secretly monitoring and threatening them, or that they can control other people's minds. Hallucinations cause people to hear or see things that are not there.

• Disorganized Symptoms include confused thinking and speech, and behavior that does not make sense. For example, people with schizophrenia sometimes have trouble communicating in coherent sentences or carrying on conversations with others; move more slowly, repeat rhythmic gestures or make movements such as walking in circles or pacing; and have difficulty making sense of everyday sights, sounds and feelings.

• Negative Symptoms include emotional flatness or lack of expression, an inability to start and follow through with activities, speech that is brief and lacks content, and a lack of pleasure or interest in life. "Negative" does not, therefore, refer to a person's attitude, but to a lack of certain characteristics that should be there.

Schizophrenia is also associated with changes in cognition. These changes affect the ability to remember and to plan for achieving goals. Also, attention and motivation are diminished. The cognitive problems of schizophrenia may be important factors in long term outcome.

Schizophrenia also affects mood. Many individuals affected with schizophrenia become depressed, and some individuals also have apparent mood swings and even bipolar-like states. When mood instability is a major feature of the illness, it is called, schizoaffective disorder, meaning that elements of schizophrenia and mood disorders are prominently displayed by the same individual.

Cause of Schizophrenia

Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different, as a group, from the brains of people without the illness. Like many other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person's development. Recent research has identified the first genes that appear to increase risk for schizophrenia. Like cancer and diabetes, the genes only increase the chances of becoming ill, and do not cause the illness all by themselves.

Schizophrenia Treatment

During an acute episode of schizophrenia, hospitalization is often required to promote safety, and to provide for the person's basic needs such as food, rest, and hygiene.

Antipsychotic or neuroleptic medications work by changing the balances of chemicals in the brain and are used to control the symptoms of the illness. These medications are effective, but are also associated with side effects that may discourage a patient from taking them regularly. However, many of these side effects can be addressed, and should not prevent people from seeking treatment for this serious condition.

Common side effects from traditional antipsychotics may include sedation and weight gain. Other side effects are known as extrapyramidal symptoms (muscle contractions, problems of movement and gait, and feelings of restlessness or "jitters").

Long-term risks include a movement disorder called tardive dyskinesia, which involves involuntary movements. Newer agents known as atypical antipsychotics, appear to have a somewhat safer regarding side effects. They also appear to help people who have not benefited from the older traditional medications. Ongoing treatment with medications is usually necessary to prevent a return of symptoms.

Supportive and problem-focused forms of psychotherapy may be helpful for many individuals. Behavioral techniques, such as social skills training, can be used in a therapeutic setting, or in the patient's natural environment to promote social and occupational functioning.

Family interventions that combine support and education about schizophrenia (psychoeducation) appear to help families cope and reduce relapse. Patients who lack family and social support may be helped by intensive case management programs that emphasize active outreach and linkage to a range of community support services.

Expectations (prognosis) for Schizophrenia

There are many different potential outcomes of schizophrenia. Most people with schizophrenia find that their symptoms improve with medication, and some achieve substantial control of the symptoms over time. However, others experience functional disability and are at risk for repeated acute episodes, particularly during the early stages of the illness.

Supported housing, vocational rehabilitation, and other community support programs may be essential to their community tenure. People with the most severe forms of this disorder may remain too disabled to live independently, requiring group homes or other long-term, structured living environments.

Homeopathic Treatment for Schizophrenia

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc.

Following homeopathic medicines cover symptoms of various types and stages of schizophrenia:

Lachesis, Ars-alb, Aurum-met, Hyoscyamus, Lycopodium, Pulsatilla, Stramonium, Sulphur, Aconite, Belladona, Ignatia, Merc-sol, Psorinum, Rhus-tox, Anacardium, Calc-carb, Causticum, Cimicifuga, Helleborus, Kali-brom, Natrum-sulph, Opium, Sepia, Aurum-mur, Cannabis-indica etc.

* Medicines indicated in Blue Color may prove especially useful in sudden onset schizophrenia and acute crisis of schizophrenia, depending upon the symptom presentation.

** Medicines indicated in Red Color may prove especially useful if depression and suicidal tendencies are marked.

*** Medicines indicated in Green Color may prove especially useful if 'flat-effect' is marked.

Homeopathic medicines are selected on the basis of symptoms, cause, family history and constitution of the person affected. Considering all these factors any of the above (or some other) homeopathic medicine may be indicated and helpful in a case of schizophrenia.