Schizophrenia Mental Disorder - Coursework Example

Schizophrenia Introduction Schizophrenia is an often misunderstood mental disorder that causes those afflicted to hear "voices in their head" and/or believe others are "reading their minds" with the intention of doing them harm. Its a severe, disabling illness that can be frightening and cause people to be agitated or withdrawn, sitting motionless for hours on end without speaking. When they do talk it may seem like gibberish, nonsensical speak. They may also appear perfectly normal until they do speak regarding their thoughts which is anything but normal conversation. The disease also affects family members who must care for those afflicted because rarely are those afflicted able to care for themselves or secure employment. Though incurable, the symptoms associated with schizophrenia can be managed with treatment. Some are able to function in society and lead meaningful lives if symptoms arent too sever and are effectively managed. While in not-too-distant past the disease was thought to be proof of demonic possession, today, medical research has uncovered medications to help control symptoms and enabled a better understanding of its causes. History The Middle Ages were not an enlightened era. The treatment of the mentally ill was seldom based on a scientific approach. Though educated persons had developed theories regarding care and therapy for those afflicted, the general population, along with those in power, generally resorted to less than compassionate or rational methods. The mentally ill were essentially warehoused in isolation, away from the public. Some fortunate souls found sanctuary in monasteries. Spain was unique in that it provided hospitals designed specifically for this purpose but the majority of Europe wasnt as progressive. Those with mental disabilities were largely assumed to be possessed by the Devil. "In 15th century Europe, delusions and hallucinations were seen as proof of demonic possession. Treatments to overcome these disturbances included confession and exorcism." (Divine, 2014). During the 1800s, German psychiatrist Emil Kraeplin used the term "dementia praecox" meaning "dementia of early life" to describe a range of mental illnesses. Kraepelin mistakenly assumed that the mental disease occurred only in younger people and that it predictably led to a decline in mental faculties. Kraeplin would later identify nine categories of dementia praecox. In 1910, Paul Eugen Bleuler, a Swiss psychiatrist combined words of Greek origin "schizo" meaning split and "Phren" meaning mind. Misconceptions To this day, the term schizophrenia is improperly thought to mean "split personality." Bleuler had meant the term to describe a disassociation or, in his words, a "loosening" of the thought process which he thought was a main characteristic of the illness. In 1886, the fictional book The Strange Case of Dr. Jekyll and Mr. Hyde by Robert Louis Stevenson helped further the split, or multiple personality misconception, a condition that is completely different than schizophrenia. Those with schizophrenia hear voices that are not their own but do not change personalities to reflect a different individual. Bleulers intention was to replace Kraeplins concept with a more accurate description of the illness. However, the term "schizophrenia" did little to clear-up confusion regarding the condition. In fact, Bleuler thought schizophrenia assisted in heightening consciousness of experiences and memories. Even today the term schizophrenia is often used to describe "unpredictable" and "changeable" behavior which has perpetuated a gross misunderstanding of the condition. Even when used correctly, the term "schizophrenic" does little more than label a person according to an illness, implicitly diminishing him or her to little more than that illness." (Burton, 2012). Subtypes There are various subtypes of schizophrenia. The most well-known of these is Paranoid Schizophrenia, a condition which is associated with deluded thoughts and hallucination. Sufferers can become hostile rapidly if they think they are being conspired against or threatened. Disorganized Schizophrenics, as the term implies, have trouble organizing thoughts and habits that are simple, daily routines to most people. They may have difficulty getting dressed and grooming themselves. Their speech patterns may also be disorganized and incomprehensible. Catatonic Schizophrenia is a condition involving bodily movements. Those afflicted will, at times, repeat the same pointless, unusual movements. They may imitate other persons body movements or continue to compulsively repeat what they say. These behaviors are also consistent with Tourette syndrome. Undifferentiated Schizophrenics may display any or all other subtypes of the disease with no obvious pattern. For instance, at times the sufferer may show signs of catatonic schizophrenia but other times and without warning display paranoia symptoms. People who are classified with Residual Schizophrenia show declining symptoms. They are getting better with time though continue to display signs. People with all types of the illness as well as all levels of severity will likely decline unless treated. Those who are have a much greater chance to live a more independent life. ("Living," 2010). Causes Damaged neurotransmitters, the brains information highway, while still in the womb along with related chemical imbalances is currently thought to be connected with the progression of schizophrenia symptoms. "Developmental neurobiologists have found that schizophrenia may be a developmental disorder resulting when neurons form inappropriate connections during fetal development." (Smith, 2013). Symptoms related to the damage may not become apparent until the teenage years when naturally occurring brain growth reacts negatively with the damaged transmitters. Scientists continue to use brain-imaging methods along with genetic testing in an effort to better understand the mental illness. The causes associated with mental disorders, such as schizophrenia, are yet to be fully understood. As is the case for other types of disease, schizophrenia may result from a combination of physical, behavioral, biological and other sources. It is apparent that genetics are a determining factor. Risk Factors The risk of contracting schizophrenia is relatively small, up to one percent of the population, but that translates to more than two million in the U.S, alone. The risk is higher if a family member is afflicted. "Not everyone has the same risk of developing schizophrenia. By far the most significant risk factors for developing schizophrenia have to do with family members." (Harrison, 2014). A child born of a parent with schizophrenia is approximately 10 percent more likely to be schizophrenic too. People who have any close relative such as a cousin, uncle, aunt or grandparent is more at risk than those without this genetic connection. An identical twin has about a 50/50 chance. (Smith, 2013). Scientists have found factors other than genetic that may raise or lower the risk among people of various demographic groups. Those who live in rural areas are less likely than their urban counterparts to develop schizophrenia. Black Americans are more likely than white, which are more likely than Hispanic to contract the disease. However, this data may be skewed due to a higher proportion of black persons concentrated in the city. In addition, the term "Hispanic" refers to a diverse ethnic group therefore it is not known to what degree the findings are due to genetics or culture. Starvation during the first trimester by the mother, therefore the embryo, increases the chance that child develops the illness. Note that the risk factors are not indicators of schizophrenia. (Harrison, 2014). Early Diagnosis Schizophrenia is a progressive disease rarely occurring without at least a year warning. A continuing debility of cognitive functionality is usually observed. As with any disease, treatment in the early stage is preferable. The early indications mimic the general symptoms of the disease but a milder version. The key signs are observing "suspiciousness, unusual thoughts, changes in sensory experience (hearing, seeing, feeling, tasting or smelling things that others don’t experience), disorganized communication (difficulty getting to the point, rambling, illogical reasoning) and grandiosity (unrealistic ideas of abilities or talents)" (Tartakovsky, M. 2010). If just one of these indicators are observed the risk increases to one greater than if one of the subjects parents had the disease. Within three years more than a third of those who exhibited one of these early symptoms will contract the disease. Symptoms The symptoms associated with schizophrenia are classified in three main categories: Positive, Negative and Cognitive. Positive symptoms are broken down into several subcategories: Hallucinations, Delusions, Thought Disorders and Movement Disorders. The term "positive" does not imply a benefit to the sufferer. It describes psychotic behaviors where the afflicted is estranged from reality. The severity of the symptoms can appear then dissipate and vary widely, from barely noticeable to unmanageable usually depending on the level of treatment being received. Hallucinations are a "positive" symptom. The person hears, sees and can even feel and smell things no one around them can sense. The most common is "hearing voices" which may direct the person to do things they might not ordinarily do. The voices might also be mentor-like discussing the persons erratic behaviors and, remarkably, speak to each other as if the person is not part of the conversation. Suffers may be aware of these voices long before others are aware of the problem. Hallucinations also include feeling, smelling and seeing objects and people others cannot. Delusions, another "positive" symptom, are a belief in illogical, bizarre occurrences. For example, they may think the television is speaking directly to them, imparting a message only they can understand, that a neighbor is controlling their thoughts and actions with microwaves or that someone is plotting against them somehow in a continued effort to harm or harass. Thought disorders describe a dysfunctional, abnormal way of processing information. The person has great difficulty organizing thought and/or associating them in a logical manner. Their speech tends to be muddled, difficult to understand. They may experience a phenomenon called "thought blocking" and suddenly stop speaking during a thought. "When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head." (Schizophrenia. 2014). They may also invent words that are meaningless to everyone but themselves. Movement disorders, as the name implies, refers to bodily movements that appear restless or frantic. The agitated movements may be repeated over a long period of time. In extreme cases, which is rare, the person becomes catatonic, not moving or responding. Negative symptoms are more difficult to recognize than positive symptoms. Sufferers appear to be lifeless and are often thought to be depressed. Symptoms include a general lack of happiness for life, speak only occasionally and in a monotone voice and display little facial expressions even when others are trying to interact with them. They may have difficulty performing ordinary, daily tasks, appear unmotivated, disregard personal hygiene and are generally unwilling to do for themselves. Cognitive symptoms are difficult to diagnose making it less generally understood as a treatable disease. These symptoms are subtle and usually identified only after tests have been conducted. Symptoms include problems focusing on a subject, understanding directions, poor memory and, predictably, poor decision making skills. Suffers are often mistakenly perceived to have character flaws rather than physical issues because the symptoms are hard to recognize. "Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress." (Schizophrenia. 2014). Treatments Treating schizophrenia usually involves medication along with psychological counseling. Several types of therapies are helpful but antipsychotic medications are the basis of treatment. Antipsychotic drugs have proven to be effective in lessening the symptom associated with delusions and hallucinations. These medications have a high success rate. Just 20 percent of those using these drugs suffer a relapse while 80 percent of those who stop taking the drugs will. Several factors determine the effectiveness of medication treatment including availability, costs, side effects and whether or not the patient takes those drugs as instructed. Counseling, referred to as psychosocial interventions, is a vital treatment when paired with medications. Therapies most common in the treatment of schizophrenia include cognitive behavioral training, skills instruction and social interaction lessons. Therapy also extends to people who have a loved one afflicted with the disease. "Individual and family therapy can also be useful schizophrenia treatments, as schizophrenia often affects everyone in a family." (Tracy, 2012). Vocational skills training and support groups are also a vital element of treatment. Some locations offer programs to help the afflicted integrate into society. Living With Schizophrenia Medications, municipal programs and professional psychiatric counseling are essential in the treatment of schizophrenia but its the family of the afflicted, the main caregivers, who must deal with a range of issues on a daily basis. Schizophrenics, by definition, often do not think in rational ways. Because their delusions are real to them, they may not think treatment is needed therefore resists efforts to help them. Those close to the afflicted are obliged, at times, to take necessary action beyond the wishes of their mentally diseased love one such as having them forcibly taken to a hospital or mental institution. Laws vary by state but generally, involuntary admission to a facility requires staff observe psychotic behaviors. Family caregivers are keenly aware that the sufferer must take medications regularly or the symptoms, many times severe therefore dangerous, reoccur. Too often schizophrenics are wind up in jail or homeless where they seldom get the aid they require. Loving, supportive help from family is vital. Being shunned by society or constantly criticized for their behaviors only serves to aggravate the condition. Hallucinations and delusions are real to the sufferer. They should not be told otherwise, however, agreeing with these delusions is not helpful either. "Tell them that you acknowledge that everyone has the right to see things his or her own way." (Schizophrenia. 2014). Schizophrenia is of biological origins. Sufferers should be treated with respect and kindness but inappropriate, dangerous behaviors cannot be tolerated. How Dangerous are Schizophrenics? It a complex question to a complex issue but, generally speaking, most schizophrenics are inclined to withdraw emotionally when symptoms appear and are not dangerous. The actions by the majority of suffers are entirely benign. They are seldom a threat to themselves or others but a minority do display dangerous actions. Approximately 10 percent commit suicide. Some abuse alcohol and hard drugs which increases the chance for aggression. Psychotic episodes can produce violent actions but suffers are not as dangerous as the public perceives. In fact, the afflicted are more likely to be a victim of violent crime than the general public. (Brichford, 2012) Sensationalized cases such as the current Death Row controversy in Texas only facilitates the misguided misconceptions regarding dangers resulting from schizophrenia. Substance Abuse Too often those with schizophrenia are mistakenly accused of drug abuse because some of the symptoms are similar. Prevailing opinion among researchers is that drug abuse does not cause schizophrenia. Those who have the disease are much more prone to abuse alcohol and drugs than the general public, however. Abusing any substance lessens the positive effect of treatment while worsening the original symptoms. Additionally, those who abuse substances are not as likely to adhere to treatments. The majority, nearly 90 percent, of schizophrenics smoke cigarettes to excess. Smoking among the general public is now less than 25 percent. Sufferers of this particular illness smoke more than those afflicted with any other type of psychiatric malady. Attempting to get schizophrenics to stop smoking is usually fruitless and, too often, not attempted by well-meaning caregivers. "There is often a perception that (smoking cessation efforts) will be unsuccessful and will deprive individuals of one of their few pleasures. This view is inherently discriminatory." (Kelley & McCreadie, 2014). Conclusion The understanding of schizophrenia among both medical professionals and the general public has come a long way since the Medieval era yet it remains a widely misunderstood mental disorder. Scientists still do not know what causes it and there is no cure but psychiatric medications, therapies and mental health facilities have proven to be effective in mitigating the effects of this complex disease. Today, those suffering from schizophrenia are offered better opportunity to lead a productive, more normal life than ever before provided the help they need is accessible to them. References: Brichford, Connie. (2012). Schizophrenia Myths and Facts. Everyday Health. Retrieved on December 1, 2014 from http://www.everydayhealth.com/schizophrenia/schizophrenia-myths-and-facts.aspx Burton, Neel M.D. (2012). A Brief History of Schizophrenia. Schizophrenia through the ages. Psychology Today. Retrieved on December 1, 2014 http://www.psychologytoday.com/blog/hide-and-seek/201209/brief-history-schizophrenia Divine Madness – a History of Schizophrenia. (2014). Mental Illness in Antiquity. History Cooperative. Retrieved on December 1, 2014 http://historycooperative.org/divine-madness-a-history-of-schizophrenia/ Harrison, Catherine, PhD. (2014). Who Gets Schizophrenia? About Health. Retrieved on December 1, 2014 http://schizophrenia.about.com/od/whatisschizophrenia/f/WhoGetsSchiz.htm Kelley, Ciara & McCreadie, Robin. (2014). Cigarette Smoking and Schizophrenia. The Royal College of Psychiatrics. Retrieved on December 1, 2014 from http://apt.rcpsych.org/content/6/5/327.short?rss=1&ssource=mfc Living and Coping With Schizophrenic Disorder. (2010). Mental Illnesses. Retrieved on December 1, 2014 http://pasadenavilla.com/2010/07/21/living-and-coping-with-schizophrenic-disorders/ Schizophrenia. (2014). The National Institute of Mental Health.. Retrieved on December 1, 2014 http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml Smith, Brian, MS. (2014). What Causes Schizophrenia? Psych Central. Retrieved on December 1, 2014 from http://psychcentral.com/lib/what-causes-schizophrenia/000715 Tracy, Natasha. (2012). Schizophrenia Treatments: How Do You Treat Schizophrenia? HealthyPlace. Retrieved on December 1, 2014 http://www.healthyplace.com/thought-disorders/schizophrenia-treatment/schizophrenia-treatment-how-do-you-treat-schizophrenia/#ref Tartakovsky, M. (2010). Living with Schizophrenia. Psych Central. Retrieved on December 1, 2014 from http://psychcentral.com/lib/living-with-schizophrenia/0002711 Read More