What is Schizophrenia?
Schizophrenia is a mental disorder that causes people to repeatedly suffer from psychotic symptoms. People with schizophrenia often experience significant cognitive symptoms, including hearing voices, disorganized speech patterns, delusions, and visual hallucinations. Other negative symptoms include health complications related to lifestyle factors, a high rate of other comorbid mental health conditions such as bipolar disorder, and suicidal ideation.
The initial symptoms of schizophrenia usually start between ages 16 and 30. Schizophrenia is associated with changes in brain chemistry. While there is no known single cause for the condition, it is thought that genetic and environmental factors both play a role in its onset. The mental illness is severely debilitating and there is no known cure, though treatment is possible.
Most Common Types of Schizophrenia
Psychiatrists and other mental health practitioners in the past categorized schizophrenia into four distinct types: catatonic, disorganized, paranoid, residual, and undifferentiated. However, contemporary research indicates that there are no firm distinctions between these subtype. However, these categories are still often used colloquially by people trying to describe their collections of symptoms of schizophrenia.
- Catatonic Schizophrenia. Sufferers often are physically immobile and find themselves unable to speak or move.
- Paranoid Schizophrenia. People with these psychotic symptoms often believe they are being persecuted, attacked, or spied upon.
- Disorganized Schizophrenia. Individuals with disorganized schizophrenia often suffer from cognitive problems and may seem confused or incoherent.
- Undifferentiated Schizophrenia. This type of schizophrenia refers to people who suffer from the condition without any of the symptoms of catatonia, paranoia, or disorganization.
- Residual Schizophrenia. This condition refers to a state during which negative symptoms have abated significantly.
Symptoms of Schizophrenia
Instead of defining it by categories, the American Psychiatric Association now defines schizophrenia as a spectrum disorder. That means they understand it as a disorder that affects people in different ways, often at markedly different levels of severity.
While schizophrenia is a chronic mental illness with common traits, one person with schizophrenia will often display markedly different symptoms than another person with the same mental disorder. Some of the more common symptoms are:
- Visual hallucinations, such as patterns, lights, objects and people. Many people with schizophrenia believe that they “see” people who are no longer alive.
- Auditory hallucinations. They may hear voices that communicate disturbing messages or tell them what to do. A person who hears voices may find the speaker quite friendly as well.
- Olfactory and gustatory hallucinations. Smells and tastes that are purely imagined can be confusing and make it difficult to eat.
- Tactile hallucinations. Some sufferers may feel like they’re being touched or feel insects crawling all over them.
- Referential delusions. These delusions make people believe that media, such as television or movies, are communicating directly to them.
- Persecutory delusions. This refers to a feeling that people or institutions are out to attack you.
- Grandiose delusions. People with grandiose delusions believe they are more important than they actually are. This is often referred to as a “messiah complex.”
- Somatic delusions. These are delusions about the body, such as a belief that one is ill or suffering from organ failure.
- Erotomanic delusions. Erotomanic delusions are false beliefs about a person, such as a celebrity or stranger, being in love with you.
Aside from the delusions and hallucinations, many people with schizophrenia experience a range of other symptoms that affect their ability to function normally in everyday life. These include:
- Confused thoughts and disorganized speech patterns.
- Movement disorders.
- Lack of attention to personal hygiene.
- Difficulty concentrating.
- Anhedonia, or an inability to experience pleasure.
- Flattening. Individuals with a flat vocal affect may seem bored, neutral, or entirely lacking in engagement.
- Social withdrawal.
Causes of Schizophrenia
The causes of schizophrenia are poorly understood. However, research indicates that schizophrenia arises from a combination of environmental factors and genetics. Having parents or siblings with schizophrenia dramatically increases a person’s likelihood of developing the mental disorder themselves. Other risk factors, such as problems with brain development, may also play a role.
Nonetheless, genetics is the single greatest risk factor that can increase the risk of developing schizophrenia. People with a first-degree relative with schizophrenia have a 70% – 80% chance of developing the symptoms of schizophrenia. This can be a considerable source of anxiety for family members of sufferers, given that symptoms of schizophrenia rarely emerge until early adulthood, though the onset of schizophrenia can also begin much later.
The American Psychiatric Association publishes a book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. This is the book psychiatrists use to diagnose mental health conditions. The DSM-5 defines schizophrenia as follows:
- Two or more of the following for at least a one-month (or longer) period of time, and at least one of them must be 1, 2, or 3:
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms, such as diminished emotional expression
- Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care.
- Some signs of the disorder must last for a continuous period of at least 6 months. This six-month period must include at least one month of symptoms (or less if treated) that meet criterion A (active phase symptoms) and may include periods of residual symptoms. During residual periods, only negative symptoms may be present.
- Schizoaffective disorder and bipolar or depressive disorder with psychotic features have been ruled out:
- No major depressive or manic episodes occurred concurrently with active phase symptoms
- If mood episodes (depressive or manic) have occurred during active phase symptoms, they have been present for a minority of the total duration of the active and residual phases of the illness.
- The disturbance is not caused by the effects of a substance or another medical condition
- If there is a history of autism spectrum disorder or a communication disorder (childhood onset), the diagnosis of schizophrenia is only made if prominent delusions or hallucinations, along with other symptoms, are present for at least one month
Who is at Risk for Schizophrenia?
While genetics is currently believed to be one of the greatest risk factors for schizophrenia, a range of other environmental factors can also increase the risk of developing the condition. These risk factors for schizophrenia include:
- Childhood trauma or other “adverse childhood experiences” (ACEs)
- Health problems in infancy, such as viral infections, oxygen deprivation, malnutrition in the mother during fetal development, and prenatal maternal stress
- Research suggests that living in an urban environment plays a role, increasing the chances of a person developing the illness relative to the general population.
- Substance abuse, especially cannabis use.
- Having a father older than 40 years old also increases the likelihood that a person will develop schizophrenia.
Schizophrenia affects approximately 20 million people worldwide. According to the National Institute of Mental Health, somewhere between 0.25% and 0.64% of the United States population suffer from schizophrenia and related mental illnesses. Unfortunately, the true prevalence of schizophrenia is difficult to measure, given the amount of overlap there is between the disorder and other conditions.
Nonetheless, schizophrenia is demonstrably among the top 15 leading causes of disability throughout the world. Not only do patients with schizophrenia suffer significantly decreased quality of life, but their chances of premature death are 2-3 times higher than the general population. Sufferers are likely to develop comorbid health conditions, such as heart disease, liver disease, and diabetes. Schizophrenia also frequently causes suicidal ideation. As a result, approximately 4.9% of individuals with schizophrenia die from suicide attempts.
Given that schizophrenia on average takes 28.5 years off a person’s life, it is essential that anyone experiencing the onset of symptoms have access to early interventions and treatment resources.
Medications used to Treat Schizophrenia
While no medication can prevent or cure schizophrenia, the psychotic symptoms of the mental illness can be managed. Treatment for schizophrenia usually involves a combination of psychosocial support as well as pharmaceutical interventions. Psychosocial support can include treatment methods such as psychiatric nursing facilities, talk therapy, and support groups.
Most people who suffer from schizophrenia do not remain institutionalized long-term. This is due to the efficacy of antipsychotic medications, which are the first line treatment for individuals with schizophrenia.
The first generation of antipsychotic, now known as “typical antipsychotic,” affect the neurotransmission of dopamine. While they remain effective, their high rates of side effects have led most psychiatrists to turn to the second generation of antipsychotic, known as “atypical antipsychotic.” While they have little effect on cognitive symptoms such as disorganized speech, atypical antipsychotic can relieve much of the anxiety and disturbing mood problems associated with the condition. These medications include:
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Aripiprazole (Abilify)
- Brexpiprazole (Rexulti)
- Ziprasidone (Geodon)
- Cariprazine (Vraylar)
- Clozapine (Clozaril, Versacloz)
- Iloperidone (Fanapt)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Asenapine (Saphris)
Dual Diagnosis Treatment For Schizophrenia and Addiction at NuView Treatment Center
NuView Treatment Center understands that individuals who suffer from schizophrenia alongside a substance use disorder often require more care. Schizophrenia can lead people to turn to addictive substances, and substance abuse can in turn exacerbate the hallucinations and delusions characteristic of schizophrenia.
Treating one condition to the exclusion of the other often leads nowhere, since a psychotic episode can trigger a relapse, and continued substance abuse can also worsen psychosis. The relationship between these conditions is complex, often making both diagnosis and treatment difficult.
At our holistic dual diagnosis treatment centers, dual diagnosis patients can receive the integrated care they need. NuView assesses each individual patient to provide them with a treatment plan that addresses their unique needs. We offer a wide range of treatment modalities to ensure that patients improve physically, mentally, and emotionally.
Our dual diagnosis rehab program offers psychotherapy, group therapy, CAM therapy, and medication-assisted therapy. By entering our treatment program for schizophrenia and addiction, individuals can get the long term relief they need. If you are experiencing hallucinations, delusions, suicidal thoughts, or struggle with alcohol or drug abuse, we are here to help. Recovery is possible!