Exploring Schizophrenia: A Comprehensive Guide to Its Complexities  

People often ask, What is schizophrenia? Schizophrenia is a condition that impairs a person's capacity for rational thought, emotion, and behaviour. In India, around 3 out of 1000 people have schizophrenia, which is why it is of paramount importance to understand its nature. 

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 that people with schizophrenia may exhibit. These symptoms are severe enough to disturb their family members’ lives, along with their own. Unfortunately, stigma and discrimination are caused without understanding the difficulties associated with schizophrenia. This further worsens their social relationships, leading to loneliness.    

How Long Will the Treatment of Schizophrenia Take?

Many individuals and caregivers ask, Is schizophrenia curable? While there is currently no cure, schizophrenia is a highly treatable condition with long-term support.

The duration of schizophrenia treatment varies depending on the individual's condition, the schizophrenia symptoms, and their responsiveness to schizophrenia medication and therapy.

• Acute Phase: This may require hospitalisation or intensive outpatient care for several weeks.
• Maintenance Phase: Long-term medication and psychotherapy help manage catatonic schizophrenia, hebephrenic schizophrenia, and other types.
• Rehabilitation Phase: Ongoing support through social skill training, family therapy, and schizophrenia specialists is essential for several months or even years.

The key to long-term success is consistency in treatment, professional guidance, and a personalised recovery plan.

Symptoms of Schizophrenia   

Signs and Symptoms of schizophrenia usually appear in adolescence and early adulthood and affect the person throughout their life. Schizophrenia symptoms can be broadly divided into three categories: positive, negative, and cognitive symptoms, each affecting the person’s thoughts, behaviours, and ability to function in unique ways.  

Positive Symptoms of Schizophrenia   

Positive symptoms of schizophrenia 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, which is the most common type of hallucination for those experiencing schizophrenia symptoms. 

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 a 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. These delusions are often intense and persistent among schizophrenia symptoms. 

Disorganised thinking (speech)   

Disorganised thinking or speech is another prominent symptom of schizophrenia. 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 hinders their ability to evaluate situations logically and coherently. Due to their uncertain thought process, they might switch topics and reply with unrelated topics while conversing.   

Movement Disorder   

A 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 of schizophrenia 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   

Cognitive symptoms in schizophrenia reflect impairments in brain function, including 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.   

Phases of Schizophrenia

Schizophrenia disorder typically unfolds in three stages: prodromal, active, and residual. Recognising these helps with early schizophrenia diagnosis and timely schizophrenia treatment.

1. Prodromal Phase

Early warning signs appear subtly. People with schizophrenia may show social withdrawal, irritability, poor concentration, or changes in sleep. These often precede more severe schizophrenia symptoms.

2. Active Phase

This is when positive symptoms of schizophrenia, like hallucinations, delusions, and disorganised behaviour, become intense. Immediate medical care and schizophrenia medication are usually required during this phase.

3. Residual Phase

After active symptoms subside, negative symptoms of schizophrenia, such as low motivation and emotional flatness, may linger. Ongoing therapy and support help maintain recovery.

Early Warning Signs of Schizophrenia 

Schizophrenia is a complex mental health condition that typically presents with various symptoms that may emerge gradually. Recognising the early symptoms of schizophrenia can be essential for timely intervention and management. By being aware of these warning signs, families and individuals can seek help sooner, potentially improving long-term outcomes. 

Recognising Early Symptoms in Adolescents 

Adolescence is a critical period when schizophrenia symptoms may begin to manifest, though they often go unnoticed. Early signs in teenagers can include withdrawal from social activities, sudden changes in academic performance, and unexplained mood fluctuations. Adolescents may also display unusual thinking patterns or express bizarre ideas, which could be indicative of the early symptoms of schizophrenia. Seeking a schizophrenia diagnosis from a mental health professional is essential when these symptoms persist or intensify, as early intervention can make a significant difference. 

Behavioural Changes to Watch For 

Behavioural changes are often among the earliest signs of schizophrenia. Family members may notice that the person starts to neglect personal hygiene, becomes increasingly isolated, or shows a lack of motivation in everyday tasks. Other behaviours to be aware of include: 

• Increased suspicion or paranoia 

• Strange or disorganised speech 

• Difficulty focusing or completing tasks 

• Erratic sleep patterns 

These changes can be subtle at first but often intensify over time. Watching for these patterns and consulting with a healthcare provider for a potential schizophrenia diagnosis can lead to early schizophrenia treatment options, which may help mitigate the impact of the condition. 

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.   

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. These biological disruptions are among the most researched schizophrenia causes of schizophrenia.  

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 interacts with the environment. Note that a family history of schizophrenia does not guarantee the onset of the disorder, but it is one of the significant schizophrenia causes under study.   

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.  

Understanding the types of schizophrenia is equally important, as each type may be triggered or influenced by different combinations of the above schizophrenia causes.

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 significant 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 others’ 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 facial expressions, 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 to a considerably 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 about 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.  

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

Cadabam's 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.  

Schizophrenia Treatment  

Seeking early schizophrenia treatment can help manage schizophrenia symptoms more effectively, thus increasing the chances of returning to a normal lifestyle. In terms of schizophrenia treatment in India, Cadabam's offers the best services with advanced, evidence-based approaches that help not only ease the signs and 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. Cadabam's 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. Cadabam's counsellors assist patients by employing a personalised 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 

Cadabam's 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.