Have you ever seen something that wasn’t actually there? Or heard a certain voice, but found no source for it on searching? If you have, you might have considered it as your mind playing tricks on you and forgot about it. Or you might have just concluded that it was a figment of your imagination. What if I told you that there are people who hear and see things which are not there in reality? As hard as it is to believe, such people do exist. Visual and auditory hallucinations are a part of a very serious mental illness and by writing this article I hope I can shed some light on it and why everyone should know about this disorder.
The disorder is called “schizophrenia” and it is characterized by abnormal social behaviour and an inability to understand what is real. It affects how a person thinks, feels and acts. It affects about 0.3-0.7% of the population. Schizophrenia is often confused with dissociative identity disorder, commonly known as the split-personality disorder, but it’s an entirely different mental disorder.
Symptoms of schizophrenia.
Symptoms of schizophrenia usually start to show between late adolescence and early adulthood. These include hallucinations (mostly auditory), delusions, and disorganized speech and thinking. They go through distortions of self-experience. This includes feeling as though their thoughts are not really theirs, believing that someone else is inserting thoughts in their mind.
There are positive and negative symptoms of schizophrenia. Positive symptoms are those that are present in people with schizophrenia and are not experienced by normal people. These include delusions, hallucinations (auditory, visual, tactile, olfactory and gustatory), and distorted thoughts. These symptoms generally respond well to medications.
Negative symptoms consist of deficiency of normal emotional responses or thought processes. These include lack of motivation, inability to experience pleasure, lack of desire to form relationships, flat expressions, little emotion, and poverty of speech.
Another feature of schizophrenia is deficiencies in cognitive abilities. The extent of these cognitive deficits can determine how functional the individual will be, their quality of occupational performance, and how successful they will be in maintaining treatment. The impact of deficits in cognitive function are seen in areas such as long-term memory, working memory, semantic processing, verbal declarative memory, learning, attention, and episodic memory. These deficits are usually found in individuals before the onset of the illness, a review of literature shows that these deficits may be present in early adolescence, or even as early as early as in childhood.
What causes schizophrenia?
Causes of schizophrenia include a combination of genetic and environmental factors.
Estimates of the heritability of schizophrenia are 80%. However, this estimate may vary because there might be difficulty in separating influences of genetic and environmental factors. The greatest risk factor is having a first-degree relative with schizophrenia. More than 40% of monozygotic twins of those with schizophrenia are also affected. If both parents are affected, the risk is about 50%, and if one parent is affected then the risk is at 16%.
Environmental factors include prenatal stress, drug use, and the living environment. About 50% of schizophrenic patients are known to use drugs or alcohol excessively. Some drugs, and to some extent alcohol, can result in a transient stimulant psychosis, or alcohol-related psychosis that presents very similar to schizophrenia. Cannabis is also a huge contributory factor in the development of schizophrenia and is a potential cause for those who are already at risk. Maternal stress is also associated with an increased risk of schizophrenia. Maternal nutritional deficiencies and maternal obesity have also been identified as potential risk factors for schizophrenia.
Diagnosis of schizophrenia.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) released by the American Psychological Association (APA), two criteria must be met over the time period of at least one month to be diagnosed by schizophrenia. The first is, the person has to be suffering from delusions, hallucinations, or disorganized speech. The second criterion is that the person should be suffering from negative symptoms or catatonic behaviour.
The primary treatment is antipsychotic medications, often paired with psychological and social supports. Voluntary or if mental health legislation allows it, involuntary hospitalization may occur for severe episodes. Long-term hospitalization is uncommon. Some evidence also indicates that regular exercise has a positive effect on the mental and physical health of those with schizophrenia. There are different types of services that can help a person with schizophrenia which includes case management, psychological rehabilitation programs, self-help groups, drop-in centres, housing programs, employment programs, and counselling/therapy. Although schizophrenia cannot be fully cured, the symptoms can be reduced to a great extent.
Contrary to popular belief, a vast majority of people with schizophrenia do not pose a threat to others and are not violent or dangerous. It is not caused by childhood experiences, poor parenting or lack of willpower. Positive and negative symptoms can differ from person to person. Schizophrenia is an actual disease and people suffering from it need to be given proper psychiatric help. They need a lot of love and support, and with proper treatment, they will be able to live an almost regular life.