Schizophrenia

The Oscar-nominated film, "A Beautiful Mind," has brought national attention to the most puzzling and disabling of the major mental illnesses - schizophrenia. The film chronicles the experiences of John Forbes Nash, Jr., a mathematical genius and inventor of theories of rational behavior. "Non-Cooperative Games," the Ph.D. thesis Nash wrote at Princeton in his early 20s, eventually won him the 1994 Nobel Prize in economics, but only after a 30-year struggle with schizophrenia.

Although basic knowledge about the link between brain chemistry and schizophrenia is expanding rapidly, we still must speculate on the cause of this chronic brain disease. It is likely that the disorder is associated with some imbalance of the complex, interrelated chemical system of the brain. And while it is known that schizophrenia runs in families, it is not yet understood how the genetic predisposition is transmitted. Approximately one percent of the world's population develops schizophrenia during their lifetimes. Although men and women are affected with equal frequency, the disease most often emerges in the late teens and early twenties in men and in the twenties and thirties in women. With the sudden onset of the following severe psychotic symptoms, the affected individual is immersed in a confusing and often terrifying world. Unusual realities. Living is a world that can appear distorted and changeable, a person with schizophrenia may feel anxious and disoriented. He or she may sit rigidly for hours not saying a word or may be constantly moving about, alert and vigilant. Hallucinations. A person may see people or objects that are not really there, but hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Delusions. These false personal beliefs can involve themes of persecution or grandeur. For example, the individual may believe that certain people or groups are conspiring to destroy him or her, or may believe that he or she has been singled out for an important mission to save the world. Disordered thinking. The person may endure many hours of not being able to think clearly, with disconnected thoughts coming and going rapidly and an inability to focus attention. This lack of logical continuity of thought can make social interactions difficult and lead to isolation. Inappropriate affect. The person with schizophrenia may show emotion that is inconsistent with his or her emotions and thoughts. Often the individual experiences a severe reduction in emotional expression, with a monotone voice and diminished facial expression. Antipsychotic drugs are the most common treatment for schizophrenia, but they do not "cure" the disease or consistently relieve all symptoms. Even when relatively free of psychotic symptoms, the person with schizophrenia may have great difficulty establishing and maintaining relationships. And because the person most likely became ill during the critical career-forming years of life, he or she not only suffers thinking and emotional difficulties, but lacks social and work skills, as well. For this reason, individual and/or family therapy, rehabilitation programs, and support groups can contribute greatly to the individual's recovery. What is the outlook for people with schizophrenia and how can we help? Some people have only one psychotic episode, while others have many but live relatively normal lives in the interim. Studies that follow people with schizophrenia reveal a wide range of possibilities. One review of 2000 affected individuals suggests that 25 percent achieve full recovery, 50 percent recover at least partially, and 25 percent require long-term care. Part of our helpfulness must come from rejecting the myths that surround the illness. The media has cultivated fear of schizophrenia by linking it with criminal violence; most violent crimes are not committed by people with schizophrenia and most people with schizophrenia do not commit violent crimes - in fact they are more like to withdraw and isolate themselves from others. Because people with the disorder often believe their hallucinations or delusions are real, they resist treatment and do not disclose all of their symptoms. Family and friends can help by making sure that all relevant information is available to professionals and by encouraging adherence to treatment. Instead of "going along" with the person's delusions, family and friends can tell the person that they do not see things the same way while acknowledging that things do appear otherwise to him or her. Perhaps our greatest contribution can be in helping the person with schizophrenia regain his or her abilities and voice the belief that people living with this disorder can have meaning and accomplishment in their lives. The Washington County Mental Health & Addiction Recovery Board is offering a public information session about schizophrenia on April 17 at Washington State Community College. More details will be provided in a forthcoming Marietta Times article.