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Good day, Everyone. It’s quite some time since I’ve posted on here. Don’t mind me, I have been super-busy at my end (it’s a pity). Over the weekend, however, while out to get some groceries, I witnessed a phenomenon that triggered this writing and my grand interest in mental disorders and their manifestation. The phenomenon was in the personality of a madman (apparently he was a sufferer of schizophrenia). He was exhibiting a very terrifying performance at the front of the store I was initially supposed to purchase the groceries from with the store owner trying all means (including pouring a bucket of water on the madman but all to no avail) just to get the schizophrenic away from his store front; at least to prevent him from keeping his customers away. I was in a hurry so I couldn’t wait to see the end of this scary but amusing show between the schizophrenic, who was attired in a dirty rag, and the store owner, who was employing all trick to chase the guy away. As a result of this, I had to eventually go get my groceries at another store just further down the road. The scene, unfortunately, had ended before I could make my way back from the store.

However, what seem to intrigue me is the posture and the manners assumed by the schizophrenic (mad-man) throughout the time I was watching the scene. He seem entirely oblivious of what was going on yet aware that he was the orchestrator of the whole happening - like he was not there, but he was there. He was a puzzling spectacle, thus I was triggered to make some research about the mental illness and to share my findings with you guys.

And also, during the course of my research, I was fascinated by other things I found so much that I have decided to dedicate my subsequent articles to mental disorders, their manifestations or symptoms, and their treatments. Enjoy yourself with this episode.

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Schizophrenia

Schizophrenia is globally considered as a classical example of madness. Often does the word ‘’crazy” reminds one of the weird uncanny actions of the sufferers – the hallucinations, illusions, and disjointed or illogical conversations common with the victim. According to Wikipedia, “ Schizophrenia is a mental disorder characterized by abnormal social behavior and failure to understand reality”

It is quite an astonishment to encounter a person who thinks he is the president of a nation or even Adolf Hitler, or a person who would stand in a position for a very long period of time. No mental disorder seem as puzzling and bewildering as that of schizophrenia. It disables the mind of the sufferer and impedes his or her ability to function just as an energy-depleted battery disables the functionality of a gadget. Intriguingly, The Encyclopedia of Heath once published a series on Psychological Disorder where it was claimed that a large number of people admitted to Psychiatric hospitals today suffers from the disease. It was said, in one of the series titled “Schizophrenia” that Schizophrenic cases account for nearly 40% of admissions to mental hospitals.

It is important to note that the disease (schizophrenia) is incurable, its cause is unknown. As a result, it is quite difficult to tell what to expect from its sufferer, as related to cure or the toil the disease can have upon them overtime.

Features

Schizophrenia is a severe psychological disorder or mental illness depicted by wide-ranging bizarre behaviors that becomes a source of intense disturbance to the lives of the suffers and that of those around them like their relatives and friends.

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The most obvious feature of the disease is the intense disorder with which the sufferers view the world and happenings around them - their minds seem disconnected entirely from reality - a disconnection that is mostly witnessed in every facet of their beliefs, sentiments and actions. Its most spectacular symptoms are delusions and hallucinations. As a result of these, schizophrenics mostly fail to grasp the ability to logically their environment, mostly their surroundings, and their relations with others. Schizophrenics are further characterized with disjointed or irrational talks which consist of sequence of unclear speeches wound together in a manner usually leaving the listeners lost and puzzled. They may also sit or stand for a very long time like someone frozen (which is quite common with the sufferers). Withdrawal from the outside world is also observed from the attitude of the sufferers, including anxiety, fear, “flat” emotion, apparent continual loss of appetite, insomnia and depression.

History of Schizophrenia

The term “schizophrenia”, which was derived from the greek words ‘schizo’ (split) and ‘phren’ (mind), was first devised 1910 by Paul Eugen, a Swiss psychiatrist who had used the term to describe the features prominent with his patient suffering from the disease. It was a German psychiatrist, Emil Kraepelin, who first told apart the illness from other forms of mental disorder. However, evidences of the illness have been portrayed in old records, including the Scriptures; “the Lord will smite you with madness and blindness and confusion of mind. (Which Verse)” Even Horace, the Roman poet who lived through (65-8B.C) informed us, in one of his writings (Which writing), about a man who would visit an empty theater every day and would take a seat to enjoy a show, laughing and celebrating actors and actresses no one else could see. Macbeth, King Lear and Hamlet, classic plays written by the English writer Willaim Shakespare (1564 -1616) bears heavily on the presence of wrecked and unstable minds that could very much fit as minds of schizophrenics this present day.

The Middle Ages was a period where the illness was handled with a much worrying tone, with the illness being associated with spiritual theories claiming the sufferers are possessed by evil demons. Shortly after the fall of Rome, during the time referred to as the Dark Ages, the middle age scholars were reported to have a list which contain all kinds of madness, the name of the evil spirit responsible for it, and the type of treatment best suitable for the sufferer. Such treatment would range from burning at the stake (which was used on Joan of Arc, 1412-31, who led the French Army against the English troops claiming she was hearing voices from heaven that told her to, and the French believed her) to confinement in a ships which are sailed aimlessly throughout the European countries, including Spain, England and France.

Types and Differences between them

It is held that not all schizophrenics have the same experience with the disease although they may all exhibit similar symptoms. Several attempts have been made to distinguish the various types of the illness thus aiding the diagnosis and subsequent treatment of the sufferers.

Paranoid Schizophrenia was the first to be noticed, and was described in 1868 (by whom). It was at least three years later before another (hebephrenia) would be reported, then in 1974 Catatonia Schizophrenia was announced. In 1896, Emil Kraepelin discovered that the similarity between these three forms of schizophrenia is more pronounced than their difference, and since this time (1896), Kraeplin’s effort to distinguish this disorders has continued to serve as the basis for the detection of schizophrenia.

Catatonia (meaning tension in Greek)

The peculiar variations in the tension of the sufferer’s voluntary muscles are the most notable symptoms of a catatonic schizophrenia. The sufferers may remain frozen in one position for a very long time, seemingly oblivious of their surroundings, or may run around in a complete frantic thrill. During the stupor, the sufferer may feign a statue-like position and maintain this for very long hours, with some parts of their bodies usually limbs defying exhaustion or even gravity sometimes. If someone attempts to move the limb to assume another position, the limbs will maintain the new position – just like the limbs of a doll. At times, catatonic schizophrenics are noticed to move around in a robotic stride like they are responding to a computer programmed command. They seem to be dissociated from their immediate world but it has often been reported that it is not unusual to find them repeating words that were uttered by the nurses or those attending to them during their frenzied state weeks or even months later.

Catatonics are also characterized by rapid or excited gestures, which could be lethal. Some sufferers are reported to have died from exhaustion or heart failure due to their frenzied actions.

Hebephrenia

Hebephrenics are known to have childish and silly behaviors. The name itself was derived from one of the Greek Mythologies. Hebe was the cupbearer to the gods who was known to overindulge in the wine she was supposed to serve the gods. As a result, she would be seen giggling and acting like a clown in the court of the gods. Thus, the sufferers (hebephrenics) are known to always giggle, making faces in the mirror or peeking around the corner like children does. This type of schizophrenia seems to crawl upon the sufferer slowly and is noticeable when patients begin to withdraw gradually from social contacts.

Paranoia

The major features of this type of schizophrenia are delusions and hallucinations which are usually followed by anger, anxiety, argumentativeness and most times, violence. This type is known to occur in more older people than the other two types. The sufferers are known to be much more intelligent, alert and clever than catatonics and hebephrenics.

Paranoid schizophrenic’s lives are usually dominated with the delusion that they are being persecuted, even sometimes giving a detailed evidence of the assumed persecutions, just to prove their ‘case’. They are very specific, unlike Hebephrenics and Catatonics whose delusions are mostly vague and undefined. The sufferers may also be obsessed with the fantasies of their own eminence. It is not unusual to find the sufferers introducing themselves to others as Jesus Christ, Abraham Lincoln, Napoleon Bonaparte, Julius Ceaser or even Warren Buffet, others may even declare to have been communing with God. However, not all paranoids are schizophrenics.

Even though these groups of schizophrenias seem quite plain and specific, most sufferers often exhibit a blend of the symptoms from two or even the whole of the three at a time. And also, symptoms have the tendencies to change with time.

Causes of Schizophrenia

Biological Aspect

Over the year, despite the massive effort expended by researchers on the cause of schizophrenia, none is yet able to say what the cause might be or what could ever go wrong at first. What seem to be clear, however, is that schizophrenia is such complex weird disorder whose rudimentary tools, i.e biological and environment, are expected to take several years to comprehend.

The disease runs in families, no doubt. This is a fact that is now well established by several sources. Of children who have a parent suffering from the disease, about 10 of 100 will suffer from the disease overtime, and almost half of the children who have both parents as schizophrenics will end up developing the disease themselves. It is sufficient enough to conclude that the disease/disorder can be inherited. However, it is also possible that schizophrenics raise their children in ways that greatly influence the chances of their offspring developing the disorder – a phenomenon known as “nature-nurture” controversy. This is according to a two-sided argument that is schizophrenia caused by people’s gene or by the environment. This is a decades old argument which have led a large number of experts to conclude that both gene and the environmental factor plays a very vast role in the development of the disorder. However, to establish the exact contribution of each factor seem an enormous challenge which mental health experts are embarking on answering each year.

Psychological Aspect

Shortly after Paul Eugen devised the word “schizophrenia”, the Austrian scientist, Sigmund Freud, in 1911, published his treaty offering a theoretical explanation of the disorder. He claimed that the major key to mental disorder is in the unconscious mind; a theory which earned Freud many followers even until this day. He claimed unexpressed or repressed sexual feelings and wars or conflicts are the major cause of mental disorders. That is why during treatment, the psychoanalyst tries to help the patient detects their repressed feelings so they can exploit these to rectify the mental condition of their patients. Unfortunately, Freud wasn’t so lucky to have been able to have access to schizophrenics personally In order to probe his own theory further. In fact, his 1911 published treaty was based entirely on an autobiography written by one Daniel Schreber who has a mental disorder, where he described his own experience with the illness. The autobiography was published in 1903 but Freud never had the opportunity to inspect Schreber nor did he had the opportunity to discuss with him ever yet his theory held sway in the world of psychiatry for decades.

There are other arguments, however, that the disorder actually occur in the womb while others claim that it is during various stages of infancy and young childhood. However, all mental health experts do conclude that an abnormal child-parent relationship is a recognized psychic injury causing schizophrenia. Some specific attributes in the parents of the schizophrenics were held liable. Schizophrenic mothers were alleged to be cold, rejecting, insecure, aggressive, domineering, and mostly mentally disturbed or ill, while the fathers were said to be too passive and indifferent to the affairs and well being of their offspring. A double-bind theorem was proposed by Gregory Bateson toward the attitude of some parents toward their wards. The psychiatrist E. Fuller Torrey, in his book, Surviving Schizophrenia: A family Manual, clarified Bateson’s theory thus:

According to this theory, schizophrenia results when children are put into an impossible heads-I-win-tails-you-lose situation. For example, a mother buys her son two ties for his birthday. He comes downstairs wearing one of the ties the next morning and his mother asks, “What’s the matter, dear, don’t you like the other tie I gave you?”

Another argument points to stress. The failure of an individual to manage psychological stresses properly is a schizophrenia-causing factor is another idea particularly popular among the general public. The sufferers (and the recovered ones) often mention pressures (family, job and finance), and sometimes the idea of “simply living” as causes of their disruption with reality. Although it is quite true that some researchers discover some link with physical, emotion and mental stress with symptoms of schizophrenia but what is also true is that such symptoms, which usually appear suddenly, last for only a few days and vanish without any continuing ill effect on the victim. And even until now, there is not a single concrete evidence that truly links stress with true schizophrenia.

Treatment

A particular treatment for schizophrenia is yet to be established but what is presently perceived as treatments are usually the acts of eradicating or purging the symptoms of the disorder from the victim. Such treatments comprise of the prescription of psychotic drugs, psychotherapy and various other treatments that shall be examined further below. It is, however, imperative to state that about 5-6% of schizophrenics die by suicide and at least 20% of them have attempted suicide once or twice during the period in which they suffer the mental disorder.

Anti-psychotic drugs, such as Barbiturates and Thorazine, have overtime enhanced the broad outlook of a schizophrenic due to their tendencies to reduce the psychotic symptoms and also relaxed hyperactive patients. These are presently the most effective treatment available however; they do not completely cure the sick nor guarantee that any further psychotic incidents will not ensue. Also, not all schizophrenics are being able to be helped with the medications hence therapeutic treatments are often opted for.

Therapeutic treatments are usually given to patients who are more stable but still find it challenging to engage in their day-to-day activities. It employs some techniques of learning and some coping mechanisms to aid the victims with their integration back into the society, social living and even their work place. It helps them comprehend their mental condition better and adapt to managing it without further external aid. Such treatments also include scheduled meetings with mental health professionals who offer helps to the patient by building the patient confidence in him/herself and the therapist, thus broadening the mind of the schizophrenia to accept, firstly the disease as their reality, and the society as a place where they are accepted.

Rehabilitation is another form of non-medical interventions employed to helping patients re-adjust themselves into managing their mental illness by underlining the importance of social and vocational training in cognitive or thinking capabilities. This, particularly, has proved from time to time to be as effective and reliable as medications given that the schizophrenia symptoms witnessed in the victim is still in their mild state.

And most importantly, families play a major role in the treatment processes of a schizophrenic. At a point in time, a schizophrenic will be discharged from his/her point of receiving treatment and will be required to return to him/her family. Families must understand the intricacies associated with the disease so as to know how they can relate and help the schizophrenic recovers faster.

Stay tuned and allow me to bring you more on Mental Disorders, Their Symptoms and Their Treatments,

References:
The Encyclopedia of Heath - Schizophrenia by Patrick Young.
Schizophrenia - Wikipedia, Mental Health America, Medical News Today, National Alliance on Mental Illness, America Psychiatric Association, Mayo clinic, SANE Australia.