Recognizing how Schizophrenia causes the distinction between internal and external voices to become hazy
Have you ever experienced auditory hallucinations or a blur between reality and illusion, a delusion? This is schizophrenia, a chronic mental disorder that affects approximately 20 million people worldwide, with varying features and severity of symptoms. Despite its prevalence, schizophrenia remains one of the most misunderstood mental health conditions, often shrouded in stigma and misconceptions.
Schizophrenia currently contributes to disability and morbidity among 24 million people, or 0.32% of the world’s population. This rate translates to 1 in 222 people (0.45%) in the adult population living with the disease.
According to statistics reported by the World Health Organization (WHO), schizophrenia affects nearly 24 million people globally. Both men and women are equally affected. Men most commonly experience schizophrenia in their late teens or early 20s, and women in their 20s or 30s. It is rare among younger children (under 12 years old) and usually does not appear for the first time in adults over 40.
In India, schizophrenia affects millions of people. According to a study, it is estimated that about 7% of Indians suffering from mental disorders have schizophrenia in varying degrees of severity.
The National Mental Health Survey (2015-2016) conducted by NIMHANS reports that the prevalence of schizophrenia in the Indian population is approximately 0.5% for current cases and 1.4% for lifetime experience. Around 7% of individuals seeking treatment for mental health issues in India are diagnosed with schizophrenia. Many studies have reported varying prevalence rates, ranging from 0.7 to 14.2 per 1,000 individuals. This situation indicates a need for increased awareness and better mental health infrastructure to support those impacted by the disorder.
What is Schizophrenia?,
People with schizophrenia live in a state of delusions, disorganized thinking, and significant social withdrawal. This mental condition affects how a person thinks, feels, and behaves. People with schizophrenia often seem like they have lost touch with reality, which can be distressing for them and their loved ones.
According to the World Health Organization (WHO), people living with schizophrenia often experience persistent difficulties with cognitive or thinking skills, such as memory, attention, and problem-solving. Therefore, it is important to build a safe space and increase sensitivity and awareness towards mental health issues.
Types and Phases of Schizophrenia,
There are several types of this mental disorder: Paranoid Schizophrenia, Disorganized Schizophrenia, Delusional Schizophrenia, Catatonic Schizophrenia, and Schizophrenia. The condition also has three phases:
Prodrome: A person may experience the prodromal phase of schizophrenia for up to 24 months before fully meeting the diagnostic criteria for the condition. Early warning indicators during this phase may include a notable drop in IQ, overall cognitive functioning, academic achievement, communication skills, or verbal memory, as well as isolated disease symptoms.
Active: Positive symptoms of schizophrenia, which are ideas, sensations, or behaviors not typically experienced by most people, appear during the acute or active phase of the disease. These sensations can be extremely frightening for the person experiencing them and often signify a break from reality. These include abnormal movements, chaotic thought processes, skewed beliefs, and hallucinations (i.e., false perceptions).
Residual: The time between active (acute) episodes is known as the residual (or recovery) phase. Negative and cognitive symptoms frequently last longer than positive ones, which may lessen in intensity or disappear entirely.
Causes and Symptoms,
The exact cause of schizophrenia is not fully understood. But, patients with schizophrenia share a common trait: they all have raised levels of the chemical 'Dopamine' in their brains. The exact cause of this mental disorder is unknown, although experts believe that both genetics and environmental factors may play a role. As a "feel good" chemical, dopamine is actually necessary for all of us to maintain stable moods. If it falls too low, worry, sadness, and bad mood are likely to follow. If it is set too high, we may have hallucinations and/or delusions.
The basic and primary feature of schizophrenia is hallucinations and distorted sense of thinking and perceptions. The symptoms of schizophrenia are generally categorized into three types:
Psychotic Symptoms:
Hallucinations - Seeing or hearing things that aren't there.
Delusions - Strong beliefs in things that are not true.
Disorganized Thinking - schizophrenic people feel trouble in organizing thoughts and speech.
Negative Symptoms:
Lack of Motivation: Difficulty in planning and sticking with activities and disoriented speech.
Social Withdrawal: Means he/ she tries to avoid social interactions.
Flat Affect: he lost expression of emotions.
Positive symptoms which include delusions, hallucinations, and impaired cognitive ability.
Cognitive Symptoms:
Memory Issues: Problems with working memory.
Attention Deficits: Difficulty focusing or paying attention.
Schizophrenia could be genetic or idiopathic but has quickly identifiable symptoms, and with proper awareness, the disorder can be prevented from progressing.
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Can schizophrenia affect childbirth as well?,
Yes, a study conducted by researchers at Santa Casa de São Paulo Medical School found that "lack of oxygen (hypoxia) during the period anticipating childbirth" can indeed be a significant factor in the development of schizophrenia. This condition, often associated with pre-eclampsia in pregnant women, affects astrocytes, which are crucial brain cells. The study observed that hypoxia impacts the functioning of mitochondria, the energy-producing components of cells, potentially leading to brain damage and increasing the risk of schizophrenia.
Risk of Suicide in People with Schizophrenia,
Yes, individuals with schizophrenia have a significantly higher risk of suicide compared to the general population. Acute psychiatric symptoms, negative symptoms, psychosocial stress, substance abuse, and co-occurring depression are factors that can increase the risk of suicide in people with schizophrenia. Studies show that about 10% of people with schizophrenia die by suicide, which is much higher than the 1.3% rate in the general population. Additionally, around 40-79% of people with schizophrenia have reported experiencing suicidal thoughts.
How Human Rights Violations Faced by Persons with Schizophrenia Have Become a Global Concern,
Today, human rights violations faced by persons with schizophrenia have indeed become a significant global concern. Some key points highlighting this issue are as follows:
People with schizophrenia often face intense stigma and discrimination, leading to social isolation, which affects their access to essential services such as healthcare, education, housing, and employment. Moreover, they are subjected to degrading, physical, and verbal abuse in mental health institutions. Presently, many mental health institutions worldwide are associated with gross human rights violations. Organizations like the World Health Organization (WHO) are advocating for a shift towards community-based mental health care. WHO's "Guidance on Community Mental Health Services" emphasizes the need for mental health care to be grounded in a human rights-based approach.
Additionally, the Convention on the Rights of Persons with Disabilities (CRPD) has been instrumental in pushing for reforms in mental health laws and policies. However, many countries still lack the necessary frameworks to fully comply with international human rights standards.
Indeed, schizophrenia is not confined to any one region but is a worldwide issue. These points illustrate the multifaceted nature of the human rights violations faced by persons with schizophrenia and underscore the need for continued global efforts to address these issues.
Myths Concerning Schizophrenia,
Since the word schizophrenia is Greek in origin, it essentially translates to "split mind." It's commonly believed that those with the condition will exhibit split personality symptoms. This misunderstanding arose from the condition's nomenclature. Instead of referring to a split personality, it actually denotes a separation from reality.
Erroneous depictions of schizophrenia in movies and on television have contributed to the misconception that people with the illness are aggressive, whereas these individuals typically exhibit passive symptoms like anxiety and fearfulness. In reality, only 5–10% of those with the illness will go on to commit crimes in the future.
Previously, schizophrenia was considered a "hopeless" condition with no cure. However, there are now effective treatments and therapies available, allowing sufferers to manage their symptoms through medication and therapy, and lead full and healthy lives.
Prescribed Medications and Therapies for Schizophrenia are,
Antipsychotic drugs are used as an effective treatment regimen. Psychotherapy, such as Cognitive Behavioral Therapy (CBT) and family counseling, helps patients learn coping mechanisms.
Complexities and Nuances of Schizophrenia Beyond Common Misconceptions,
Although schizophrenia has both negative and positive symptoms, very few people know that a person with schizophrenia may also exhibit creativity in their work. According to certain research, there can be a connection between creativity and schizophrenia. Even though schizophrenia can be a crippling illness, some of its hallmarks—like divergent thinking and the capacity for original association—are also present in extremely creative people. This suggests that while schizophrenia may not be the direct cause of creativity, there may be some similarities between the cognitive processes involved in the two.
Several notable historical figures are believed to have had schizophrenia or exhibited symptoms of the disorder. For example, the famous mathematician John Nash, who was the subject of the movie “A Beautiful Mind,” lived with Paranoid Schizophrenia and made significant contributions to game theory.
David Bowie is an additional example who may serve as the case study. In addition to his mother and half-brother, he was an indisputable genius. However, he lived a lifelong terror of losing his sanity, and both of his aunts and half-brother suffered from schizophrenia.
Including educational awareness campaigns, humanizing the condition of individuals suffering from schizophrenia, and providing platforms to raise awareness can help reduce social stigma. Media can play a significant role in changing perceptions about mental illness. Often, the media depicts people with schizophrenia as violent or unpredictable, which is not representative of most individuals with the condition. Therefore, it is necessary for the media to encourage accurate and respectful portrayals of schizophrenia.
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