Schizophrenia: What You May Not Know

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Schizophrenia can feel like living soundly in reality with stability, even as life is completely falling apart. Symptoms of the illness can put people in a position where they may lose jobs, relationships, and housing. Many will quit high school or college, unable to concentrate.

Despite these unfolding, devastating life events, it is typical for those with schizophrenia to discontinue antipsychotic medication and treatment due to confidence that nothing is wrong with them.

They commonly do not accept that they are sick. One of the most elusive goals and biggest milestones in schizophrenia recovery is gaining enough personal insight to recognize and accept the diagnosis and consent to long-term treatment. The technical term for this lack of insight is “anosognosia.”¹

The Definition

According to Psychology Today, schizophrenia is a serious and chronic mental illness that impairs a person's thoughts and behavior and, if left untreated, can include psychosis. It affects nearly 1 percent of the population.

Delusions

Delusions are fixed false beliefs in a distorted reality that can be ingrained deeply in the mind. Unrealistic expectations may come on so slowly, over months and years. You can be certain beyond a shadow of a doubt that you will be a billionaire, Nobel Peace Prize winner, or make a worldwide impact.

Hallucinations

Hallucinations can feel like living in a dream from which you can never awaken. You might be entirely unaware that you are hallucinating, convinced that the imaginary things you see and hear are real. Hallucinations can create an alternate world that is contrary to true reality.

The technical name for schizophrenia, schizoaffective disorder, and related disorders is “schizophrenia spectrum disorders.” Recently, it has been proposed that this spectrum of disorders is a syndrome (a collection of diseases) that may actually encompass many subtypes.² Different persons with schizophrenia will have widely different experiences.

Age of Onset

The typical age of onset for schizophrenia is 18-25. This is the period of transitioning to adulthood. Developing schizophrenia prior to age thirteen is exceedingly rare at one out of 40,000.³

Schizophrenia Is Genetic

Schizophrenia is genetic. If one parent has schizophrenia, there is a 10 percent chance that the son or daughter will develop schizophrenia later in life. If both parents have the brain disorder, the chance is 50 percent. For those with a genetic predisposition to schizophrenia, stress, and trauma, especially childhood trauma, can trigger symptoms of psychosis that may have never appeared in the absence of adverse events. In other people, schizophrenia will develop regardless of their experiences and situation.

No Known Cause

Schizophrenia is still commonly “idiopathic,” which means it has no known cause. Other conditions which trigger psychosis are called “secondary psychosis” and include Wilson’s Disease and certain vitamin deficiencies.⁴ Substances such as marijuana may also trigger a psychotic episode.⁵

Stigma

Being diagnosed can feel humiliating due to the stigma, and the stigma of schizophrenia can feel hurtful. Stigma also keeps people from accepting the diagnosis and seeking treatment.

Schizophrenia Is Treatable

Thanks to medications that affect the brain's chemical balance, schizophrenia is treatable. Newer medications (called “second generation medications” or “atypical medications”) are “neuroprotective,” which means they actually restore brain tissue. These medications are especially effective on the “positive” symptoms of schizophrenia, including paranoia, delusions, hallucinations, and delusions.

Breakthroughs in Treatment

Multiple drug companies are pursuing breakthrough studies of medications with new mechanisms of action to treat schizophrenia. There is hope for new drugs that will have fewer side effects and, hopefully, will treat more of the symptoms of schizophrenia. The hope is that these new medications will treat cognitive deficits and apathy, which are currently not treated by any FDA- approved antipsychotics.

Some of the new medications in the pipeline for schizophrenia do not bind to the dopamine receptors (called D2 receptors) in the brain, instead affecting dopamine indirectly. When medications bind to D2 receptors in the brain (as do all of the currently FDA-approved antipsychotics), they can cause Parkinson-like psychosis, tardive dyskinesia, and other side effects.

Psychosis Essential Reads

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Psychosis in Displaced Refugees

I hope that new medications in the pipeline for schizophrenia will be a game changer, making schizophrenia less of a debilitating condition and something less serious from which most people can recover and move on.

The Importance of Education

Education about brain disorders should begin from a young age and be emphasized throughout junior high and high school because early intervention provides the best scenario for the highest level of recovery.

Just like the education on sleep, eating right, sexual health, and exercise is offered in school, mental health education should be as well.

It is imperative that we teach our children the facts from a young age so the next generation will seek help when they need it, support their peers who are struggling, and not buy into the stigma.