On Schizophrenia

Schizophrenia is a psychological disorder characterized by such symptoms as delusional thinking, hallucinations, disorganized speech, substantially inappropriate emotional responses, and considerable social dysfunction. However, the aforementioned list is not exhaustive, and persons with schizophrenia will not necessarily report the same symptoms. Not only can people experience different types of symptoms, but also varying amounts thereof. What do these terms really mean though? Let's take a quick look at some explanations of common indicators.

Delusions:

According to the Diagnostic and Statistical Manual of Mental Disorders, 4^th ed., Text Revision, (DSM-IV-TR), delusions can be described as, “...erroneous beliefs that usually involve a misinterpretation of perceptions or experiences. Their content may include a variety of themes (e.g., persecutory, referential, somatic, religious, or grandiose)”, p. 299. This misinterpretation does not mean that an individual failed to understand a joke or missed the hidden meaning in a movie. Rather, such distorted interpretations, as can be seen in this illness, would be something like believing that someone is plotting to steal money from you because you saw three green bicycles on the way to work today and in your mind the colour green represents money. These faulty interpretations, as previously mentioned, may also have some grandiosity to them. For example, as you pull your car toward the traffic light, it changes from red to green, but rather than just feeling fortunate, you take this to mean that you have innate supernatural abilities to alter the physical world around you without being in direct contact with it.

Hallucinations:

The website, www.dictionary.com, describes an hallucination as, “a sensory experience of something that does not exist outside the mind...”. While hallucinations are most commonly of the auditory type, it should be noted that they can be experienced in any of the five senses. For instance, it is uncommon even among those who experience hallucinations, but nonetheless possible for someone who is suffering from schizophrenia to encounter olfactory hallucinations. In other words, the individual will smell something that is not actually present. Bear in mind, this experience is different from recalling a scent, sound, sight, taste, or touch. Nearly everyone has the ability to recall sensory experiences. However, the person suffering from hallucinations may actually believe the encounters are present outside of his or her own mind at that moment. I recall a discussion with a patient who was afflicted with schizophrenia. The patient, in a much healthier and lucid state, was talking with me between group sessions. He described having occasional visual hallucinations while maintaining an awareness that the sensory experience was not really occurring outside of his mind. So, despite sometimes seeing blue trees in the middle of the group room, the patient was able to realize that his brain was merely formulating another hallucination.

Disorganized speech:

A person suffering from schizophrenia may exhibit disorganized speech. This can range from mild to severe in nature and presentation. Although it may appear oddly disturbing, just because someone exhibits disorganized speech does not necessarily mean he or she has schizophrenia. The disorganization exhibited may be frequent derailment, or jumping from one topic to another more than usual. Again, keep in mind that a person presenting this does not necessarily have schizophrenia, as this speech pattern may also be seen in the context of a manic episode or usage of a stimulant, such as cocaine. The presentation of disorganized patterns of speech may also be much more severe, as in the case of a word salad. This may sound something like the following:

So, there hotdog cantilevered and books on the blue shoe made right. President buttons can never tabletop a skateboard sandwich. Music likes water pitchers. 

 A word salad may also be present in conditions of traumatic brain injury or severe oxygen deprivation, resulting in expressive aphasia.

So, where does it come from? Well, with regards to its origin, we're just not 100% sure. However, it is believed that schizophrenia has a very strong genetic component. The DSM-IV-TR, reports, “The first-degree biological relatives of individuals with Schizophrenia have a risk for Schizophrenia that is about 10 times greater than that of the general population.”, p. 309. The text goes on to note, “Adoption studies have shown that biological relatives of individuals with Schizophrenia have a substantially increased risk for Schizophrenia, whereas adoptive relatives have no increased risk.”, p. 309.

Is it treatable? Many people suffering from schizophrenia have found immense help through a combination of psychiatric medication and psychotherapy. Many antipsychotic medications are available to treat the symptoms of schizophrenia and an individual should discuss his or her options with a psychiatrist. Furthermore, be advised that just like nearly everything else, the medicines that work for one patient may not work so well for another. Our bodies are like individual chemistry sets so expect that it may take a bit of trial and error, as well as, adjusting of dosage levels in order to get your exact fit; a psychiatrist will know best how to do this. Once on a stable and sufficient regimen of medication, psychotherapy can help one develop coping skills and self-awareness in order to prevent, manage, and alleviate the onset of possible psychotic episodes in the future. This is not going to be a one time fix, like painting over a scratch on your car's surface. Rather, this is going to be ongoing periodic maintenance, like changing the car's oil. However, simply because one suffers from schizophrenia does not mean one cannot lead a happy and fulfilling life. We will all encounter bumps, potholes, and sharp curves in our individual journeys, though we may have a different road map than someone else.

I hope this has offered you some enlightenment and awareness on the often misunderstood illness, schizophrenia. If you have encountered any of the aforementioned symptoms, or know someone who has, please speak with a physician, psychologist, or therapist about your experiences. Here's to wishing you Good Mental Health.