My sister has schizophrenia, though her case is a bit unusual since she's had it since childhood, which is pretty rare. Most people develop schizophrenia between 15 and 30 years of age. I've talked quite a bit to a few such people too.
Schizophrenia is a psychological and neurological psychotic disorder affecting everything from thoughts to emotions to sensations. Its causes seem to be a combination of genetic predisposition and environmental causes. It is one of the most disabling illnesses of all types.
The two main characteristic markers of schizophrenia are Hallucinations and Delusions.
Hallucinations is when someone experiences something which isn't actually happening. It's the well-known "hearing voices" or "seeing things" stuff everyone knows about, though it can also affect any of the other senses (like touch, when for example a sufferer feels insects crawling on their skin). The important thing to realise about hallucinations is that by definition they are exactly as real, in every way similar, to experiencing "real" events. There's no qualitative difference between an hallucination and the real thing. Some schizophrenic people with auditory hallucinations, for example, will use a pet's reactions to gauge whether a voice or sound they are hearing is real or not: if the pet reacts to it too, then it's real, but if the pet shows no reaction at all, then it's probably an hallucination. On their own, they have no way to make the distinction. They can teach themselves to consider some recurrent hallucinations as "probably a hallucination", but it won't feel any less real nonetheless.
Delusions are strongly held, illogical, inflexible, and yet obviously false beliefs (obviously false to everyone else, I mean). The most commonly known delusions are the classic persecutory type, where someone believes, for example, that they are being monitored by the government via a chip implanted in their head, or that everyone else can read their thoughts, but there are all kinds of delusions possible. What matters is that the person absolutely believes them, cannot be convinced otherwise no matter how many logical, tangible proofs you show them (they will always find a way to explain away your "so-called proof"), and that the belief cannot be true.
Hallucinations and delusions are the main two positive symptoms of schizophrenia, "positive" here meaning "added", as in "something this person has that normal people don't have". A bizarre behaviour is another such positive symptom.
And then there are the negative symptoms, meaning the stuff "missing" from the person's life compared to normal people. In schizophrenia, these can be for example: a flat affect (hiding an actually extremely high sensitivity), lack of motivation, difficulty to experience pleasure, low desire for relationships of any kind, difficulty or inability to carry on even basic conversations (not answering questions, giving very brief answers, asking no questions of their own...) and so on.
The best-known feature of schizophrenia is of course the severe psychotic episodes pretty much all sufferers go through at least once, during which they more or less completely lose contact with reality. Their behaviour becomes completely erratic, their speech can go from disjointed to nothing more than an endless stream of incoherent sounds ("word salad" is an intermediate state where they still speak words, but these words don't make any kind of sentences, don't make sense together), they can become extremely agitated or on the contrary catatonic, and so on.
The positives symptoms tend to react well to medication, but most anti-psychotics can have strong side-effects, sometimes to the point of being so debilitating or painful that the person cannot endure taking them anymore.
I want to insist that schizophrenics are typically NOT dangerous - except to themselves. It can happen that a paranoid schizophrenic, during a psychotic episode, becomes violent towards others, but this is extremely rare. Far more often, schizophrenics will hurt themselves, either deliberately (including high rates of suicide attempts) or through lack of proper self-care. Moreover, schizophrenics are extremely susceptible to being abused, because their very poor social skills prevent them from properly discriminating between the people they can trust, and those they should stay away from. So very far from the popular image of the dangerous schizophrenic, the truth is that schizophrenics are actually very often *victims* of abuse and violence.
16 Sep 2015, 5:19 am
