Schizophrenia is a mental illness that completely affects the personality of the sufferer. Those affected often have a disturbed relationship with reality, which manifests itself, for example, in delusions and hallucinations. Schizophrenia usually occurs for the first time between puberty and a maximum of 35 years.
What is schizophrenia?
Schizophrenia is a mental disorder that affects all of the sufferer’s perceptions. Both the inner and the outer perception change, sometimes considerably. This affects the emotional life and thinking of the patient. The drive and motor skills also change. See bittranslators for About Temporomandibular Disorders.
Schizophrenia usually occurs in episodes. A flare-up is also called psychosis. Those affected can completely lose touch with reality. Psychiatry distinguishes different forms of schizophrenia depending on the symptoms. Hallucinations and delusions occur in paranoid hallucinatory schizophrenia.
Catatonic schizophrenia is characterized by motor symptoms. If mainly the emotional life is disturbed, it is a question of hebephrenic schizophrenia. When there is a lack of drive, social withdrawal and a lack of feelings, one speaks of residual schizophrenia.
Various factors probably play a role in the causes of schizophrenia . It is assumed that a genetic predisposition is the central factor. However, other factors must be added as triggers. This can be, for example, stress, drug use or drastic events in life.
Psychosocial factors could also be a cause of schizophrenia. However, it has not yet been scientifically proven that problems in the family, partnership or job are responsible for the onset of schizophrenia. Biochemical causes have not yet been conclusively scientifically proven. However, it has been proven that the docking sites for dopamine in the brain of a schizophrenic are hypersensitive. Dopamine is a messenger substance that transmits nerve impulses.
Neuroanatomical causes are also suspected to be the cause of schizophrenia. It was found that in some patients there is an enlarged chamber in the brain that is filled with brain fluid. In addition, cerebral blood flow is altered in the presence of schizophrenia.
Symptoms, Ailments & Signs
A prominent symptom of schizophrenia is delusion. The sick suffer from absurd delusions that have no real basis. Nevertheless, these ideas seem realistic to people with schizophrenia, so that even logical arguments cannot change their opinion. An example of a delusion is delusions of persecution.
Those affected think that they are being followed and threatened. In the case of a relationship delusion, on the other hand, they relate all possible events to their person. Thinking changes significantly as the disease progresses. The trains of thought suddenly break off and/or are torn apart. Another symptom of schizophrenia is ego disorder.
The boundary between one’s own person and the outside world is blurred, parts of one’s own body or thoughts are perceived as foreign. Hallucinations are also common in people with schizophrenia. These usually manifest themselves in an acoustic form and are perceived by the patients as extremely threatening.
People with schizophrenia are often listless, powerless or [apathy|apathetic]]. They have little interest in social contacts or leisure activities. Emotions have leveled off, and those affected are irritable, suspicious, or depressed. Not all signs of schizophrenia are always present to the same extent. They vary both in the course of the disease and from patient to patient.
Course of the disease
The course of the disease of schizophrenia is individually different for each person affected. For many sufferers, the first signs appear months or even years before the actual onset of schizophrenia. However, these first signs do not yet clearly point to schizophrenia.
For example, those affected distance themselves and withdraw. They are often depressed and have a distorted perception of reality. This early stage of schizophrenia is called the prodromal phase. If schizophrenia breaks out acutely, hallucinations, delusions (eg paranoia) and ego disorders occur.
In addition, there are disturbances in thought, lack of emotion and lack of drive. However, the severity and combination of symptoms are different for each patient. An acute phase can last from a few weeks to a few months. After that it subsides again. The course of schizophrenia can occur in phases. It can happen that some of the symptoms persist after each new outbreak. This is called chronification of schizophrenia.
A possible complication of schizophrenia is worsening symptoms. This occurs in around one-third of those affected, while a further third experience improvement or no significant change. Many schizophrenics suffer from a chronic physical illness.
Neuroleptics or antipsychotics are drugs that can be used in schizophrenia. These psychotropic drugs can also cause complications. Some drugs from the group of atypical antipsychotics seem to increase the risk of diabetes mellitus. Other neuroleptics increase the likelihood that the affected person will develop Parkinson’s disease.
A parkinsonoid is a drug-induced parkinsonian syndrome resembling neurodegenerative disease. However, the symptoms are not due to a loss of the substantia nigra, as is the case with Parkinson’s disease, but to the taking of a drug. Other potential side effects of antipsychotics include seizures, movement disorders, and/or weight gain.
A serious but rare complication of neuroleptics is neuroleptic malignant syndrome, which occurs in 0.2 percent of patients taking antipsychotics. Typical symptoms include fever, rigors and clouded consciousness, among others. The neuroleptic malignant syndrome is life-threatening and must therefore be treated. In individual cases, the doctor treating you weighs up whether the benefits or risks of a drug outweigh the risks for a specific patient.
Complications are also possible on a psychological level. Every second schizophrenic suffers from another mental illness. The most common comorbidities are anxiety disorders, mood disorders and psychotropic substance disorders.
When should you go to the doctor?
Consultation with a doctor is indicated as soon as the person concerned behaves abnormally and is described as abnormal. Hallucinations, seeing and perceiving imaginary entities, or intuitions with calls to action are worrisome. Clarification by a doctor is necessary as soon as voices are heard, an aggressive demeanor or a threat to the person concerned and to people in the immediate vicinity.
If social rules are not observed, if relatives suffer emotional injuries or if parts of one’s own body are perceived as foreign, a doctor’s visit is necessary. Many patients justify their actions by believing that the thoughts came from, and are being controlled by, an outside source. To be distinguished from schizophrenia are religious or spiritual inspirations without a disease value.
If everyday life cannot be managed without help, if the person concerned changes their personality or their behavior triggers fear in those around them, there is a need for action. A doctor is needed because patients with schizophrenia require drug therapy. A withdrawal from social life, isolation or a strong distrust of all people are characteristic of the disease and should be monitored by a doctor. Depressive behavior also requires medical help.
Treatment & Therapy
Since many different factors can be responsible for the development of schizophrenia, multidimensional therapy is used in the treatment. It consists of treating patients with psychotropic drugs, psychotherapy and sociotherapy. In the field of psychotherapy, supportive psychotherapy is sometimes used.
This therapy gives those affected support in dealing with their illness. In addition, all methods of behavioral therapy are applied. The therapy always depends on the individual clinical picture of the patient. Sociotherapy supports the affected person in all skills that are important for everyday life. Sociotherapies can be work or occupational therapies, for example.
However, rehabilitation offers may also be part of sociotherapy. Treatment for schizophrenia usually begins with inpatient treatment in a clinic. After that, treatment takes place in a day clinic. In most cases, the patient then moves to a residential community with therapeutic support, in which he can lead an independent life despite schizophrenia.
Since hereditary factors play a major role in schizophrenia, general prevention of the disease is not possible. However, if there is a hereditary predisposition, it is advised to avoid all stress and drug use, as these factors can promote the onset of schizophrenia.
Since schizophrenia is a serious mental illness, follow-up care is often difficult for those affected. Therapy to treat the disease is a lengthy process, the duration of which is often unpredictable. After initial therapy, patients are recommended to receive further psychiatric care and support. This is intended to reduce and curb the occurrence of possible sequelae.
A complete cure of the disease is rarely possible. Those affected must therefore constantly work on their well-being. For this reason, aftercare primarily concerns the patient’s environment. Friends, family members and significant others should therefore work closely with therapists and doctors to actively support those affected in the aftercare.
Active aftercare is not possible for most patients due to the complex clinical picture. The ongoing effects make the possibility of inspection almost impossible. Filtering out bad behavioral habits is an almost impossible task for sufferers.
Those affected can hardly cope with positive changes and measures on their own, which is why the aforementioned support from the environment is of massive importance. In addition, in most cases, further medical treatment in the form of medication cannot be dispensed with. Therapeutic measures can immensely increase the well-being of those affected and prevent symptoms.
You can do that yourself
Many sufferers and relatives experience schizophrenia as an illness that can only be influenced by medication. Although medication plays an important role in therapy, self-help is another important building block. To facilitate treatment and minimize disability, it is important to detect recurrence of symptoms as early as possible. An important part of self-help is therefore to be aware of your own schizophrenia symptoms and to consult a doctor or therapist if they recur. Relatives can also support schizophrenic people in this task.
Critical life events and a high level of stress can re-evoke or intensify psychotic symptoms. However, not all schizophrenics respond negatively to stress —experience can help assess and prepare for future responses to stress at work or family conflict.
If a patient’s psychotic symptoms are exacerbated by stress, general stress-reducing measures in everyday life can be helpful. However, it should be noted that relaxation techniques such as autogenic training and progressive muscle relaxation, which are otherwise popular, are not recommended for psychotic symptoms. Instead, it may be useful, e.g. B. to plan sufficient breaks in everyday life and to ask for help in good time if problems arise.