What is schizophrenia?

Welcome to the weekend everybody! Hope this week has been manageable for you. Fun fact, we have just passed World Schizophrenia Day, which was on Tuesday, 24 May. It is a day dedicated to raise awareness for schizophrenia as it is often misunderstood and stigmatised but is one of the most common psychotic disorders around the world. According to the Institute of Mental Health (IMH), in 2021, 1 in 116 persons had a diagnosis of schizophrenia at some point in their lives, making schizophrenia the most common psychotic disorder in Singapore. In this article, we hope to help you understand what schizophrenia is and to debunk some of the myths surrounding the disorder.

What is schizophrenia? 

Schizophrenia, like other mental illnesses, is a disorder of the brain.  Neurological changes have been observed in the brains of people with schizophrenia. Specifically, gray matter volume – used to process information that helps control things like muscles and hearing, was observed to be lower than a neurotypical brain. This observation was especially prominent in the areas that are crucial for thinking and judgement (i.e., temporal and frontal lobes). The amount of gray matter continues to fall overtime which would result in worsening of symptoms. On the other hand, white matter, key to signal all of the body’s activities, looked damaged or altered in these imaging tests. 

Schizophrenia is characterised by hallucinations, delusions, and cognitive impairments. Commonly, these symptoms are categorised as positive or negative symptoms. It should be noted that these categories are not about having positive or negative moods. Positive symptoms occur when our normal mental functions - thoughts, feelings, perceptions, and behaviour becomes distorted or exaggerated resulting in symptoms like hallucinations and delusions. Conversely, negative symptoms are the absence of these normal mental functions that lead to symptoms like diminished emotional expression or the total lack of motivation to do anything at all. Negative symptoms can often look a lot like symptoms of depression. Like most disorders, schizophrenia is a spectrum and it affects people differently. Symptoms and behaviour manifest and present differently in each individual. 

Causes

Although the exact cause of schizophrenia is still unknown at the moment, its development has been typically found to occur due to the interaction between genetic and environmental stresses. As such, the onset of schizophrenia is often during a life transition. Life transitions are stages in life where it requires one to make huge adjustments in life which can cause a large amount of stress (i.e., starting your first job or going into national service). Schizophrenia can occur at any age and it affects both genders equally. However, it usually develops in adolescence or young adulthood. 

When left untreated, persons with schizophrenia and the people around them can feel highly distressed and uncertain of its management. Moreover, it has been associated with higher risk of suicide, aggression, drug abuse, serious physical illnesses, reduced life expectancy, and large health and social costs. Therefore, it is crucial that one seeks help early. Early intervention has shown to increase the success rates of recovery, helping the individual lead an equally fulfilling life. 

Treatment 

As neurological changes are key to the development of schizophrenia, medication is the cornerstone of its treatment. These medications work on brain chemicals like dopamine and serotonin to help reduce and prevent symptoms from occurring. Fear not, these medications are not addictive. Based on your experience with the medication, the doctors would adjust the dosage accordingly. 

Recovery from schizophrenia is not just about taking medication. Psychotherapy is used to help the individual understand their illness, how it has affected their mental well-being (i.e., self-esteem and acceptance of this diagnosis), their experience of the medication, and the impact on other aspects of their life (i.e., interpersonal relationships and career). Additionally, rehabilitation and counselling aim to help the client gain the skills required to do the things that they want to. For example, occupational therapy can help the client return to their work or studies. While life skills training can teach clients independent living skills and social skills training can help the client develop meaningful relationships. 

If you suspect that you or your loved ones may have symptoms of schizophrenia, it is crucial to seek early intervention to increase the chance of recovery. It is not recommended for one to wait and see as this condition would only get worse without intervention. Don’t wait, reach out, there are many resources out there that you can tap on to help you or your loved ones lead a fulfilling and meaningful life. 

Interesting read

https://www.imh.com.sg/Documents/research-announcements/21%20May%202021_%20Prevalence%20of%20Schizophrenia%20and%20Other%20Psychotic%20Disorders%20in%20Singapore.pdf

https://www.imh.com.sg/Newsroom/News-Releases/Documents/GIS-IMH_Genes%20associated%20with%20schizophrenia%20risk_press%20release_7April.pdf

https://www.healthline.com/health/schizophrenia/schizophrenia-brain-vs-normal-brain


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