A serious mental disorder in which people interpret reality abnormally is known as schizophrenia. Schizophrenia may give an outcome with some mixture of hallucinations, delusions, and extremely disordered thinking and behavior that might damage daily functioning, and can be disabling.
Lifelong treatment is needed for people diagnosed with schizophrenia. To get symptoms under control early treatment might be helpful before any serious complications develop and may help in improving the long-term outlook.
Schizophrenia involves a variety of problems with cognitive thinking, behavior and emotions. Signs and symptoms may differ, but mostly delusions, hallucinations or disorganized speech, and reflect an impaired ability to function is involved. Symptoms included:
- Delusions mean false beliefs that are not founded in reality. For example, thinking that you’re being harmed or harassed; specific gestures or comments are directed at you; having exceptional ability or popularity; other person is in love with you; or a major disaster is about to happen. Delusions have occurred in most people having schizophrenia.
- Hallucinations are mostly involving seeing or hearing things that do not exist. But for the person having schizophrenia, they might feel the full force and impact of a normal experience. Hearing voices is the most common hallucination but it can also be in any of the senses.
- Disorganized thinking is concluded from speech being disorganized. Communicating effectively could be impaired, and answers to questions may be partially or completely related to what is being asked. In rare cases, speech may include combining meaningless words that can’t be understood, sometimes called as word salad.
- This may be shown in a number of ways, from childlike silliness to unpredictable anxiety. It might be hard to do tasks as the behavior is not focused on any aim. Resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement can be included in behavior
- Negative symptoms are referred to as decreased or lack of ability for functioning normally. To give an example, the person may abandon personal hygiene or appear to lack emotion i.e. not making eye contact, not changing facial expressions or speaking in a monotone. Also, the person’s interest might be lost in everyday activities, socially withdraw or lacking the ability to experiencing pleasure.
Symptoms can differ in type and severity over the time period, with periods including worsening and remission of symptoms. Some symptoms may never waive off
Schizophrenia symptoms in men typically begin in the early to mid-20s. Symptoms in women typically begin in the late 20s. It’s unusual for children to be diagnosed with schizophrenia and for those older than age 45 it is rare
Symptoms in teenagers
Symptoms in teenagers for schizophrenia are same as that in adults, but the condition may be harder to determine. This may be recognized partially because some of the early symptoms of schizophrenia in teenagers are same as typical development during teen years, such as:
- Withdrawal from friends and family
- Performance drop at school
- Trouble in sleeping
- Irritability or depressed mood
- Lack of motivation
Also usage of recreational substance, such as marijuana, methamphetamines or LSD, can sometimes cause signs and symptoms which are same.
When compared schizophrenia with symptoms in adults, teens may be:
- Delusions are less likely
- Visual hallucinations are more likely
Lack of awareness that their difficulties root from a mental disorder that needs medical attention is often found in people with schizophrenia. So it is often up to the family or friends to get them help.
If having a doubt on someone you know of having symptoms of schizophrenia talk to him or her about these concerns. Encouragement and support can be offered and help the loved one find a qualified doctor or mental health professional although this might not be forced on someone.
If there is a danger posed by a loved one to self or someone else or can’t provide his or her own food, clothing, or shelter, 911 may need to be called or other emergency responders for help so that the loved one can be examined by a mental health professional.
Emergency hospitalization may be needed in some cases. Laws on involuntary commitment for mental health treatment differ by type. Community mental health agencies or police departments can be contacted in the area where residing for details.
Suicidal thoughts and behavior
People with schizophrenia commonly have suicidal thoughts and behavior. It should be made sure that someone stays with the person who is in danger of attempting suicide or has made a suicide attempt. 911 or local emergency number should be called immediately. Or, if taking the person to the nearest hospital emergency room seems easy then do so with safety
Causes of schizophrenia are not known, but researchers believe that a mixture of genetics, brain chemistry and environment adds to development of the disorder.
Problems which are occurring with certain naturally brain chemicals, including neurotransmitters called dopamine and glutamate, may be a contribution to schizophrenia. Neuroimaging research show changes in the brain structure and central nervous system of people having schizophrenia. While researchers aren’t sure about the importance of these changes, schizophrenia being a brain disease is indicated by that.
The exact cause of schizophrenia is unknown, specific factors seem to increase the risk of having or triggering schizophrenia, including:
- Family history of schizophrenia
- Pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that can impact the development of brain
- Taking drugs which are mind altering during teenage years and young adulthood
Schizophrenia can result in problems which can be severe that affect every area of life if not treated. Schizophrenia complications may cause or be related may include:
- Suicide, suicidal attempts and thoughts about suicide
- Anxiety disorders and obsessive-compulsive disorder (OCD)
- Alcohol or other drugs abuse, including nicotine
- Inability to work or attend school
- Financial problems and homelessness
- Social isolation
- Health and medical problems
- Being victimized
- Aggressive behavior
For preventing schizophrenia there no sure way, but following the treatment plan can help in preventing relapses or worsening of symptoms. Additionally, researchers hope that learning more about factors of risks for schizophrenia may lead to diagnosis and treatment earlier.
Diagnosis of schizophrenia involves excluding other mental health disorders and understanding that symptoms are not because of substance abuse, medication or having a medical condition. Diagnosis of schizophrenia may include:
- Physical examination may be conducted to help point out other problems that could be causing symptoms and to check for any associated complications.
- Tests and screenings may be done and can include tests that help in ruling out conditions having similar symptoms, and screening for substances such as alcohol and drugs. Imaging studies may also be requested by the doctor, such as an MRI or CT scan.
- A doctor or mental health professional evaluates mental status by observing appearance and demeanor and asking questions about thoughts, moods, delusions, hallucinations, substance use, and potential for violence or suicide. A discussion about family and personal history may also be included
- A doctor or mental health professional may use the diagnostic criteria for schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Lifelong treatment is required for schizophrenia, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help in managing the condition. Hospitalization may be needed in some cases.
An experienced psychiatrist for treating schizophrenia usually guides in the treatment. The treatment team also can include a psychologist, social worker, psychiatric nurse and possibly a case manager for coordinating care. The approach of full-team may be available in clinics with expertise in treatment of schizophrenia.
The foundation of schizophrenia treatment is medications, and antipsychotic medications are the most commonly prescribed drugs. By affecting the brain neurotransmitter dopamine they are thought to control the symptoms
The aim of the treatment with antipsychotic medications is to manage signs and symptoms at the lowest possible dose effectively. The psychiatrist may use different drugs, different doses or mixtures of drugs or doses over time to achieve the desired outcome. Other medications such as antidepressants or anti-anxiety drugs may also be helpful. To notice an improvement in symptoms it might take several weeks
People with schizophrenia may be reluctant to take medications because of their side effects which can be serious. Drug choice may be affected by the willingness to cooperate with treatment. For example, someone who is not willing to taking medication consistently may need to be given injections instead of consuming a pill.
Doctor should be asked about the advantages and side effects of any prescribed medications
Second-generation medications are newer and are usually preferred because risk of serious side effects is lower than doing first-generation antipsychotics. Second-generation antipsychotics may include:
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Brexpiprazole (Rexulti)
- Cariprazine (Vraylar)
- Clozapine (Clozaril, Versacloz)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
These first-generation antipsychotics medications have frequent and potentially serious neurological side effects, including the possibility of a movement disorder to be developed (tardive dyskinesia) that may or may not be reversible. First-generation antipsychotics may include:
These antipsychotics medication are often less expensive than second-generation antipsychotics, especially the generic versions, which can be an critical consideration when long-term treatment is important.
Long-acting injectable antipsychotics
Some antipsychotics medications may be given as an intramuscular or subcutaneous injection. They are given every two to four weeks usually, depending on the medication. Doctor should be asked about more information on injectable medications. Injections may be an option for those who have a preference for fewer pills and may be adhered also.
Common medications that are obtainable as an injection include:
- Aripiprazole (Abilify Maintena, Aristada)
- Fluphenazine decanoate
- Haloperidol decanoate
- Paliperidone (Invega Sustenna, Invega Trinza)
- Risperidone (Risperdal Consta, Perseris)
Once psychosis decreases, in addition to continuing on medication, psychological and social (psychosocial) involvements are important which may include:
- Individual Psychotherapy may help in normalizing thought patterns. Also, learning to managing with stress and identify early warning signs of relapse can help people in managing schizophrenia illness.
- Social skills training focuses on improving the communication and social interactions and improving the ability to engage in daily activities.
- Family therapy provides help and education to families who are dealing with schizophrenia.
- Vocational rehabilitation and supported employment focuses on helping people with schizophrenia for the preparation, finding and keeping jobs.
Some form of daily living support may be needed with most individuals having schizophrenia. Programs are conducted by many communities to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. To help in finding resources a case manager or someone on the treatment team helps. Most people with schizophrenia can manage their illness if appropriate treatment is given
Hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene in times of crisis periods or severe symptoms.
For adults having schizophrenia who does not respond to drug therapy, considering a electroconvulsive therapy (ECT) may be an option. ECT may be helpful for someone who is also having depression.