Schizophrenia and other Psychotic illnesses

WHAT IS PSYCHOSIS?

  • The term psychosis implies a marked impairement in reality testing
  • This can be due to a myriad of medical problems and psychiatric disorders

Some common manifestations of psychosis (impaired reality) include:

  • Percepual abnormalities-hallucinations
  • Abnormalities in thought content-dellusions
  • Abnormalities in the form of thought-thought disorder
  • Lack of insight

An individual may experience a psychotic episode due to

  • Schizophrenia
  • Psychological stress
  • Substance abuse
  • Other general medical problems

 

What is Schizophrenia?

It is a mental disorder which affects thinking, feeling and behaviour. It is most likely to start between the ages of 15 to 35 and will affect about 1 in every 100 people during their lifetime.

Although the word ‘schizophrenia’ is often associated with violence in the media, this is the exception rather than the rule. Hospital admission is often not needed and many people with schizophrenia live a stable life, work, and have relationships.

What causes schizophrenia?

It seems to be a combination of different factors. These include genes, subtle brain damage at birth or viral infections during pregnancy and childhood abuse. Street drugs (ecstasy, LSD, amphetamines and crack) can probably trigger it, particularly in teenagers using cannabis. Stressful events and family tensions make it worse.
In most cases, schizophrenia is an end result of an complex interaction between thousands of genes and multiple environmental risk factors - non of which on their own causes schizophrenia.

What are the symptoms of schizophrenia?

“Positive” symptoms include:

Hallucinations - hearing, smelling, feeling or seeing something that isn’t there. Hearing voices is the most common problem. These can seem utterly real. Although they can be pleasant, they are more often rude, critical, abusive or annoying.

Delusions - believing something completely even though others find your ideas strange and can't work out how you've come to believe them.

Difficulty thinking – you find it hard to concentrate and tend to drift from one idea to another. Other people can find it hard to understand you.

Feeling controlled – you may feel that your thoughts are vanishing, or that they are not your own, or that your body is being taken over and controlled by someone else.

“Negative” symptoms include:

Loss of interest, energy and emotions. You may not bother to get up or go out of the house. You don't get round to routine jobs like washing, tidying, or looking after your clothes. You may feel uncomfortable with other people. Some people hear voices without negative symptoms. Others have delusions but few other problems. If someone has only muddled thinking and negative symptoms, the problem may not be recognised for years.

Can treatment help?

The earlier you get help, the better the outlook - and less need for hospital treatment.

Antipsychotic Medication

This helps to weaken any delusions and hallucinations. It should also help you to think more clearly and to look after yourself better. It can control (but not cure) the symptoms in around 4 out of 5 people. It works best when taken regularly, even when you have felt better for some time.

Older, ‘Typical’ antipsychotics These work by reducing the action of a chemical in the brain called dopamine. They can cause side effects such as stiffness and shakiness and feeling slow, restlessness, sexual difficulties and unwanted movements, mainly of the mouth and tongue.Â

Newer, ‘Atypical' antipsychotics These work on different chemicals in the brain. These are less likely to produce unwanted movements but can cause weight gain, diabetes, tiredness and sexual problems.

Psychological Treatments

Cognitive Behavioural Therapy can help you to live with your experiences or even help you to work out what makes you unwell. You can then find new ways of thinking or behaving that help you to stay well.

Counselling can help if you need to talk to someone or if you need support with the daily problems of life. Family therapy can help you and your family cope better with the illness. Sessions can help families learn about the disorder, ways to support someone with schizophrenia, and how to solve some of the practical problems that can arise

 

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