Schizophrenia Treatment, Causes, and Symptoms
What is Schizophrenia?
The way you interact with and perceive your surroundings can have a huge impact on your life. So, what happens if you perceive things that aren’t really there? Or believe in things that aren’t true? You’ll likely face difficulties in completing even the simplest of tasks. That’s how you feel with schizophrenia, a mental disorder that causes you to develop psychotic symptoms. Nevertheless, seeking appropriate treatment is important if you or a loved one is struggling with schizophrenia. Let’s discuss the symptoms, causes, and available treatment options to help you start your journey to recovery.
It’s a mental disorder characterized by psychotic symptoms like hallucinations, delusions, and disorganized speech and behavior. You also experience negative symptoms like restricted expression and inappropriate emotional responses. It’s a debilitating condition that can significantly impact your quality of life and relationships with others. That’s because you cannot tell what’s real and what’s not, leading to inappropriate responses to situations.
Compared to other disorders, schizophrenia is a rather rare condition, and according to the National Institute of Mental Health, it affects less than 1 percent of the US population. The report shows that most people are diagnosed with the condition between late adolescence and early thirties. However, men tend to develop it earlier, around adolescence and early twenties, than women. In terms of gender, both men and women develop the condition at equal rates.
Symptoms of Schizophrenia
A defining characteristic of schizophrenia is that it causes major impairments in how you behave and perceive reality. Symptoms include:
- Hallucinations: seeing, hearing, or feeling things that aren't there
- Delusions: rigid beliefs about something being true, even when there's evidence to the contrary
- Feeling like you're being controlled or influenced: you may feel like your thoughts, actions, and feelings aren't your own. Rather, you think that they're being placed inside your mind, are visible to others, or are being extracted by outside influences.
- Disorganized thinking: it manifests in the form of irrelevant or jumbled speech.
- Engaging in purposeless or bizarre behavior or displaying unpredictable emotional responses that are inappropriate for the situation.
- Showing negative symptoms: these can include social withdrawal, lack of interest in activities, restricted expression of emotions, and limited speech.
- Psychomotor agitation or retardation
Due to these symptoms, you may experience problems with problem-solving and other cognitive skills, like attention and memory.
Causes
Researchers have not yet determined the exact cause of schizophrenia, but most studies show that it occurs due to a combination of genetic, environmental, and psychological factors. It’s possible that you’re predisposed to developing schizophrenia, and a stressful experience leads to a psychotic episode.
Genetic predisposition:
You’re more likely to develop schizophrenia if a sibling or parent has experienced psychotic symptoms. Therefore, it’s possible to develop the condition if it runs in the family.
Neurotransmitter imbalance:
Studies show that having schizophrenia is associated with differences in the brain’s neurotransmitter levels. This reasoning is based on the fact that psychiatrists prescribe medications that lower neurotransmitter levels, which helps alleviate symptoms.
Changes in brain development:
Studies on the brain structures of people with schizophrenia indicate subtle differences. These include smaller volumes in areas like the thalamus, amygdala, and hippocampus.
Although the above factors can increase your risk of developing the condition, they don’t guarantee it. Rather, exposure to certain triggers, such as a highly stressful event, can cause you to start showing symptoms.
Inpatient Treatment for Schizophrenia
When you’re struggling with psychotic symptoms, you require the assistance of a community mental health team. In most cases, residential treatment at a mental health center like URP Behavioral Health is the best approach to addressing schizophrenia. It’s a long-term approach that involves intensive care and assistance from certified practitioners and registered nurses.
Not to mention, it’s beneficial because family members usually lack the awareness or professional knowledge required to support you during treatment. When you approach a treatment center to enroll in a residential program, you’ll have to go through an evaluation and diagnosis.
Pretreatment Evaluation
Medical Assessment
First, your physician will perform a medical assessment, which involves looking at your medical records. This is to get a detailed look at your medical history and determine whether you have any preexisting conditions. They’ll also take a few tests to check if you’ve taken any substances or alcohol. By doing so, they can rule out the possibility of your symptoms occurring because of a medical condition or substance abuse.
Psychiatric evaluation
Then, your mental healthcare provider will perform a psychiatric evaluation. It can involve talking to you about your symptoms and changes you’ve experienced. They may also speak to your family members and friends to get a clearer picture of your symptoms and degree of impairment in day-to-day functions. This is important to help them rule out the existence of another mental illness that could be causing the symptoms.
Diagnosis
Lastly, they will compare your symptoms and the timeline of your condition against the criteria provided in the Diagnostic and Statistical Manual of Mental Disorders. It’s published by the American Psychiatric Association and helps mental health professionals confirm a diagnosis. Your psychiatrist will also refer to the manual to differentiate your condition from other disorders that have similar symptoms.
Schizophrenia Treatment Options
Treatment in a Hospital or Clinic
One of the first options for treatment involves seeking inpatient care at a hospital or clinic. When you have schizophrenia, psychotic symptoms can increase the risk of self-harm or aggressive behavior. It’s a much more effective approach than staying at home because you’ll be under constant supervision and receive round-the-clock care. Moreover, you also get the opportunity to learn about your symptoms and how to manage them.
Psychotherapy for Treating Schizophrenia
This involves techniques that are designed to treat mental disorders by talking to a mental health practitioner. Commonly known as talk therapies, the most popular evidence-based psychotherapies for schizophrenia include:
Cognitive Behavioral Therapy
Research indicates that CBT is effective for addressing symptoms in the prodromal stage, as well as impairment in general functionality. Moreover, mental health practitioners are looking into its potential uses for managing positive and negative symptoms. Cognitive behavioral therapy has the potential to address impairments in functioning that occur as a result of negative symptoms. The reason it’s now a part of various treatment plans is that some negative symptoms can be unresponsive to antipsychotic medication.
Similarly, having schizophrenia can make you susceptible to mood disturbances and anxiety, both of which can be addressed using CBT. During this form of therapy, you’ll work with a therapist to identify and challenge distorted perceptions. You’ll also learn healthy ways to cope with symptoms, and your therapist will encourage you to practice these skills in different environments, such as with other residents or family members. With time, you’ll be able to control how you respond to symptoms and can use the skills you’ve developed to manage basic functions. Research indicates that people who received CBT for schizophrenia showed a faster rate of improvement in positive symptoms.
Individual Psychotherapy
Individual psychotherapy is one of the most basic forms of therapy used for different mental disorders. In these sessions, you’ll be in one-on-one sessions with your therapist, discussing your symptoms, thoughts, and behaviors.
Your therapist will build a rapport with you so you feel safe and comfortable while talking about your condition. Other components of individual psychotherapy include discussing the effects of your illness and helping you navigate the issues you experience as a result of your condition.
Psychosocial Therapy to Treat Schizophrenia
The purpose of psychotherapy is to help you build a rapport with your mental health care provider. Once you talk to them about your issues and gain some insight into your condition, you can attend psychosocial therapy sessions.
Keep in mind that once you leave an inpatient treatment center, you’ll need to return to your family and close friends. Therefore, psychosocial techniques are useful for learning how to be a member of a community and adjust to different social situations.
Group Therapy
When you have schizophrenia, it’s common to become socially withdrawn and emotionally restricted. Attending group therapy sessions gives you a chance to work on your social skills and surround yourself with people who share similar struggles. It also acts as a source of support, which can ensure medication compliance and treatment adherence for better outcomes.
Skills Building
At residential treatment programs, the goal is to help you live a fulfilled life rather than just being able to manage symptoms. It’s why most inpatient treatment programs have skill-building initiatives that are designed to improve your social, emotional, and intellectual functioning. Some examples include communication and vocational training, which encourage you to feel confident in your ability to manage things without much assistance.
Family therapy and Psychoeducation
For an effective treatment plan, family-focused therapy is crucial to ensure that you have a source of support once you go back home. In family psychoeducation sessions, your therapist will help you and your family build the necessary skills to collaborate whenever a problem occurs. At the same time, this form of therapy will help your loved ones navigate through the stress and struggles they face due to your diagnosis.
Schizophrenia Medications
Regardless of which specific therapies your mental health practitioner recommends, it’s likely that they’ll prescribe medication for your symptoms as well. Taking medication can alleviate psychotic symptoms and make you more responsive to therapeutic interventions. Generally, medications for schizophrenia fall into two main categories: typical and atypical antipsychotics.
Newer Antipsychotic Medications
Commonly referred to as atypical antipsychotics, these second-generation drugs have a lower risk of causing extrapyramidal symptoms. They work differently than their predecessors because they only partially block dopamine receptors while affecting other neurotransmitters, such as serotonin.
First-Generation Antipsychotic Drugs
The main function of typical antipsychotics is to block dopamine receptors to alleviate symptoms. They’re also known as neuroleptics because of the effects they cause, namely emotional quieting and slowed psychomotor responses. When first-generation antipsychotics were first developed, clinicians considered these symptoms to be signs that the medication was working.
Treatment-Resistant Schizophrenia
Treatment-resistant schizophrenia is when positive symptoms (hallucinations and delusions) persist despite completing two or more trials of antipsychotic medication. The condition differs not only from treatment-responsive schizophrenia but among other people with treatment-resistant schizophrenia as well.
Currently, one of the few treatments used in the case of treatment-resistant schizophrenia is the second-generation antipsychotic, clozapine. It works as an agonist to serotonin and dopamine receptors to alleviate delusions and hallucinations.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8498814/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530284/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852683/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181651/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/
- https://pubmed.ncbi.nlm.nih.gov/20620888/
- https://www.nimh.nih.gov/health/topics/schizophrenia
- https://www.who.int/news-room/fact-sheets/detail/schizophrenia
- https://www.samhsa.gov/mental-health/schizophrenia
- https://www.rcpsych.ac.uk/mental-health/problems-disorders/schizophrenia
- https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020212
FAQ for Schizophrenia Treatment
Here are some of the most common questions people ask regarding schizophrenia treatment.
Psychosis is when you experience a disruption in your interpretation of reality. It’s a symptom of schizophrenia, as well as other mental health disorders. Therefore, someone could experience psychosis but never be diagnosed with schizophrenia. In schizophrenia, you show symptoms like disorganized behavior and speech, impaired function, and decreased emotional expression.
Both mental illnesses have overlapping symptoms and can develop as a result of a traumatic experience. However, they are separate conditions and fall under different categories in the DSM-5. Schizophrenia is part of the schizophrenia spectrum, while dissociative identity disorder is a dissociative disorder. Although the latter may include psychotic symptoms, you have multiple personalities and experience lapses in memory, which doesn’t occur in schizophrenia.
Based on statistics by the World Health Organization, the condition affects about 24 million people worldwide. That’s 0.32 percent of the population or 1 out of 300 people. Among adults, this rate increases to 0.45 percent, with one person out of every 222 people developing the condition. Considering these statistics, it’s clear that schizophrenia isn’t as common as other mental disorders. However, symptoms such as psychosis can occur as part of other mental health conditions. In some cases, individuals can experience psychotic symptoms without ever being diagnosed with schizophrenia.
Schizophrenia can affect emotions, behavior, and even cognition. Some common symptoms of schizophrenia include lack of motivation, trouble thinking, disorganized speech, and delusions. All of these symptoms of schizophrenia can significantly affect how an individual functions. Therefore, you may be unable to take care of basic hygiene or maintain a consistent lifestyle, which is crucial for physical health. One study indicates that people with schizophrenia have a higher risk of physical conditions such as cardiovascular disease, metabolic syndrome, diabetes, abdominal obesity, and weight gain.
The schizophrenia spectrum is a category of psychotic disorders in the fifth edition of the Diagnostic and Statistical Manual by the American Psychiatric Association. It includes the following disorders:
- Schizophrenia: Includes hallucinations, delusions, restricted emotional expression, disorganized speech, and disorganized behavior.
- Schizoaffective disorder: includes hallucinations, delusions, and mood symptoms, such as depression.
- Schizophreniform disorder: impacts your perception of reality, how you express emotions, and how you think and act. It lasts for less than six months rather than your entire lifetime.
- Brief psychotic disorder: it involves the sudden onset of psychotic symptoms like hallucinations and delusions, which last less than a month.
- Delusional disorder: the main symptom of this disorder is that you experience one or more delusions.
- Schizotypal personality disorder: it’s characterized by intense discomfort with social interactions and relationships with others.
In most cases, schizophrenia develops slowly. Your level of functioning will slowly decline before you experience the first episode. Some common early signs include:
- Social withdrawal
- Making odd statements or speaking strangely
- Insomnia or excessive sleeping
- An inability to concentrate
- Either inappropriate crying/laughter or restricted emotional expression
- Flat gaze
- Poor personal hygiene
- Suspiciousness or hostility
It’s possible that these signs are the result of another disorder rather than schizophrenia. Regardless, you should see a healthcare provider and look into treatment options.
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