Stress defined as "an internal state which can be caused by physical, social and environmental situations which are an appraisal by the body as potentially harmful and threatening. Here physical, social and environment situations are known as stressors.
Till 1930, stress was primarily used in the context of engineers and defined merely as a strain on a material object. There is still a confusion between stress as a "cause" versus "trigger" or stress as a trigger or a response. It has seen that same stressor produce different reactions in the different individual. This response depends on the coping behaviour of the individual which include defensive behaviour, information seeking behaviour, affiliative behaviour and problem-solving behaviour. The genetic and environmental factor also plays a vital role in determining the stress responses.
Other factors determining the effect of stressor are
1. Nature of stressor: acute or chronic one
2. The frequency of stressor: exposed to a single occasion or multiple times
Body response to the stress
Many systems, including neurotransmitters, (noradrenaline, dopamine and serotonin), hormones (CRH, ACTH, Cortisol), and the immune system involved in the manifestation of the stress response of the body. The overall impact of all these systems can be summarised as follows:
1. All these effects lead to the development of stress-related disorders, including major depression.
2. They decrease the cellular and innate immunity.
3. They increase the risk of cardiovascular disease like coronary artery disease, myocardial infarction, congestive heart failure.
4. Increases the risk of infections secondary to decrease in immunity.
Stress and psychiatric illness
Schizophrenia and other psychotic illness
Stress plays a significant role in the course of schizophrenia. The person with schizophrenia who resides with families with high expressed emotion has doubled relapse rate in comparison with family having low expressed emotions. Here expressed emotion refers to the attitude of the family member towards the person who has a mental disorder.
Stress and depression have a complicated interaction. There is a complex interaction between stress, environment factor and gene which determine the outcome.
Childhood adverse event like abuse, Interpersonal conflicts or serious illness in a close relative may trigger the onset of Panic Disorder and other Anxiety Disorder.
Posttraumatic stress disorder (PTSD) and Acute Stress Disorder (ASD)
PTSD develops after either experiencing or witnessing a life-threatening event or life-altering event. Its symptoms are flashback, nightmares and severe anxiety and intrusing thought about the event-mostly uncontrollable one.
Schizophrenia is a disease of the mind that is usually degenerative in nature. The complex disorder is generally characterized by symptoms, such as delusions, hallucinations (both auditory and visual) and disturbances in speech and is usually chronic in nature. The symptoms are not regular and can appear at any point of time. So it is highly possible that a person suffering from schizophrenia may sometimes bear resemblance to any other normal person and all of a sudden, might exhibit symptoms typical of Schizophrenia.
Symptoms which most people do not experience normally, but are found in people diagnosed with schizophrenia are said to be positive symptoms. They are:
These positive symptoms generally respond well to medications.
In addition to this, schizophrenics think and speak differently than the rest of the society. They jump from idea to idea, lose track of speech mid-way and often speak in fragmented and haphazardly joined sentences. They are, in fact, unable to fix their attention on anything in particular.
Examples of the most common negative symptoms include:
Schizophrenia is a psychiatric disorder in which a person’s mood, knowledge, thought and several other characteristics gets disturbed. We can notice most of the adults and old people with few symptoms of schizophrenia, which are most commonly left unidentified. The exact cause of schizophrenia is not yet known. The person feels that they are being constantly watched, they feel the presence of someone or something, which is not actually there. They are always suspicious and think that other people are gossiping and thinking about them.
Possible causes of Schizophrenia
Though the exact cause of schizophrenia is not known there are few factors, which contribute to the cause of schizophrenia.
Sings and symptoms of schizophrenia
Treatment for schizophrenia
Schizophrenia can be treated, if identified at an early stage. It is best advised to consult a psychiatrist the moment you spot the symptoms. Anti psychotic drugs, self help behaviour change, counselling and rehabilitation are few treatment modalities available for schizophrenia.
Schizophrenia affects over 1% of the world’s population and affects the way a person thinks, feels and behaves. In most cases, it is diagnosed when a person is between the ages of 16 to 25. This condition can be hereditary and is said to affect men more often than women. Schizophrenia is characterized by an inability to distinguish between real and imaginary which can lead to delusions, social withdrawal, hallucinations and other forms of social and occupational dysfunction.
Schizophrenia affects different people in different ways. On the basis of the type of symptoms exhibited, this disease has been categorized into 5 sub types. These are:
With schizophrenia, an early diagnosis can make treatment easier and hence if you notice anyone exhibiting signs of schizophrenia, you must advise them to seek medical help immediately. Schizophrenia cannot be cured but it can be managed with a combination of typical or atypical medication and cognitive therapy. The latter can be in the form of self-help groups, housing and employment programs, counselling and therapy.
Genetics is a fascinating subject which has received much attention during present times in the field of medical science as it gives the solutions to many a puzzle. The same applies to the hard to pronounce medical term ‘schizophrenia’ that refers to a mental disorder which disrupts the innate human ability to feel, express, behave, and think clearly.
The condition is a chronic illness, and the disorder may last for years or even a lifetime. Often considered to be the most disabling of mental illnesses, schizophrenia does not refer to multiple or split-personalities. It is more about psychosis where patients become unable to differentiate between reality and fiction.
How does the condition manifest itself?
The symptoms of schizophrenia are rendered into three categories. The positive signs include delusions, hallucination, movement disorders, and dysfunctional, and unusual ways of thought. The negative symptoms include the inability to experience happiness or pleasure in everyday life, reduced talking, and difficulty in sustaining or beginning any activity. While ‘positive’ means exaggerating certain behavior in this context, the term ‘negative’ does not imply bad behavior, but the absence of regular behavior patterns. Then follows the cognitive aspect (the subtlest behavior changes) which includes trouble in paying attention, or problems with using memory, etc.
What could be the possible causes?
There’s no specific reason that may cause schizophrenia; however, some factors play an important role in making a person have this mental condition. Various environmental factors are suspected to be responsible for the condition; these may include viral infections, excessive exposure to toxins like marijuana, extreme stress, etc. In some instances, schizophrenia can occur solely due to abnormalities or chemical imbalances in the brain. Experts note that a history of schizophrenia in the family tree can increase the risk of schizophrenia in future generations.
Who can develop schizophrenia?
Schizophrenia can develop at any age. However, it is during the teenage years or the 20s when the condition takes effect. Though rare, it can sometimes invade the minds of children below five years of age.
How can it be treated?
There’s no cure available for schizophrenia. However, the periods of recovery from this illness and its symptoms can be reduced through various possible treatments. These include medication and psychosocial therapy, supportive psychotherapy or cognitive behavioral therapy, electroconvulsive therapy, and psychosurgery. The administration of these procedures can reduce the chances of recurrence and relapse. Sometimes hospitalization may become necessary as a part of treatment to stabilize patients that do not have anyone to take care of them at home.
Modern medicine is yet to discover failsafe remedies for schizophrenia. Early diagnosis and treatment can reduce the condition in patients. Hospitalization can reduce the chances of a relapse and can prevent the mental condition from worsening. The moment any sign of schizophrenia is noticed, one is strongly advised to opt for psychological treatment. These actions can help to reduce disruptions in a patient’s personal and social life.
Schizophrenia has been recognized as a mental disorder that combines symptoms like hallucinations with distorted thinking and others like fright and severe paranoia. This condition is one that gets progressively worse over time and leads to delusional thinking. Oversleeping and complaining of fatigue are usually the earliest signs of this condition's onset. Eventually, it becomes a debilitating factor in the life of the patient, who will not be able to function in a normal way due to the severe symptoms.
Since the diagnostic criteria for schizophreniform disorder and schizophrenia differ primarily in duration of illness, the discussion of the differential diagnosis of schizophrenia also applies to schizophreniform disorder.
Brief psychotic disorder. Schizophreniform disorder differs in duration from brief psychotic disorder, which has a duration of less than 1 month.
Residual Schizophrenia is a condition where the patient does not experience the various debilitating symptoms of the condition, and is on the road to recovery. Yet, even in this type of Schizophrenia, the patient will not really show any interest in life and the activities around him or her. Finally, the last type of Schizophrenia is Schizoaffective Disorder which is characterised by the symptoms of Schizophrenia as well as the symptoms of major mood disorders. When combined, this condition can lead to major complications and complex behavior.
A patient suffering from this condition will need to see a mental health specialist like a psychiatrist or a psychologist on an immediate basis. The treatment will be carried out on a long term basis for the results to start appearing.
Schizophrenia is a debilitating mental and emotional condition that is characterised by a heavily distorted thought process as well as hallucinations and even extreme fear that borders on paranoia. Let us find out more about this debilitating disease:
This disease has a variety of symptoms include cognitive and emotional ones that can vary in the degree and severity. One of the most common symptoms included hallucinations and delusions where the patient may end up imagining things that do not really exist. The patient may also be gripped by sudden and crippling fear like paranoia, which can be debilitating as far as everyday functioning of the person goes. The symptoms can also interfere with the way a person deals with situations and life skills on a cognitive basis. Withdrawal and hopelessness are also a part of this disease.
The earliest signs and symptoms must be referred to a psychiatrist. The treatment involves the management of the case of an individual basis along with psychological rehabilitation programs and inclusion of the patient in self-help groups. Housing and employment programs must also be availed so as to keep the patient busy. Also, behaviour therapy will be required in such cases. The mode of counselling should usually be on a one on one basis, although many doctors also suggest that group therapy can help in showing examples of progress so as to encourage the patient to change and get a new lease of life.
There are a number of mental disorders and conditions that may affect the psyche of a person, due to various reasons including hormonal changes, environmental factors and even genetic conditions. Paranoid Personality Disorder is one such condition that gives rise to eccentric behavioral patterns. This may make the patient seem odd or even strange to others. Here are the signs, causes and various forms of treatment available for this condition.
Schizophrenia is a mental disorder which is characterized by disturbed mental thoughts in the patient, paranoia, phobias, hallucination, slow dementia and etc. As it is clear from this brief definition, Schizophrenia is a serious mental illness which can leave a patient stranded from performing basic day-to-day activities or even keeping healthy relationships with their close ones.
Even though there is no particular age where people are vulnerable from suffering from this disease, yet from a common observation and study conducted on the patients, it has been observed that schizophrenia hit men in their early 20’s and early 30’s in case of women. The study also feels that it is impossible for a schizophrenic to be of age younger than 12 or older than 40. According to another study conducted by the universities, the life of a schizophrenic patient is not guaranteed.
Symptoms of Schizophrenia:
As mentioned above, there is a common pattern in each schizophrenic patient, however, it is next to impossible to diagnose schizophrenia in teenagers since the onset of the disease is symbolized by the patient's constant change of friends or decrease of performance in school, both of which is normal in teen years. Schizophrenics also isolate themselves and become moody which again, is a common instinct of the teenager. However, apart from these, there are other differentiating symptoms as mentioned below which help in the accurate diagnosis of the disease.
Causes of Schizophrnia
According to the researchers, there are more than one reasons for this disease. Read them all below:
As it was mentioned above, there is absolutely no way to cure schizophrenia known to man as of yet. However, the only way to approach it medically is by managing its symptoms separately. Such as:
Schizophrenia is a severe mental illness that leads people to interpret reality in an abnormal way. People with Schizophrenia experience hallucinations, get false illusions, and display an unusually disordered behaviour, which negatively impacts their daily life .
Schizophrenia is a serious condition that requires treatment for a lifetime. Early diagnosis and treatment can keep symptoms under control and prevent any serious complications from building up.
Schizophrenia is mainly associated with cognitive problems that is exhibited in a person's daily behavior or state of emotions. Though there may be difference in signs and symptoms across patients, but it majorly involves hallucinations, delusions, disordered speech, and impaired body functionalities. Common symptoms are:
- Delusions. These are false conceptions and interpretations of reality. For instance, a person with schizophrenia can have various delusions. He might think that he is targeted or harassed; he has supernatural abilities or power; he remembers his past life; or a huge tragedy is going to happen.
- Hallucinations. People with schizophrenia may see or hear things that do not exist. Such hallucinations have a powerful force and feel like a normal experience. Hallucinations can impact all the senses, but most commonly it is associated with hearing strange voices.
- Disordered thought (speech).Schizophrenia affects the cognitive abilities of a person. Often, it results in impaired speech ability and meaningless communication. People experiencing this ask questions that are partially or totally unrelated. Their speech is broken and without any clear sense or meaning.
- Highly disoriented motor behavior. Schizophrenia might lead people to behave weirdly. Sometimes, they may show childlike absurdity to episodic aggressiveness. The behavior is erratic and without any intention. You may notice people suffering with schizophrenia showing resistance to instructions, improper or eccentric posture, irresponsible reactions , or silly and unnecessary movement.
- Negative/withdrawal symptoms. This happens when there a person shows lessened or resistance to function normally. For instance, the person may disregard personal hygiene or be immune to any kind of emotion; does not respond to eye contact, shows no facial expressions or talks in a monotone). The person may withdraw himself from the society and refuse to part take in daily activities. Such persons are incapable of finding happiness in any thing and remain negative towards life.
Symptoms differ in form and severity and may change over time, sometimes with worsening show of symptoms and sometimes showing reduced impact. However, they do not go completely.
Men with schizophrenia may show signs of the disorder in the early to mid-20s. Women start displaying the impact of the mental condition during their late 20s. The mental illness is rare in children and those who are aged 45 and above.
Symptoms in teenagers
Teenagers with Schizophrenia may have symptoms same as that of adults, though it might be difficult to identify the condition in teenagers as in adults . This is because a few of the early signs of schizophrenia in teenagers are usually the same as seen during the typical growth in teen years and noticeable change in behavior, like:
- Withdrawal or secrecy from friends and family
- A low performance in studies
- Difficulty in sleeping
- Irritability or erratic mood
- loss of motivation
In comparison to adults with schizophrenia, teens may not have symptoms like delusions. But teens might have visual hallucinations.
The real or exact cause of schizophrenia is not known. However, according to various researches and studies, a variety of factors like genetics, brain chemicals and external surroundings may lead to the development of the mental disorder.
It is believed that difficulties associated with some naturally occurring brain chemicals, like neurotransmitters called dopamine and glutamate, may develop into schizophrenia. According to neuroimaging studies, there are visible differences in the chemical component and structure of brain and certain imbalances in the central nervous system of people diagnosed with schizophrenia. Though researchers are not sure whether these changes or differences are of any significance, yet they stress that schizophrenia is a brain disorder.
The exact cause of schizophrenia is unknown, but there are some factors that may increase the risk of developing or inhibiting this mental disorder called schizophrenia. They are as follows:
- A known family history of schizophrenia
- Heightened immune system activation, emanating from inflammation or autoimmune diseases
- very old age of the father
- Few pregnancy and birth related complications, like malnutrition or vulnerability to toxins or certain viruses that negatively affect brain development
- Certain cognitive (psychoactive or psychotropic) drugs taken during teenage and adolescence period
If not treated, schizophrenia can lead to serious problems that hamper the day to day life. Complications associated with schizophrenia may be as follows:
- Suicidal thoughts and attempts of suicide
- harming and injuring self
- Anxiety disorders
- Depressive nature
- Alcohol or harmful drug intake, excessive tobacco use
- obsessive-compulsive disorder (OCD)
- low attention span at school and in studies
- problems understanding legal and financial issues
- Social withdrawal
- Health and medical issues
- Feeling victimized
- Sporadic bursts of aggressive or bizarre behavior
A proper diagnosis of schizophrenia will involve looking out for and ruling out any other mental state illness and determining whether symptoms are due to drug abuse, excessive alcohol intake, substance abuse or any other health condition. Determining a diagnosis of schizophrenia may include:
- Physical diagnosis. This is necessary to find and rule out any other issues behind the occurrence of the said symptoms and to determine any near complications.
- Clinical Tests and exams. All such tests and screenings may be done to aid ruling out similar symptoms for other medical conditions and checking for alcohol and drug abuse. The physician may call out for an MRI or a CT scan.
- Psychiatric evaluation. A person with symptoms of schizophrenia may be checked upon by a psychiatric or mental health professional for determining the mental order of the patient. The doctor will check the physical behavior and emotional conduct and discuss the patient's thoughts, mental state, experiences of delusions, hallucinations, drug abuse, and chances of for aggressive moments or suicidal attempts. This even involves finding out family and personal history of similar conditions .
Schizophrenia is a severe mental condition that necessities lifelong treatment, even though symptoms may subside. Medical attention and treatment coupled with psycho-social therapy can help keep the condition under control. In few cases, hospitalization might be necessary.
Treatment involves regular consultation with a psychiatrist having experience in dealing with patients of schizophrenia . Apart from that, the patient will require a social worker, a psychiatric nurse and often a case manager to manage the overall treatment and care. Treatment of schizophrenia involves a full-fledged team approach with expert clinical experience.
No patient diagnosed with schizophrenia can be treated without medications. Most commonly, antipsychotic medications are prescribed. They are meant to control common symptoms by impacting the brain neurotransmitter dopamine. Medications for schizophrenia are known to have various side effects, so patients of schizophrenia often refuse to take them. Often, there is reluctance to such medications and long-term treatment.
First-generation antipsychotics: TSuch antipsychotics are known to have frequent and highly significant neurological side effects that sometimes may lead to a motor disorder (tardive dyskinesia). This condition is non-reversible and dangerous. The most commonly prescribed first-generation antipsychotics include:
Second-generation antipsychotics: These are comparitively newer and safer medications that are usually preferred by many doctors. They have lower risks and possibilities of side effects as compared to first-generation antipsychotics. The common second-generation antipsychotics are:
- Asenapine (Saphris)
- Cariprazine (Vraylar)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Brexpiprazole (Rexulti)
- Quetiapine (Seroquel)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Paliperidone (Invega)
There is no sure formula to prevent schizophrenia, but continuing with the treatment can help manage and control the disease from worsening or aggravating. Apart from this, one can try and know the risk factors for schizophrenia to call for early diagnosis and treatment.
Myth 1: People with schizophrenia are harmful and dangerous to be around.
Fact: There may be times when people with schizophrenia act erratically or behave weird, but generally very few are violent. Moreover, people undergoing treatment are less likely to be violent. If people with this mental disorder turn violent, it is because of an underlying condition, such as childhood behavior issues or substance abuse.
Myth 2: Lack of good parenting causes schizophrenia.
Fact: Schizophrenia is a brain related illness. It has unknown causes. Various factors like genes, tragedy-aftereffect, and drug abuse can trigger the disease. Parenting has nothing to do with the development of the disorder.
Myth 3: People with schizophrenia should be admitted in a mental hospital.
Fact: It is not true completely. There are a few cases where patients need to stay at a meental health facility. Commonly, patients of schizophrenia stay with family or in supportive facilities within the society.
Myth 4: A person can never recover from Schizophrenia.
Fact: Schizophrenia is a long term illness, but nothing is impossible. With proper treatment, medications and psychiatric therapy, it is possible that around 25% of people suffering from the disorder will recover . Again, about 50% cases show improvement in their symptoms. With managed care, people with Schizophrenia can live fully normal lives.
Myth 5: Schizophrenia is like having a split personality.
Fact: This is the most common myth about schizophrenia. A split personality is a condition medically termed as Dissociative Identity Disorder or a Multiple Personality Disorder. There are rare cases of MPD or DID. But, Schizophrenia is a cognitive illness, relating to the thinking ability of a person and is vastly different from the split personality disorder.
Question 1: What are the different types of Schizophrenia?
Answer: The following are the different forms or types of schizophrenia:
- Paranoid schizophrenia
- Residual schizophrenia
- Disorganized schizophrenia
Question 2: Is Schizophrenia curable?
Answer: Not exactly. There is no permanent cure for schizophrenia but one can get treated for the same. With proper care and treatment, psychiatric therapy and social rehabilitation, people with Schizophrenia can lead a fully normal life.
Question 3: Can substance abuse cause Schizophrenia ?
Answer: Not known. Schizophrenia is a mental condition that is still under research and studies. The causes of it are not yet fully deciphered. There are a variety of factors including genetics, environment and other substance and drug abuse factors that can lead to the disorder. Some people are born with problems in the brain chemicals, which can get accentuated or triggered by substance abuse.
Question 4: What is the future of people with the disorder?
Answer: Though significant developments have been made in research and studies on schizophrenia but still it is not clear why some patients have worsening symptoms than others; why some patients do not recover fast and why some people fail to respond to the given treatment and medication. However, there are also positive results in many cases where people have responded well and recovered with the right treatment, rehabilitation, and social support and care.
Question 5: Are Schizophrenia Patients Depressed?
Answer: Depression is common in patients with schizophrenia. In fact, depression is a primary effect that is seen in schizophrenic patients. About 80% of people with this mental disorder get notable depressive attacks.
Question 6: Are there any chances of relapse?
Answer: Medication can help control symptoms to an extent; however, there is no guarantee that a relapse will not occur. Though majority of the medications are known to lessen the occurrences of relapse by up to 80%. TO counterfeit, doctors prescribe secondary medications that are particularly meant to control depression, anxiety, or psychological attacks.
Question 7: Is there any therapy apart from medicinal treatment?
Answer: Yes, additional therapy is necessary . Support and counseling from family and society works like psychotherapy. Sessions of psychotherapy usually stress the emotive and functional effects of the illness, and how the family and near ones can help in managing the illness. The therapy involves discussion over the signs and symptoms of the disorder, the nature of relapse, the role of sticking to medicines and the possible side-effects, recognizing and living with the symptoms, behavior with family members or colleagues, or continuing with a job or school. There are many programs designed specifically to address rehabilitation and practical abilities.
Question 8: Is it possible for a person with schizophrenia to lead a "normal" life?
Answer: If appropriate treatment, social rehabilitation, psychotherapy and adequate family support is provided, it is easier to manage and control symptoms in schizophrenic patients. There are many examples of people leading an independent life with families, routine jobs, and social involvement.
Question 9: How to manage depressive symptoms in schizophrenic patients?
Answer: To help patients manage depressive symptoms of Schizophrenia, you can do the following:
- Mingle and involve with them rather than leaving them alone.
- Put them on an antidepressant drug after consulting with their doctor managing their disorder.
- Supplement their medication with proper nutritional diet.
- Help them engage in regular physical exercise.
- In cases of severe depression, consult with their psychiatric for electroconvulsive therapy or transcranial magnetic stimulation.