Schizophrenia: Part 2

Causes?
There are tons of theories surrounding the cause of schizophrenia and, honestly, it's probably a combination of many things.

Research has done a lot of looking into genetics for a cause. Wanna know a secret? If you want to see how much something is genetically based, study identical twins. Since they're genetically...identical...what happens

to one should happen to the other, right? If it's a 100% genetic thing, then yes.

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When it comes to schizophrenia, research has found that if one identical twin has it, there's about a 50% chance of the other having it...

...which, in layman's terms, means that you might as well flip a coin: Heads--he/she has it, Tails--he/she doesn't...

...which shows that schizophrenia isn't all genetic. There are other factors involved.

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We also know that, generally speaking, the noticeable onset of it (the first psychotic breakdown) is in one's late teens-early 20's. It's likely that the person had it before that, but the symptoms were minimal and not seen as abnormal. The causal theory that coincides with the time of onset is the stress theory.

It's usually in one's late teens/early 20's that one moves out of the house, goes to college, gets married, starts a family, begins a career, and the list goes on. That causes stress. If it's too much to handle...

...yeah.

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Another causal theory is the dopamine theory. Dopamine is a chemical messenger in the brain. This theory suggests that there are more dopamine messengers in the brain than it actually needs. Thus, the brain gets confused with all of these access messages going around.

The only problem with this theory is that, if dopamine were the only cause, than a simple dopamine-regulating medication would fix it. It doesn't.

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In other news, research has also found that:

1. In adoption studies, if one of your biological parents has it, your risk of developing it is higher if you stay with that parent, as opposed to being adopted.
2. Those with lower SES (socioeconomic status)--meaning lower class in society--are at a higher risk for developing it.
3. It's becoming more common in people using cannabis (marijuana).
4. Living in a stable family environment can cut one's risk for developing schizophrenia in half.

Treatments

It's not easy to treat schizophrenia because as I said in part 1, there is no cure; the only thing that anyone can do is work to control it. Many counselors will be working with someone for over a year before even daring to give the schizophrenia diagnosis because it really is that big of a deal. By way of treatment, here's what we do have:

Medications are always recommended. The type may differ depending on the person, but a medication of some type is always used. There is never a 100% "I'm cured" response to the medication, but the research has shown that a placebo does not work in a vast majority of cases.

In addition, some type of therapy is also always undergone. Commonly used therapies include:

1. Family Therapy
1. This involves working with the person as well as his/her family in order to give him/her the support system needed to learn to control the symptoms
2. Social Skills Training (SST)
1. This does what its name implies: Teaches the person the proper social skills needed in order to interact appropriately with the world around him/her
3. Milieu Therapy
1. If the case is severe enough, milieu therapy involves institutionalizing the person so that he/she has the appropriate professional help at all times. 
4. Cognitive Behavioral Therapy (CBT)
1. This is the most successful therapy used to treat schizophrenia. The man for whom the movie A

   

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   Beautiful Mind was based on was interviewed regarding his experience. He is known as one who "overcame schizophrenia." When asked how he did it, he just laughed and said that he didn't; he still has schizophrenia. He just learned how to question everything that didn't seem normal. Thus, he has regained control of his life.
2. That's what CBT does: it trains the patient to question even their own thoughts in order to control them.

When he said that he learned to control his thoughts, please don't think that doing so was an easy task. Around 80-85% of those who are in treatment for schizophrenia go off treatment (stop taking their medication and practicing the techniques learned in therapy) once they are left to themselves.

If you ever meet someone who has schizophrenia, I hope that reading this post has helped to gain a greater understanding of what they're going through.

Schizophrenia: Part 1

First off, some myth-busting:

Despite the movie Me, Myself and Irene, as well as the quote that "I used to have schizophrenia, but we're okay now," schizophrenia has nothing to do with Dissociative Identity Disorder (DID, commonly known as multiple personalities).

The reason many people think it has to do with DID is because they think that if you have multiple personalities, you talk to yourself. This is not true. Most people with DID don't even know that their alters exist. But I'll go more into DID later.

If you would like a good example of what schizophrenia really is, watch the movie A Beautiful Mind.

Now that we've cleared that up, on to the fun stuff:

We all think to ourselves. It keeps our brains--and our lives--organized. We all feel paranoid at times. It's a natural defense/protection mechanism. We all have felt defensive of something that we consider to be ours. As we accomplish certain tasks in life, we may feel a sense of grandeur associated with said accomplishment, and that's perfectly okay.

But what happens when some of those things get out of hand...and out of our control?

Welcome to schizophrenia.

Symptoms
There are a few main types of symptoms that mental health pros look for in someone who might have schizophrenia. One main symptom is hallucinations. About 20% of hallucinations experienced by someone with schizophrenia are visual, 70% are auditory, and 10% are another type (smell, touch, etc.).

Since it's the auditory hallucinations (hearing something that isn't really there) that most people think about when they hear of someone with schizophrenia, I'm going to focus on that part of the hallucination category.

Everyone talks to themselves in their heads. It's called self-talk. As children, we talked to ourselves out loud while we were learning how to talk, but as we grew older, that self-talk went internal. If you were to have an MRI, a certain part of your brain called Broca's area would light up while you were thinking to yourself.

Now here's the kicker: There's another area of the brain called Wernicke's area that's in charge of hearing.

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So, it would make sense that this is the area that would activate if you're having an auditory hallucination, right? Not true with schizophrenia. Neuroscientists (people who study the brain) have found that if someone with schizophrenia has an auditory hallucination, Broca's area--not Wernicke's area--will light up.

So, the latest theory is that people with schizophrenia who are having auditory hallucinations are actually hearing their own self-talk, but not in their own voice.

Generally, if you hear someone talking to you, do you think back your answer? Of course not. You talk to the person. This is why it looks like people with schizophrenia are talking to themselves; according to this theory, they are.

How would it be if you were hearing a strange voice and couldn't get it out of your head because it was, in fact, your voice?

That would be enough to drive anyone crazy.

But wait. There's more.

Delusions. These don't just show up every once in a while. These delusions are thoughts that the person will organize his/her entire life around. There are generally three types of delusions associated with schizophrenia: Delusions of grandeur, delusions of persecution, and delusions of jealousy (defined as the need to be vigilant in guarding something). One may have only one of these types of delusions or he/she may experience all three.

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"A delusion of grandeur is the fixed, false belief that one possesses superior qualities such as genius, fame, omnipotence, or wealth" (source). Many years ago I met a woman with schizophrenia who had this symptom. She had visual hallucinations of Jesus and his 12 disciples walking out of her wardrobe, talking with her as they walked past and disappeared through the wall of her kitchen. This lead her to put herself on a religious pedestal and even go to school for a degree in theology in order to follow the instructions given by the figures that came out of her wardrobe.

Other delusions of grandeur may be associated with the idea that you are a high-profile secret service agent trying to solve a case, the president of a country (the "real" one is either a phony or an impostor), or that you have made an amazing discovery that                                                                                                                     others just don't seem to understand.

The woman I mentioned also had the symptoms of persecution. She fully believed that her next-door neighbors were international spies who had attempted to kill her on multiple occasions. This type of delusion leads to extreme paranoia: every time her neighbors walked past her house, she was convinced that they were scoping out their next attack. When she saw her neighbors across the street go to a dinner party at "the enemies'" home, she decided that they had been accepted into the spy ring. To protect herself, she had a 6-foot high cement wall built around her entire property with a metal, windowless door as the only way in or out.

In the place where this woman lives, treatment options are minimal and, for the most part, practically non-existent simply due to lack of resources and information. How would it be to live a life in genuine fear of everyone around you?