SCHIZOPHRENIA Schizophrenia, from the Greek word meaning “split mind”, is a mental disorder that causes complete fragmentation in the processes of the mind. Contrary to common belief, schizophrenia does not refer to a person with a split personality or multiple personalities, but rather to a condition which affects the person’s movement, language, and thinking skills. The question of whether schizophrenia is a disease or collection of socially learned actions is still a question in people’ mind. People who are suffering from schizophrenia think and act in their own the world and put themselves in a way that is totally different from the rest of society. In other words, they have lost in touch with the reality. Most schizophrenics accept the fact that they have this disorder and are willing to receive necessary treatment and listen to, if not follow, professional advice. However there are cases where patients have lost insight and do not acknowledge the fact that they suffer from a mental disorder. As a result, these people do not have the treatment normally patients with schizophrenia do. To observers, schizophrenia may seem like a disease or madness because people who have this disorder behave differently to the people that are considered “normal.” It impairs a person from doing work, going to school, taking care of his/herself or having a social relationship with others. Yet, by looking at some of the symptoms, it is sometimes hard to classify schizophrenia as a disease because it enables those inflicted with it to develop new ways of communication intellectually and creatively, as well as enhancing artistic abilities. A disease is usually some kind of sickness that will lead to death or under heavy medication. However, this is not the case. For now, there is no cure but only treatment to help people with schizophrenia to live more productive lives. Generally, schizophrenia carries enormous threats to the society. About one percent of the people in United States develop schizophrenia and the probability of developing this disorder is independent of the patient’s gender, race or culture. Women are as likely to develop schizophrenia as men but women tend to have less severe symptoms with fewer hospitalizations and are generally able to cope better in the community. About ten percent of the people who have schizophrenia commit suicide and many others attempt suicide. In the United States, schizophrenics occupy one third of the beds in psychiatric hospitals and make up ten percent of the homeless population. The government has spent tens of billions of dollars each year in the direct treatment of, social services for, and lost productivity due to such patients. Usually schizophrenia develops during late adolescence or early adulthood between the age of fifteen and thirty. Earlier symptoms may develop rapidly in the beginning but slows down over months or years. There are two areas, positive and negative, in which schizophrenic symptoms are classified. Positive symptoms can be seen as those which cause the patient to actively do things, and these include delusions, hallucinations, mood changes such as excitement or depression, and acute thought disorder. Negative symptoms are those that come on insidiously and are characterized by what the patient fails to do, e.g. lack of volition, emotional flattening, and withdrawal from society so that there is inability to communicate or socialize. These symptoms are going to be discussed in detail on the next paragraph. Firstly, delusions are false beliefs that clearly appear untrue to other people, and are divided into three kinds: paranoid, grandiose and depressive. In paranoid delusions, the patients believe they are being watched or spied on by some group of people such as the police or FBI. They may also believe that aliens from outer space are controlling their mind. In grandiose delusions, patients believe that they are some special person, often with great powers such as the queen or king of England. In depressive delusions, the patients believe that they are guilty of some terrible crime or it is their fault for the tragic world events. Next, hallucinations are false sensory perceptions meaning that the person who experiences them may see, hear, smell, feel or taste tings that are not really there. Auditory hallucinations such as hearing voices when no one is around are very common to schizophrenics. Patients may hear a single voice or two voices having conversations with each other. Sometimes, they may hear voices commanding them to do something such as to kill someone or to help someone. Tactile hallucinations cause the patient to believe that they are being sexually interfered with, or that their prosecutors are putting electricity through them. Taste and smell hallucinations cause paranoid patients to think that what they are eating has been poisoned. In this case, they may not eat for days which can lead to life-threatening situations. Visual hallucinations are very rare in schizophrenics but it is possible for patients to think they have seen the ghost of their deceased relatives in their room. Hallucinations often cause aggression, stress, anxiety, and fear in the patients. In addition, bizarre behaviors are also very common to people with schizophrenia. They tend to do things those not suffering from schizophrenia typically would not do. This is why mostly people think schizophrenia is a disease. However to the schizophrenics themselves, they do not think that what they are doing is very bizarre. For example, they may talk to themselves, walk backwards, suddenly make loud laughs and funny faces, or even masturbate in public. Sometimes, schizophrenics may perform an action randomly and respectively for hours. In rare cases, they may freeze on a bizarre pose for long periods of time. Another symptom is the disorganized thinking and speech. Schizophrenics may think illogically or expressing their thoughts with consecutive unrelated ideas being linked together. In conversation, they may jump topics or link together long phrases of bizarre words somehow meaningful to them but not to the “normal” people. Their creative language skills make it hard to believe schizophrenia is a disease. Schizophrenics are too intelligent to consider them as an illness. For example, one asked for an explanation of Too many cooks spoil the broth’, for example, one may get replies such as It’s all to do with the kitchen’, There are too many people there’, Interference ruins a good dinner’. By linking and rearranging the phrases, that patient really answered the question. In addition, schizophrenics often create new inventive words called a neologism such as blanketyboo’ for being sad or growlinger’ for feeling angry. Finally, another characteristic of schizophrenia is social withdrawal. Schizophrenics may avoid contact with the public as if society does not exist at all. Moreover, the patient may have lack of expressions such as talking in a low, monotonous voice, showing no facial expressions or avoiding eye contact. They may also lose interest in participating in activies due to lack of pleasure. Other symptoms of schizophrenia include memory loss, planning ahead, and abstract thinking. Most of the patients become alcoholics and drug abusers and this, in turn, often worsens their symptoms. Now that the symptoms of schizophrenia are explained, it is hardly acceptable that schizophrenia is a kind of disease. Schizophrenics are merely acting in ways that “normal” people may not do and as such, should not be coined as abnormal, crazy, or diseased. In order to further understand if schizophrenia is a disease or not, the causes of how schizophrenia appears is very important to consider. Most scientists think that schizophrenia appears from a variety of factors. Research reveals that schizophrenia can be passed from one person to another genetically or by the prenatal environment. There is about forty-six percent chance that a child will develop schizophrenia if both parents already have the illness. Another factor is the chemical imbalance and the structural abnormalities of the brain. Some studies show that schizophrenia occurs when neurotransmitters (chemicals in the brain) are imbalanced, changing the way by which the neurons to communicate with each other. The excess activity of the neurotransmitter dopamine or an abnormal sensitivity to dopamine in certain parts of the brain can also cause this illness. In addition, researchers discover that schizophrenics usually have enlarged brain ventricles and smaller volume of brain tissue. The frontal lobe of the brain that governs abstract thought, planning and judgment is hardly used. Defects in other parts of the brain such as temporal lobes, hippocampus, thalamus, basal ganglia and superior temporal gyrus are also some factors contributing to the development of schizophrenia. Besides looking at the biological causes, a person might also develop schizophrenia due to the environment he/she is living in. A stressful environment such as living in an overcrowded city, or a stressful experience such as death of a loved one, a change in job or relationships are some examples of factors which make increase the risk of developing schizophrenia. Being able to handle stress efficiently decreases the chances in suspecting the negative effects of the illness. By looking at the different causes, it is clear that schizophrenia cannot be categorized as a disease since it is not a virus contains in the human body. A disease is usually some sort of virus that enters into the human body and destroys human organs and tissues. There is not cure for the disease and the patient is soon going to die. Now that schizophrenia cannot be considered as a disease, it is still some kind of disorder because schizophrenics behave differently from the rest of the society. As a result, those who are considered “normal” think of ways to bring people with schizophrenia back to reality. These treatments cannot cure schizophrenia but instead, it can improve the long-term course of the illness. Various treatments used by psychiatrists includes: drug treatment with neuroleptics, biological treatments other than drugs such as notable electro convulsive therapy (ECT), psychological treatments, including psychotherapy, family therapy, behaviour therapy and self-control (cognitive therapy), and social treatments, including occupational therapy while in hospital and recommendations for a change in living style when outside hospital. Antipsychotic medications can prevent symptoms from returning but it cannot treat other symptoms such as social withdrawal and apathy. Also, there are some side effects to these medications, including dry mouth, blurred vision, constipation, muscle spasms or cramps, and tremors. One of the major side affects is tardive dyskinesia, a permanent condition when the lips, mouth, and tongue move without any control. Besides medications and therapies, family intervention programs exist which focus on the families of the schizophrenics instead of the patients themselves. This is particularly useful since family members can learn and understand how to cope with the patient and provide for them a low-stress environment and aiding them as much as possible. By looking at all the aspects of schizophrenia, it is very hard to believe schizophrenia is a type of disease. Different from AIDS or cancer that may lead to death, schizophrenia alone will not kill the patient. In contrast, schizophrenics become more gifted and inventive in their way of thinking. The inability of the “normal” people to understand the patients’ styles of presentation does not mean those patients are abnormal or have a disease. When viewing from their world, schizophrenics may think that the “normal” people are the ones who display bizarre behaviour. Schizophrenia can be called a disorder, a collection of socially learn actions, an illness but never called a disease.