The Center for Reintegration

Back to Work, Back to Life

Schizophrenia

Schizophrenia is a mental illness that can seriously affect a person's life, as well as the lives of their family and friends.

The onset of schizophrenia usually takes place in the late teens or early 20's - sometimes later for women. Around the world, approximately 1% of the population -- or one in a hundred people - will experience some form of schizophrenia.

Even though schizophrenia is rare, its early onset and the lifelong disability it brings to people affected, including their families, make schizophrenia one of the most catastrophic mental illnesses.

The name 'schizophrenia' has its roots the ancient Greek language, where two words meaning 'split' and 'mind' were combined. This explains the common misconception is that schizophrenia is a "multiple personality" - which is a very rare disorder and completely unrelated to schizophrenia.

Symptoms & Causes

The possible symptoms:

The symptoms appear gradually over time, usually beginning when a person is in adolescence or young adulthood. Tenseness, inability to sleep or concentrate and social withdrawal often mark the initial onset of the disease.

More serious symptoms emerge as the illness progresses, including nonsensical statements and unusual perceptions of common experience. People suffering from acute schizophrenia may quickly change from topic to topic with no relation to each other, or make up completely new words or sounds.

People suffering from schizophrenia often believe that someone is spying on them, or that someone can "hear" their thoughts. Many believe that others are trying to insert thoughts into their minds and control their actions. They may hear voices that insult or command. Some people might believe they are the President, or that they can travel back and forward in time. People suffering from schizophrenia can, at times, appear relatively normal. But during the acute or "psychotic" phase, the same person may suffer from hallucinations, delusions, or disconnected speech and thinking.

The acute psychotic symptoms usually lessen during a period called the residual stage or remission. When they return, it's called relapse. Other less acute symptoms, like social withdrawal and blunted emotions may continue through remission and relapse.

It's also important to note that while schizophrenia has a recognizable and specific set of symptoms, this illness varies widely in its severity from person to person, and from one time period to another.

The possible causes:

The exact cause of schizophrenia remains unknown, but a number of theories are being researched to identify the root causes of the disease.

The research so far supports the conclusion that people inherit a genetic vulnerability to schizophrenia, which can be brought on by outside events such as a viral infection that changes the body's chemistry, a highly stressful situation in adult life, or a combination of each.

But unlike eye or hair color, the susceptibility to schizophrenia isn't inherited directly. Like many genetically related illnesses, schizophrenia appears when the body is undergoing the hormonal and physical changes of adolescence.

Some theories suggest that brain of a person with schizophrenia is more prone to be affected by certain biochemicals; others speculate that it produces inadequate or excessive amounts of biochemicals needed to maintain mental health.

Genetic triggers could alter the physical development of part of the brain, or could cause problems with the way the person's brain screens stimuli, so that the person with schizophrenia is overwhelmed by sensory information.

Schizophrenia is similar to "autoimmune" illnesses -- disorders like multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS or Lou Gherig's disease.) These diseases are caused when the body's immune system attacks itself. Like these diseases, schizophrenia is not diagnosed at birth but develops during young adulthood. Also, like other autoimmune diseases, it fluctuates through remission and relapse, and it appears more commonly in families where it has already been diagnosed.

Some scientists speculate that viral infections play a key role, along with the genetic makeup of the body. Genes determine the body's reaction to infection. But instead of stopping when the infection is over, the genes may be telling the body's immune system to continue attacking a specific part of the body - the brain.

Finally, a home or social environment marked with emotional or physical abuse and severe poverty may play a role in the onset of schizophrenia, but only in those with genetic vulnerability.

Most psychiatrists believe that schizophrenia is caused by this group of "stress factors" that include a genetic predisposition and environmental factors such as viral infection, as well as serious stress in the home or social environment.

Psychiatrists also believe these stress factors can often be offset with "protective factors." That's when the person with schizophrenia receives proper medication, and finds help in building a stable network of family and friends, can live with some degree of independence, and can maintain steady and satisfying employment.

Hope & Help

Schizophrenia is an illness that can be treated and managed. In fact, with continuous treatment and rehabilitation, over half the people with the disease experience a recovery. The majority will have long periods of good functioning, with occasional problems.

The emergence of second generation antipsychotic medications(SGA's) may lead to further advancements in recovery rates, especially when a dedicated and informed group of people are available to help both the person with schizophrenia and their family.

Yes there has been much debate about potential adverse events of SGA's, weight gain which may lead to metabolic changes, but those risks are inferior to first generation antipsychotic medication(FGA's). FGA's even at lower dosages, can lead to neurological damage, Tardive Dskyinesia being a prime example. In the last few years, often led by cost concerns, there has been a downplay of these neurological consequences.

Reaching out. Looking in.

Reintegration doesn't happen without help. The help may come from a caregiver, a sibling or even an employer. Often, the help comes in the form of psychotherapy as well as social and vocational training-all of which are helpful in providing support, education, and guidance to people with mental illnesses and their families.

When combined with consistent and appropriate drug therapies, these types of therapies and training can be very effective.

Individual Psychotherapy

Individual psychotherapy involves regularly scheduled sessions between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or psychiatric nurse. The goal of this treatment is to help people with serious mental illness understand their experiences, thoughts, and feelings. By sharing experiences with a trained, knowledgeable, and understanding person people with mental illnesses may gradually understand more about themselves and their problems.

Psychoeducation

Psychoeducation involves teaching people about their illness, how to treat it, and how to recognize signs of relapse so that they can get necessary treatment before their illness worsens or occurs again. Family psychoeducation includes teaching coping strategies and problem-solving skills to families (and friends) of people with mental illnesses to help them deal more effectively with their ill relative. Family psychoeducation reduces distress, confusion, and anxieties within the family, which may help the person recover.

Social skills training

This training, which can be provided in group, family or individual sessions, is a structured and educational approach to learning social relationship and independent living skills. By using behavioral learning techniques, such as coaching, modeling and positive reinforcement, skills trainers have been successful in overcoming the cognitive deficits that interfere with rehabilitation. Research studies show that social skills training improves social adjustment and equips patients with means of coping with stressors, thereby reducing relapse rates by up to 50 percent.

Self-help and Support Groups

Self-help and support groups for people and families dealing with mental illnesses are becoming increasingly common. Although not led by a professional therapist, these groups may be therapeutic because members give each other ongoing support.

Members of support groups share frustrations and successes, referrals to qualified specialists and community resources, and information about what works best when trying to recover. They also share friendship and hope for themselves, their loved ones, and others in the group.

FAQ

What is schizophrenia?

Schizophrenia is a mental illness that can seriously affect a person's life, as well as the lives of their family and friends. The onset of schizophrenia usually takes place in the late teens or early 20's -sometimes later for women. Around the world, approximately 1% of the population -- or one in a hundred people - will experience some form of schizophrenia.

Even though schizophrenia is rare, its early onset and the lifelong disability it brings to people affected, including their families, make schizophrenia one of the most catastrophic mental illnesses.

How is schizophrenia diagnosed?

Only a trained mental health professional can make a diagnosis of schizophrenia. They will look for periods of acute psychosis lasting longer than two weeks, or a pattern of acute psychosis over time.

What are the symptoms of schizophrenia?

The symptoms appear gradually over time, usually beginning when a person is in adolescence or young adulthood. Tenseness, inability to sleep or concentrate and social withdrawal often mark the initial onset of the disease.

More serious symptoms emerge as the illness progresses, including nonsensical statements and unusual perceptions of common experience. People suffering from acute schizophrenia may quickly change from topic to topic with no relation to each other, or make up completely new words or sounds.

People suffering from schizophrenia often believe that someone is spying on them, or that someone can "hear" their thoughts. Many believe that others are trying to insert thoughts into their minds and control their actions. They may hear voices that insult or command. Some people might believe they are the President, or that they can travel back and forward in time.

People suffering from schizophrenia can, at times, appear relatively normal. But during the acute or "psychotic" phase, the same person may suffer from hallucinations, delusions, or disconnected speech and thinking.

The acute psychotic symptoms usually lessen during a period called the residual stage or remission. When they return, it's called relapse. Other less acute symptoms, like social withdrawal and blunted emotions may continue through remission and relapse.

It's also important to note that while schizophrenia has a recognizable and specific set of symptoms, this illness varies widely in its severity from person to person, and from one time period to another.

What causes schizophrenia?

The exact cause of schizophrenia remains unknown, but a number of theories are being researched to identify the root causes of the disease.

The research so far supports the conclusion that people inherit a genetic vulnerability to schizophrenia, which can be brought on by outside events such as a viral infection that changes the body's chemistry, a highly stressful situation in adult life, or a combination of each.

Is there a cure?

There is no cure for schizophrenia. With the causes rooted in a complex combination of genetics, brain chemistry and environmental factors, an outright cure is unlikely for the immediate future.

How is schizophrenia treated?

The treatment of schizophrenia has advanced dramatically in recent years. Using a combination of medication - especially newer SGA's combined with the intervention of concerned and informed caregivers and family members, people with schizophrenia are reaching higher levels of reintegration than ever before.

Is a complete recovery possible?

Schizophrenia is a disease that will likely affect a person for the rest of their life. But there are more and more people who, through skillful treatment, are finding satisfying work, living independently and forming meaningful relationships. Helping people and their families achieve this level of reintegration is the mission of the Center of Reintegration, and Reintegration.com.

Where can someone turn for help?

There are many organizations and other information resources that are available to help people with serious mental illness, their families and concerned caregivers. They include both local organizations and national advocacy groups. Many states have created programs specifically to help people reintegrate.