Schizophrenia - insanity disproved
We’ve all heard the stereotypical interpretation of schizophrenia. People that have it are often offered public sympathy, yet mindlessly judged and branded as ‘crazy’ in ignorant minds. Why do people cast it off in this way? Well, for starters because it’s hugely misunderstood and unknown. Learning how to approach schizophrenia isn’t exactly in the PSHE schedule. It isn’t regarded in the same terms as depression or anxiety and the education system does not consider it a pending struggle to cover in class. To some extent, this is understandable, as 31% of teens have some sort of anxiety disorder, as opposed to less than 1% having schizophrenia. It is also very rare to be diagnosed with it before adulthood, and adolescents are not commonly exposed to it in their known surroundings. This brings us to another reason why it is perceived as a form of insanity and not an illness, because of the stigma around it. In a way, the two are very linked; humans fear the unknown, and often view it as a threat. How do humans deal with threats? They find a way to avoid them or overpower them. So, if the lack of knowledge about schizophrenia is leading to its misconception, why isn’t that knowledge being translated into society? Before I answer that question, it is important to share some wisdom with you about what schizophrenia really is.
Schizophrenia is a life altering disorder that there is no known fully effective way of curing. There are countless symptoms for schizophrenia, and no one truly experiences it in the same way. Positive symptoms (an addition to normal functions) include hallucinations, delusions, movement disturbances, disorganised thoughts and speech, confusion, paralyzing extreme anxiety, suspicion, and many more. Negative symptoms (limitations of normal functions) include speech distortion, mood disturbances, lack of emotion, inability to look after oneself, lack of motivation, memory loss, social withdrawal etc. Essentially, it affects every aspect of life and completely debilitates and stunts people suffering with it. People can also enter psychotic episodes, where they cannot distinguish between what is reality and what isn’t.
The cause of schizophrenia is not a simple concept, as there are links to its roots lying in both genetics, individual psychology, and environment. Evidence shows increased likelihood to develop it within close biological relationships, with Kendler (1985) suggesting first-degree relatives to be 18 times more at risk than those without these schizophrenic relations. Many positive symptoms previously identified have been associated by Benzel (2007) as being linked to three genes; COMT, DRD4 and AKT1 which cause dopamine imbalances in specific D2 receptors. This suggests a genetic predisposition for the development of schizophrenia. Gottesman studied monozygotic (identical) twins and compared them to Dizygotic ones (non-identical twins). Those with identical genes had a 48% risk of developing it if their twin had it, whereas the non-identical statistic was 17%. This alerts us of a definite genetic factor that contributes, but also explains that environmental factors play a role in its development, otherwise the concordance rate would have been 100% between monozygotic twins, as they would have the exact same genetics. This genetic theory is amongst extensive biological research with common physical links between brain function, such as an increase in the size of ventricles in the brain. However, no biological explanation provides explanation for all patients or completely confirms the cause of the disorder. The psychological explanation for schizophrenia provides other
possible causes. In the 1950s, many psychologists believed the main cause is family disfunction. Bateson (1956) suggested the double bind theory, which suggests it to come down to contradictory messages. Prolonged exposure to this distorted emotional environment could lead to an incoherent version of reality, resulting in the nature of schizophrenic symptoms being forms of seeking an alternate reality, such as paranoia. There is also research into the cause being down to cognitive deficits. Difficulty to process information is common, and ability to develop skills is common in schizophrenia patients. Sufferers report various cognitive biases, often their minds convince them they are always in danger, leading to delusions. This distortion in reasoning can cause blame and distrust of others, all symptoms of schizophrenia.
Treatment for schizophrenia is as complicated as its cause, with antipsychotics blocking excess dopamine from being created by blocking D2 receptors in synapses. However, these are extremely difficult to endure, as they consequently block other types of dopamine activity, which is harmful. There is also atypical antipsychotics such as Clozapine which bind to dopamine, serotonin and glutamate receptors, attempting to tackle negative symptoms and stabilizing mood. Psychological therapies are often undergone in order to improve communication and reduce levels of expressed emotion to avoid relapse. It also allows family members to understand and learn how to aid their schizophrenic relative(s), in order to attempt to make their lives more manageable. This is called psychoeducation. Many patients also undergo regular CBT (cognitive behavioural therapy), to help them manage their disorder and comprehend their surroundings. Alternative treatments include various medicines and forms of therapy, however none have been proven to eliminate schizophrenia completely, but instead most help to manage it to some extent.
People with schizophrenia are entirely misunderstood. Their brains work in ways incomprehensible to many people and due to their minority status, they are brushed off and discarded as abnormal and therefore lesser. However, their abnormality is not a choice in itself, it is a perception of life which is unconsciously undergone, without the control of those who must face it. The complications and lack of scientific definite towards its cause and solution creates the unknown stigma which fuels distasteful attitudes towards those with it. Misinformation is spread quickly, and people often class unknown truths as scary concepts, confirming the misconception of ‘insanity’ rather than difference. Patients with schizophrenia do not often make their status known, with fear of judgement or social isolation. Therefore, the cycle of suppression of conversation continues, and sufferers continue to feel alone. How can we help? If we can destigmatise anxiety disorders, which are not chosen and cause distress, we can do the same for schizophrenia. Replace the regard of insanity with one of acknowledgement of difference, and respect schizophrenic patients. We need to be gaining a better understanding of schizophrenia in education, in order to break the cycle and develop our generation’s claim increased acceptance. Translating knowledge about schizophrenia into society by educating others will make it a little bit easier for those with schizophrenia to live a comfortable life.
By Alex