Schizophrenia describes a condition that changes how a person thinks, feels and behaves. It also changes how they perceive the world, themselves and other people. About 1% of the population have a diagnosis of Schizophrenia.
The early phases of Schizophrenia may display changes in behaviour such as eccentric traits, becoming unmotivated, emotionless, and reclusive. The person may become isolated, neglect their appearance, say strange things and show an indifference to life. They may lose interest in hobbies or activities and work or school performance may deteriorate. Symptoms usually begin between 16-30 years of age and symptoms are more common in men than women.
The symptoms of disorders such as Schizophrenia may vary between people who have been diagnosed with Schizophrenia. They may be mild or severe. Some people have one single episode whereby they experience symptoms consistent with the diagnosis. Others have more frequent episodes but remain well for extended periods. However, a proportion of people may experience unrelenting symptoms that cause a great deal of distress and may require ongoing support and treatment.
Medication is usually a central part of the treatment. Counselling, social support, and assistance with employment, accommodation, finances and education are also important in assisting a person and their family to cope and manage the illness.
Symptoms associated with Schizophrenia
The symptoms associated with Schizophrenia encompass a range of experiences that result in cognitive, behavioural and emotional impairment. There are groups of symptoms associated with Schizophrenia and generally should be noticeable and present for at least 30 days. A person must display at least two of the symptoms for a diagnosis of Schizophrenia to be considered.
Known as psychotic or active symptoms that reflect a distortion of normal functioning and include the following:
These are false personal beliefs that are held with extraordinary conviction despite clear evidence to show otherwise. They may involve bizarre, or illogical thoughts and fantasies. Delusions may be paranoia, someone is out to get him or her, reference of an environmental event that is believed to have personal meaning such as messages delivered through a billboard or television, delusions of grandeur, believing that one is famous or an important figure such as God, Jesus or another historical reference, control, belief that one’s thoughts or actions are controlled by outside forces, such as being transmitted to others.
These refer to sounds or sensations experienced as real when they exist only in the person’s mind. The most common are auditory hallucinations, e.g hearing voices or another sound. Hallucinations may also be visual or a smell that the person experiences.
Grossly disorganised or Abnormal Motor Behaviour (including Catatonia)
Disorganised or abnormal motor behaviour encompasses a broad range of possible behaviours, ranging from childlike to unpredictable agitation, and will have an impact on the person’s ability to carry out goal directed tasks and day-to-day functioning, such as impairments to care for themselves, their work and the ability to interact with others.
Disorganised thinking (speech)
Fragmented thinking may be observed in the manner in which the person speaks. People with Schizophrenia may have difficulty concentrating and maintaining train of thought. They may respond to questions with unrelated answers, or move from one topic to another in mid- sentence, or speak incoherently and say illogical things.
The absence of normal behaviours found in otherwise healthy individuals. Symptoms may include the following:
Lack of emotional expression or Affective Flattening
This may be unchanging facial expression, poor or no eye contact, reduced body language and spontaneous movements. The person may stare vacantly into space.
Loss of motivation or Avolition
The person may have decreased motivation and lack of interest for activities that previously interested them. There may be a lack of energy and difficulty in making decisions or completing tasks including school or work.
Speech Difficulty or Alogia
This may display an inability to carry on a conversation, or to appear disconnected and lack of response to questions, possibly speaking in monotone or flat tones.
Loss of Feeling an Inability to Experience Pleasure or Anhedonia
The person may show lack of interest in social or recreational activities and have difficulty forming close relationships. Simple pleasures that were enjoyed are no longer enjoyable. They may also spend time alone and not enjoy being with other people.
Other Effects of Schizophrenia:
Paranoia and isolation may effect a person’s relationships. They may become suspicious of family and friends.
Drug and Alcohol Abuse
Some people with Schizophrenia develop problems with substance abuse in an attempt to self-medicate or relieve their symptoms. They may be heavy smokers. Any substance use can interfere with the effectiveness of prescribed medications.
Increased Suicide Risk
People with Schizophrenia may have a higher risk of attempting suicide. Any threats or talk of suicide should be taken seriously. Risk is higher during psychotic episodes and periods of depression, and in early stages of treatment.
What Causes Schizophrenia?
The causes of schizophrenia are not yet clearly understood although a combination of factors is seen as the most likely. These include biological, psychological, social and environmental factors. A full medical history will be taken by the doctor to check for other medical problems that may be causing or contributing to symptoms.
What Help Is Available?
The symptoms of Schizophrenia can be a very distressing and debilitating experience. It is important to realise you don’t have to deal with it on your own. There are a range of supports that you can access if you need them.
Antipsychotic medication is usually prescribed for someone with Schizophrenia. These types of medication may help to control the symptoms, particularly delusions or hallucinations that a person may experience.
Because each person is different, the effects of medication can differ significantly. Treatment options should be explored with a psychiatrist on an individual basis. If you are unhappy with your medication you have a right to have this reviewed. Several medications are currently available for Schizophrenia.
Rehabilitation services can assist the person to find and maintain accommodation, education, and employment. They are able to assist with developing social skills and reintegrating to the community.
Cognitive Behavioural Therapy (CBT)
CBT can be useful in helping someone learn ways of managing their symptoms. This is generally provided by a trained psychologist. Supportive counselling may also be beneficial.
This may be necessary at times if the person becomes unwell or their medication needs to be changed or stabilised.
Support groups offer people with schizophrenia and their families the opportunity to meet those in a similar situation, share experiences, find support, education and reassurance.
Learning about the illness is useful in helping to understand your experiences and reduce stigma.
How Relatives and Friends Can Help
- Be consistent, even when your loved one is struggling to engage with you or in activities they would have previously enjoyed
- Learn more about the illness by joining an organisation like the Schizophrenia Fellowship
- Share your experiences of caring with the professionals treating your relative
- Encourage your relative to comply with medication
- Have important phone numbers ready in case you need them, e.g. the crisis team or other friends who can help
- Discuss the person’s early warning signs and decide what to do if they seem to be deteriorating
- Develop a plan with the person when they are well, about how they would like things to be done if they become unwell again.
- Take time off from your caring role when you can to refresh and look after yourself
Talk to Someone
Remember that many people learn to manage their schizophrenia well and carry on normal functioning lives. Don’t let misconceptions about mental illness stop you from seeking help.
- Contact the Mental Health Information Service on 1300 794 991 for information about services in your area.
- Maintain regular contact with your local doctor (GP) as they will play an important role in monitoring your general health
- Ask your GP for a referral to a psychiatrist
- Contact your local Community Mental Health Centre
- Contact the Schizophrenia Fellowship of NSW on (02) 9879 2600 www.sfnsw.org.au