Schizophrenia: What is it, symptoms, diagnosis and treatment
Schizophrenia is a chronic mental health problem that lasts for a long time.
Schizophrenia is a chronic mental health problem that lasts for a long time. In the case of schizophrenia, symptoms may include delusions (unusual beliefs), hallucinations (seeing things that do not actually exist), disorganized speech, difficulty thinking, and lack of motivation. Many of the symptoms can significantly regress with the help of different treatment approaches. Although there is no definitive cure for schizophrenia, it is possible to control the symptoms and reduce their recurrence in most cases with the help of existing options.
What is Schizophrenia?
Schizophrenia is a chronic mental health problem with symptoms lasting at least a month and often requires lifelong treatment. The person may not appear to have any problems with functioning or behavior except when talking about or acting out the delusions. Schizophrenia disease is divided into types as follows, according to the symptoms that occur:
- Catatonic schizophrenia: Psychomotor state in which the person remains unresponsive without moving for a long time.
- Paranoid schizophrenia: It is the most common type of schizophrenia. The person experiences hallucinations and delusions.
- Disorganized schizophrenia: In this type of schizophrenia, people tend to show disconnected reactions.
- Hebephrenic schizophrenia: It is a type of schizophrenia in which the person experiences mood disorders such as depression and mania.
- Residual schizophrenia: It is the period in which the symptoms of schizophrenia in patients are almost absent. The symptoms have decreased, but the person does not have positive thoughts about life.
- Undifferentiated schizophrenia: If the type of schizophrenia cannot be determined despite the diagnosis, this type of schizophrenia is accepted.
What Causes Schizophrenia?
The exact cause of schizophrenia is unknown, but it is estimated to be caused by a combination of genetic and environmental factors. The interaction between genes and a number of environmental factors can cause schizophrenia. Apart from this, psychosocial factors may also affect the onset and course of schizophrenia. Men and women are equally likely to develop schizophrenia. But men may start showing symptoms of schizophrenia earlier. Symptoms of schizophrenia may begin suddenly or become more pronounced over time. Although there is no known definitive cause of schizophrenia, there are several conditions associated with schizophrenia. These situations are:
- born in winter
- very low birth weight
- Complications occurring during birth
- Recreational substance use
- genetic factors
- brain structure
How to Diagnose Schizophrenia?
Multiple tests and checks are required to diagnose schizophrenia. For this reason, the person is first referred to a psychiatrist and the symptoms are asked to be evaluated. The evaluation includes questions about current symptoms, medical history, family history, and any substance abuse problems. It may also be necessary to talk to a family member for more information about the person’s symptoms. The doctor may then perform a physical examination and order blood tests or a brain scan to rule out underlying causes.
Doctors order various imaging techniques to make sure that symptoms suggestive of schizophrenia are not caused by problems such as stroke, brain injuries, tumors, and other changes in brain structure. These techniques are usually CT or MRI.
At the same time, when necessary, electrical activity in the brain can be recorded and evaluated with the help of an electroencephalography (EEG). Doctors can diagnose schizophrenia or related disorders by observing the symptoms or behaviors a person describes. The symptoms found are then compared with the criteria required for a diagnosis of schizophrenia. To make a diagnosis, the relevant symptoms must last for at least six months. Symptoms may be severe enough to cause problems in the person’s ability to function at work, school, home, or socially.
What are the symptoms that occur with schizophrenia?
People with schizophrenia often have persistent difficulties with cognitive or thinking skills, such as memory, attention, and problem solving. While some people with schizophrenia may experience periodic worsening and remission of symptoms throughout their lives, others experience gradual worsening of symptoms over time. The severity, duration and frequency of symptoms may vary from patient to patient; however, the incidence of severe psychotic symptoms generally decreases with age. Not taking medications as recommended by the doctor, alcohol or drug use, and stress can increase symptoms.
Symptoms of schizophrenia can be divided into negative and positive symptoms. Negative symptoms express what is abnormally missing or absent in the person experiencing schizophrenia. Negative symptoms include symptoms such as loss of interest and motivation in life and activities, including relationships and sex, lack of concentration, not wanting to leave the house, and changes in sleep patterns. The phase in which the first negative symptoms appear is called the prodromal period of schizophrenia. Symptoms during the prodromal period usually appear gradually and gradually worsen. It often involves the person becoming more socially withdrawn. Patients may also lose interest in their appearance or personal hygiene. Negative symptoms may include:
- Impairment in emotional expression ability
- speech disorders
- Decreased desire for social contact
- Decreased desire to engage in daily activities
Positive symptoms of schizophrenia usually appear several years before the first acute mood changes. In detail, positive symptoms may include:
- Hallucinations: Hallucinations can be defined as seeing, hearing, smelling, tasting or feeling things that do not exist. The most common hallucination is hearing voices.
- Psychosis: Psychosis can be defined as a loss of contact with reality due to a disruption in the way the brain processes information. Psychoses are vivid and clear, with an impression similar to normal perceptions. When psychosis is severe, it can cause problems in performing a person’s activities of daily living. Thoughts and speech may become confused due to psychotic symptoms. This makes it difficult for other people to understand the person’s speech.
- Changes in behavior and thoughts: The person’s behavior may become erratic and unpredictable. His appearance or the clothes he wears may seem unusual to others. People with schizophrenia may become agitated, shout or swear for no reason. They may believe that their thoughts are controlled by someone else, that they do not belong to them, that they are placed in their mind by someone else, and that they disappear as if someone is removing the thoughts from their minds.
Treatment should be under the supervision of a psychiatrist but may involve a team of different mental health professionals, including a doctor, mental health nurse, social worker, occupational therapist, and clinical psychologist. Treatments are tailored to the individual’s needs. Schizophrenia is usually treated with a combination of medications and therapies tailored to each individual. Medications and cognitive behavioral therapy (CBT) are often preferred in treatment. Although there is currently no permanent treatment option for schizophrenia, various antipsychotic medications are effective in reducing psychotic symptoms seen in the acute phase of the illness and may also help reduce the likelihood and severity of future acute attacks. It can also contribute to reducing stress, supporting employment or improving social skills through treatment. People with schizophrenia are at higher risk of misusing medications than the general population. Treatment options are discussed in more detail below.
Medication is the main form of treatment for schizophrenia. Antipsychotic medications can reduce major symptoms such as hallucinations and delusions. However, it may take up to 6 weeks for it to start showing its normal effect. Some people develop side effects to the drug, so regular follow-up is important.
Psychotherapies can help people understand and manage their symptoms and learn new ways to cope. Psychotherapy methods such as cognitive behavioral therapy can help people with schizophrenia cope with their illness and manage their condition. Other methods available for treatment include art and drama therapy, which can help a person overcome loss of motivation and recognize their symptoms. Healthcare providers may also recommend techniques that focus on other areas, such as helping with social skills and creating self-care routines.
Mental health services can also provide practical support for people with schizophrenia. A stable living environment, supportive relationships, and meaningful work or activity are essential components for recovery. Some people with schizophrenia may need rehabilitation and skills training to help them return to work or education.
Some patients with schizophrenia may need to be treated in hospital from time to time. Hospitalization is preferred to help when symptoms get out of control or the person cannot manage at home.
Electroconvulsive therapy (ECT) is a preferred treatment option when symptoms do not improve after trying certain medications and the person is at risk of harming themselves or harming others. This treatment involves using an electric current applied to the scalp and stimulating certain parts of the brain. If you are experiencing some mental problems, do not forget to contact a health institution and get support.