WRZESINSKI: A complicated illness

Unlocking the mystery of schizophrenia

By Daniel Wrzesinski

Daniel Wrzesinski

I want to write about one of the most misunderstood of all mental illnesses: schizophrenia. It is the most chronic and disabling of the severe mental disorders, and it affects more than 2 million Americans.

The illness may impair a person’s ability to think clearly, manage emotions, and interact with others. Symptoms include hallucinations, delusions, disordered thinking, and social withdrawal, and disorganized thinking and speech; ranging from loss of train of thought, to sentences only loosely connected in meaning, to incoherence in severe cases.

Social withdrawal, sloppiness of dress and hygiene, loss of motivation and judgment, an inability to experience pleasure, and lack of desire to form relationships are all common in schizophrenia. There is often an observable pattern of emotional difficulty, for example a lack of responsiveness. Impairment in social cognition, symptoms of paranoia and social isolation are all associated with schizophrenia.

Obsessive-compulsive disorder has also been seen in patients suffering from schizophrenia. In rarer cases, a person may become catatonic, remaining mute, motionless in bizarre postures, or exhibiting purposeless agitation.

The lifetime occurrence of substance abuse among people with schizophrenia is almost 50 percent. Social problems, such as long-term unemployment, poverty and homelessness, are common. The average life expectancy of people with the disorder is 12 to 15 years less than those without, due to increased physical health problems and a higher suicide rate.

The illness typically develops in the late-teens or early-20s. The average age of onset is age 18 in men and age 25 in women. It ranks among the top 10 causes of disability in developed countries worldwide.

People with schizophrenia continue to suffer chronically or episodically throughout their lives. The sufferer is often plagued with bouts of active illness, lost opportunities for relationships and careers, residual symptoms such as anxiety and depression, and medication side effects. One in every 10 people with schizophrenia eventually commits suicide.

Schizophrenia exacts a heavy toll on the sufferers and their families. And it’s also financially expensive. In the U.S., the cost of schizophrenia is estimated to be 62.7 billion dollars. The direct costs include outpatient/inpatient care, medication, and long-term care. Non-health care costs include law enforcement, reduced workplace productivity, and unemployment.

Social stigma is a major obstacle in the recovery of patients with schizophrenia. Nearly 13 percent of Americans believe that folks with schizophrenia are “very likely” to do something violent against others, and 48 percent said that they were “somewhat likely” to.

Contrary to the common belief, schizophrenia does not mean “split or multiple personality.” Although a person with schizophrenia may hear voices and experience the voices as distinct personalities, this does not involve the person changing from one personality to another.

It is unfortunate that people with schizophrenia are often are portrayed as violent on TV and in movies. But that is rarely the case. In fact, people with schizophrenia are more likely to be victims of violence themselves, and they tend to be shy and socially withdrawn.

In 2002 the term for schizophrenia in Japan was changed from a word that means “mind-split-disease” to a word that means “integration disorder” in order to reduce stigma.

Fortunately, schizophrenia is rare in children. Parents may have cause for concern if a child often hears voices saying offensive things about him or her, or makes voices conversing with one another, talks to himself or herself, reports hallucinations and delusions, stares at things that aren’t really there, and shows no interest in making friends. But be aware, however, that these things may be a sign of autism, and not schizophrenia.

The cause of schizophrenia is believed to be a combination of genetic and environmental factors. People with a family history of schizophrenia have a 20 to 40 percent chance of being diagnosed.

Environmental factors associated with the development of schizophrenia include the living environment, drug use and prenatal stressors. Living in an urban environment during childhood or as an adult has been found to increase the risk of schizophrenia by a factor of two, even after taking into account drug use, ethnic group, and size of social group.

Stress and malnutrition in the mother during fetal development may result in a slight increase in the risk of schizophrenia later in life. A number of drugs have been associated with the development of schizophrenia including cannabis, cocaine, alcohol and amphetamines.

Prevention of schizophrenia is difficult. Evidence for the effectiveness of early intervention is inconclusive. The mainstay of treatment is antipsychotic medication, which primarily suppresses dopamine and serotonin receptor activity. Psychotherapy and vocational and social rehabilitation are also used in treatment.

In more serious cases — where there is risk to self and others — involuntary hospitalization may be necessary.

If you believe you or someone you know suffers from schizophrenia, remember that the sufferer is not at fault and help is available. Contact Centra Wellness Network to learn more about treatment options. Call (877) 398-2013 or visit us online at www.centrawellness.org.

To learn more about schizophrenia, visit: www.insideschizophrenia.com, or www.dmoz.org/Health/Mental_Health/Disorders/Schizophrenia. There is also an online Schizophrenia Magazine available, with regular articles and updates on the latest research, online at: www.szmagazine.com

Daniel Wrzesinski is a customer service representative for Centra Wellness Network, and can be reached by e-mail at: DWrzesinski@centrawellness.org.

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