Schizophrenia: A loss of Contact with Reality
Schizophrenia is a crippling mental disorder that affects about one percent of the global population. In the United States alone, there are about two million Americans suffering from this debilitating illness. Schizophrenia could affect anyone—both men and women and usually develops throughout a person’s life (National Institute of Mental Health ).
The discovery of schizophrenia as a mental disorder goes side by side with the history of psychiatry. The first clear description of schizophrenia as a disease was in 1809. The description was a product of exhaustive research conducted through observation on patients confined on asylums, madhouses, or are categorically branded as insane. These “lunatics” or participants on the research where then classified based on the speculated causes of their afflictions—researchers even went so far as to perform some sort of autopsy to discover the physiological source of madness. It was through this experiments and research that psychiatry grew out to be a branch of scientific study to “understand and cure diseases of the mind, particularly those tragic, chronic mental illnesses that condemned thousands to debilitated lives in institutions.” It is therefore safe to assume that schizophrenia has always been at the heart of the concern of the psychiatric profession (Noll ix).
What is Schizophrenia?
Schizophrenia is a psychotic illness wherein the person suffering from it has lost touch, gradually through progression, with reality—could also be called delusion. For instance, the individual find it difficult to grasp reality to the point that it cannot possibly be true; starts hearing voices where there is none; talking to a person they believe to exist with them either imaginary or based from a living person; and sees vision when there is no sensory stimulus to cause it as in hallucinations (Christopher D. Frith 24). Though it is quite difficult to really see the disease based on the perspective of the patient, because most observation of the character of the ailment are from the outsider’s perspective—that of the researcher, a very insightful glimpse was written by an 18-year old boy who was diagnosed to be suffering from schizophrenia. What is great about this is that he was able to express in detail the emotion and experience he was having with the disease; as it reads:
I am more and more losing contact with my environment and with myself. Instead of taking an interest in what goes on and caring about what happens with my illness, I am all the time losing my emotional contact with everything including myself. What remains is only an abstract knowledge of what goes on around me ad of the internal happenings in myself…. Even this illness which pierces to the centre of my whole life I can regard only objectively. But, on rare occasions, I am overwhelmed with the sudden realization of the ghastly destruction that is caused by this creeping uncanny disease that I have fallen a victim to…. My despair sometimes floods over me. But after each outburst I become more indifferent, I lose myself more in the disease, I sink into an almost oblivious existence(Christopher D. Frith 2).
Theories and Approaches to Schizophrenia
It has been speculated that schizophrenia could be inherited. This means that people who have relatives suffering from the disease have higher risk or are more likely to develop schizophrenia than people who have no family members with the illness.A clinical study done in Europe asserts this fact. Direct relative—parents, siblings of a patient with schizophrenia are on average ten times more likely to develop the disease than a person who does not have a family member who is suffering from the disease(National Institute of Mental Health ; Ming T. Tsuang 43). For children of sufferers, the risk is even greater—15 times higher than that of the general populace. However, more recent and rigorous studies have showed that though schizophrenia could be inherited, the risk of it being acquired by another member is only 3 percent—far less than the European study but is still five times higher than that of the general population’s chances of developing the disease. Though these studies suggest that there is a string hereditary basis, shared environment could also be an explanation for a person to develop the same disease as that of his or her relative (Ming T. Tsuang 43-44).
In terms of shared environment, environment alone would not cause or trigger the illness but it could be an added factor towards the development of the disease. If this is the case, then changes in the environment could greatly decrease the chances of the occurrence of the disease (Ming T. Tsuang 58-59). For instance, if mental illness could be triggered by poverty—i.e. poor sanitation, poor housing condition, then it is safe to conclude that by changing or improving the environmental factors—i.e. providing decent housing, could decrease the likelihood of a person to develop the disease.
But more than the physical environment, the bearing falls on the social and cultural environment. When we say social environment, the analysis of schizophrenia goes down to the micro, mezzo, and macro levels—investigating the complexities of interaction over time i.e. role of the family and various social factors. But this approach to schizophrenia had been too overwhelming if not impossible because of the many variables involved. Added to that is the poor methodological approach to the research study (Harrison 33).
Thus, the researchers tend to take the strategy of approaching schizophrenia as a biological mechanism which can easily be measured. Thus, it became known as a ‘brain disease.’ Ergo the argument that if, it is biological in nature then it is but logical to assume that its cause is also biological(Harrison 33).
Diagnosis and Treatment
Before taking any possible treatment, proper diagnosis has to be made to rule out other illnesses as there are cases where people who suffer from severe mental symptoms could be due to an underlying cause of a medical condition. A thorough medical history, physical examinations, and laboratory tests are conducted to rule out possible causes of the symptoms before concluding that a person is indeed suffering from schizophrenia.Moreover, since there are many readily available drugs, that if abused could resemble symptoms of schizophrenia, blood and or urine samples are always undertaken to rule out substance abuse(National Institute of Mental Health ).
After diagnosis there are two possible treatments—antipsychotic medication and psychosocial treatments. Antipsychotic drug like Thorazine which was introduced in 1955 works by sufficiently relaxing even the most violent schizophrenics and help organize their thoughts that physical restraints is sometimes no longer needed. Although Antipsychotic drug helps control the patients and improve the quality of their lives, it does not cure the disease. And even with newer versions of Antipsychotic drugs in the market like Clozaril, Risperdal, Zyprexa, and Geodon that greatly reduced side effects present in the older version of the drug i.e. persistent muscle spasms, rigidity, restlessness, and tremors, these are still not effective cure but a treatment to help alleviate the symptoms of schizophrenia (David Sue 383).
Another approach to treating schizophrenia is through psychosocial treatment. Though antipsychotic drug helps in relieving the psychotic symptoms, it does not have any effect on the behavioral symptoms of the disorder. Even among schizophrenics with no or little psychotic symptoms, they have problems with communication and socialization skills and in maintaining relationship, partly due to the fact that most patients frequently acquire this disease in the critical career years between 18 and 35 years. Though psychosocial treatments have limited value in terms of acute psychotic patients, these approaches could prove useful for patients with less severe form of schizophrenia(National Institute of Mental Health ).
For instance, rehabilitation programs that includes a wide array of non-medical interventions with emphasis on social and vocational training to help schizophrenics overcome these difficulties and hopefully make them more independent. Programs could include vocational counseling, job training, money management skills, and social skills training to name a few. Another is individual psychotherapy wherein the patient regularly schedules a talk with a health care professional to find the root cause of the disease. Family education is also important because it highlights the role of the family in the life of the patient and how they can help improve the life of the patient and even minimize the relapse of the patient. Lastly, self-help groups works like focus group that works like advocacy groups wherein though there are no medical professional present, families, friends, or community members come together to support one another and share their insights in dealing with and coping with a loved one who is suffering from the disease.
Though science is still in a long road towards fully understanding schizophrenia as a mental disorder, progress like the availability of treatments have pave the way towards greater understanding of the disease. But what is more to be done is towards the socio-cultural aspect of it. Stereotyping and labeling of people that suffer from this illness should also be equally addressed.
Christopher D. Frith, Eve C. Johnstone. Schizophrenia: a very short introduction. New York: Oxford University Press, 2003.
David Sue, Derald Wing Sue, Stanley Sue. Understanding Abnormal Behavior. Boston: Wadsworth Cengage Learning, 2010.
Harrison, Glynn. "The Course and Outcome of Schizophrenia: Toward a New Social Biology of Psychosis." Wagner F. Gattaz, Heinz Hafner. Search for the causes of schizophrenia, Volume 5 . Germany: Steinkopff Verlag Darmstadt, 2004. 32-53.
Ming T. Tsuang, Stephen V. Faraone, Peter D. C. Johnson. Schizophrenia: the Facts. New York: Oxford University Press, 1997.
National Institute of Mental Health . schizophrenia.com. 2004. Web. 24 february 2011
Noll, Richard. The Encyclopedia of Schizophrenia and Other Psychotic Disorders . New York: Infobase Publishing, 2007.