Schizophrenia

Schizophrenia is a condition that impairs a person's capacity for rational thought, emotion, and behavior. In India, around 3 out of 1000, people suffer from schizophrenia, which is why it is of paramount importance to understand the nature of it.  

Even though there is no cure, it is a treatable condition with proper support and treatments. Many resources are available to manage your symptoms effectively and regain control of your life.  

What Is Schizophrenia?  

Schizophrenia is a chronic and serious mental disorder that affects a person's ability to perceive reality. Hallucinations, delusions, disorganised speech or behaviour, and less participation in daily activities are the signs people with schizophrenia may exhibit. These symptoms are severe enough to disturb their family members’ lives along with theirs. Unfortunately, stigma and discrimination are caused without understanding the difficulties associated with schizophrenia. This further worsens their social relationships, leading to loneliness.  

Symptoms of Schizophrenia  

Symptoms of schizophrenia usually appear in adolescence and early adulthood and affect the person throughout their life. These symptoms can be broadly classified into three categories:

Positive Symptoms of Schizophrenia  

Positive symptoms are those that affect an individual's thoughts or behaviours and are often developed as exaggerated beliefs or actions and distorted reality. Symptoms like hallucinations, delusions, disorganised speech, or movement disorders are called positive symptoms because of their presence rather than absence, and they exist within themselves only after developing schizophrenia, not before.  

Hallucinations  

People with schizophrenia often experience hearing, seeing, smelling, tasting, or feeling things that do not exist but feel real to them, which can cause disruptive behaviours. The most common type of hallucination in people with schizophrenia is an auditory hallucination, or hearing voices.  

Delusions  

A delusion is when an individual with schizophrenia firmly believes in false facts despite clear or reasonable evidence to contradict the belief. The most common type of delusion is persecutory or paranoid delusion: which occurs when a person believes that they are being harmed, stalked, hunted, framed, or harassed by another person or group.

Disorganised thinking (speech)  

Individuals with schizophrenia have trouble organising their thoughts, which are often confused and do not make sense. Their speech is jumbled when expressing and sustaining concentration and focus, which harms their way of evaluating situations logically and coherently. Due to their uncertain thought process, they might switch topics and reply with unrelated topics while conversing.  

Movement Disorder  

Movement disorder is when a person with schizophrenia has trouble regulating their body movements. They are often seen as jumpy and make unpredictable movements, like repeated movements, complete stillness for hours, twitching, and uncomfortable body postures. It gets difficult for people around them to understand.  

Negative Symptoms of Schizophrenia  

Negative symptoms refer to the absence or lack of normal mental functions that are present in most people and affect an individual’s daily functioning. Little to no facial expression, emotional responses, physical inactivity, less talking, a lack of motivation, social withdrawal, and no interest in the world are common negative symptoms and are often leading causes of relationship problems.  

Cognitive Symptoms of Schizophrenia  

There is a decline in brain function, working memory, and attention span among people with schizophrenia. Cognitive symptoms impact their ability to learn, store, and use information in their brain. Difficulty processing information and making decisions, a lack of insight into their symptoms and condition, and difficulty concentrating or keeping focus are cognitive symptoms of schizophrenia. There can be some overlap with negative symptoms.  

Causes of Schizophrenia

There are some factors that could increase the risk of an individual developing schizophrenia. Identifying these factors is important to creating a personalised and solution-oriented treatment plan.  

1. Biological Factors: Abnormal functioning of the brain and chemical imbalances may play a role in the development of schizophrenia. Typically, the parts of the brain are related to memory, auditory, and executive functions.

2. Genetic Factors: Individuals with a family history of schizophrenia have a greater risk of developing the disorder. The onset of schizophrenia may also occur when genetics interact with the environment. Note that a family history of schizophrenia does not guarantee the onset of the disorder.  

3. Environmental Factors: Environmental factors may interact with other genetic and biological risk factors that may lead to the disorder's onset. These include:

• Exposure to toxins and harmful chemicals in the fetal stage, or infancy.
• Suffering from autoimmune diseases or inflammatory disorders.  
• Exposure to psychoactive drugs.
• Working under high stress levels for long periods of time.

Risks of Schizophrenia  

Even though the exact cause of schizophrenia is unknown, these several factors are considered contributing agents.  

Genetics

If you have a family history of schizophrenia, especially siblings or parents, this early exposure often acts as a risk factor for developing schizophrenia.  

Environment  

Your surroundings, like exposure to chemicals or pre-existing autoimmune disease, can be a major contributor.  

Childhood ADHD

Since both schizophrenia and ADHD affect how the brain uses dopamine, children with ADHD are at greater risk of developing schizophrenia.  

Life Stressors  

Major life stressors like family violence, trauma, or poverty can increase the likelihood of schizophrenia onset.  

Smoking and Cannabis Use

Smoking and using cannabis pose a greater risk of not only developing but also worsening the condition.  

Types of Schizophrenia  

Schizophrenia can be classified into different types based on the individual’s symptoms, it is critical to understand what these disorders may look like in a person.  

Paranoid Schizophrenia  

This is the most common type of schizophrenia. Symptoms such as hallucinations, delusions, and dysfunction in behaviour are prominent. You may or may not exhibit disorganised speech or a lack of emotional expression. Paranoid schizophrenia mostly develops in the later part of your life than any other form of this disorder.  

Catatonic Schizophrenia  

Catatonic schizophrenia is the most uncommon type of schizophrenia, characterised by unusual, limited, and sudden movements. Individuals with this condition may be either completely still or in a hyperactive state. They might also mimic other’s speech and movements and not converse much with others. This frequent switch can be distressing for them and their loved ones.  

Disorganised Schizophrenia (Hebephrenic Schizophrenia)  

Disorganised schizophrenia, or hebephrenic schizophrenia, is a type of schizophrenia characterised by disorganised speech and behaviour, with short-term delusions and hallucinations. It is hard to find individuals with this condition showing emotion in their face, voice tone, or mannerisms, making it difficult for others to understand them. Hebephrenic schizophrenia usually develops when you’re 15-25 years old.  

Undifferentiated Schizophrenia  

Individuals with mixed symptoms of paranoid, catatonic, or hebephrenic schizophrenia are classified as having undifferentiated schizophrenia. You may exhibit one or all of the subtypes' symptoms, like hallucinations, delusions, negative emotions, or a lack of motivation, together, making it unique and difficult to categorise.  

Residual Schizophrenia

Residual schizophrenia is when a person has a history of schizophrenic episodes but no longer, or considerably to a lesser extent, exhibits positive symptoms like hallucinations and delusions or disorganised speech and behaviours. Rather, they display negative symptoms like social withdrawal, poor memory, lack of concentration, or slow speech patterns.

Diagnosis of Schizophrenia  

There are several diagnostic steps required to determine whether an individual has schizophrenia and to rule out other medical complications.  

Initial Appointment Check-up  

During this appointment, a mental health expert will ask not only about you but also your family's medical reports to aid in assessing mood patterns, cognitive abilities, academic performance reports, and any previous problems with substance abuse.

Physical Exams and Imaging Tests  

A physician might prescribe blood tests, and physical tests such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) to assess your physical health.  

Psychometric Assessments

Brain activity testing, such as an Electroencephalogram (EEG), measures and records electrical activity in your brain. This test can help rule out illnesses such as epilepsy.

Blood, Urine and Cerebrospinal Fluid (Spinal Tap) Tests

These tests examine chemical changes in bodily fluids that could help explain behavioural abnormalities. They can rule out heavy metal toxicity or other causes of poisoning, infections, and so forth.

When to See a Doctor for Schizophrenia?

When the nature of schizophrenia is very complicated, the stigma and negative or false beliefs often make it worse. Individuals suffering from this disorder are pushed into corners with different names. They have the right to avail themselves of all the resources; therefore, if you or your loved one shows any symptoms, seek mental health professional help.

Cadabams' experienced team of professionals examines and evaluates the severity of your symptoms before tailoring a treatment plan just for you.

Cadabams Psychologists help patients with Borderline Personality Disorder by providing a blend of evidence-based therapies tailored to individual needs, fostering skills for emotional regulation, interpersonal effectiveness, and recovery in a supportive environment.

Treatment of Schizophrenia

Seeking early schizophrenia treatment can help to manage schizophrenia symptoms more effectively, thus increasing the chances of returning to a normal lifestyle. In terms of schizophrenia treatment in India, Cadabams offers the best services with advanced, evidence-based approaches that help not only ease symptoms of schizophrenia but also improve the quality of life. Some options for the treatment of schizophrenia include:

Medication Management

Medication such as antipsychotics can be used to relieve symptoms of psychosis that are experienced with schizophrenia. Based on the symptoms of the individual, different types of antipsychotics are prescribed for the best results. Cadabams' multispecialty team provides the necessary medication treatment required to manage symptoms while increasing the functioning of individuals with schizophrenia.

Antipsychotic Medication

Antipsychotic drugs are effectively used to manage psychosis, a set of symptoms impacting one’s perception of reality. They play a vital role in the treatment process, and many of these conditions will require continuous psychiatric care and support without these drugs.  

Psychotherapy

Psychotherapeutic interventions such as group therapy, family therapy, and cognitive behavioural therapy are effective in the treatment of schizophrenia. Cadabams counselors assist patients by employing a personalized approach that integrates psychotherapy and holistic support, helping individuals to develop coping mechanisms and resilience in managing the symptoms of their conditions.

Family Therapy

Family support is a crucial aspect of psychotherapy that can help family members be aware of the condition itself. They are educated about the causes, effects, and symptoms in a way that would help their loved ones.

Group Therapy

Group therapy is a safe platform where individuals with schizophrenia can share their experiences with others who are facing similar difficulties. Through their experiences and success stories, it becomes easier for individuals to build hope and motivation for their own recovery.

Cognitive Behavioural Therapy

CBT is a process through which negative thought patterns are reframed to be more positive. This therapeutic process helps individuals identify their own negative thoughts and manage them effectively with the help of a mental health professional. This can specifically be useful in identifying and managing the delusions of a person with schizophrenia.  

Social Skill Training

Cadabams provides residents with the required training that would help them understand the importance of interpersonal relationships and the various social skills associated with maintaining them. Social skill training helps the individual identify social cues and respond to them appropriately. This could help in the management of schizophrenia symptoms while also ensuring high levels of functioning in society.  

Vocational Rehabilitation

With assistance from NGOs or social workers, vocational rehabilitation aims to help residents develop skills that could help them with employment. Through these Schizophrenia programs, individuals learn the skills required to maintain a stable job and earn a livelihood.