Schizophrenia: Explained And Treatments Essay, Research Paper

Schizophrenia: Explained and Treatments

Jeffrey A. Hurt

Professor Leary

Abnormal Psychology 203

2 May 1996

Schizophrenia is a devastating brain disorder affecting people worldwide of all

ages, races, and economic levels. It causes personality disintegration and loss

of contact with reality (Sinclair). It is the most common psychosis and it is

estimated that one percent of the U.S. population will be diagnosed with it over

the course of their lives (Torrey 2). Recognition of this disease dates back to

the 1800’s when Emil Kraepelin concluded after a comprehensive study of

thousands of patients that a “state of dementia was supposed to follow

precociously or soon after the onset of the illness.” Eugene Bleuler, a famous

Swiss psychiatrist, coined the term “schizophrenia,” referring to what he called

the “splitting of the various psychic functions” (Honig 209-211). Having a

“split personality” is often incorrectly associated with schizophrenia.

Possessing multiple personalities on different occasions is a form of neurosis

vice psychosis (Chapman). Symptoms most commonly associated with schizophrenia

include delusions, hallucinations, and thought disorder (Torrey 1). Delusions

are irrational ideas, routinely absurd and outlandish. A patient may believe

that he or she is possessed of great wealth, intellect, importance or power.

Sometimes the patient may think he is George Washington or another great

historical person (Chapman). Hallucinations are common, particularly auditory,

as voices in the third person or commenting upon the patient’s thoughts and

actions (Arieti). Persons may also hear music or see nonexistent images

(Sinclair). Schizophrenic thought disorder is the diminished ability to think

clearly and logically (Torrey 2). Many times, schizophrenics invent new words

(called neologisms) with unique meanings (Chapman). Often it is apparent by

disconnected and meaningless language that renders the person incapable of

participating in conversation and contributing to his alienation from his family,

friends, and society (Torrey 2). There appears to be three major subtypes of

Schizophrenia: paranoid, hebephrenic, and catatonic. Delusions, often of

prosecution, are prominent in the paranoid type (Arieti). Hebephrenic

schizophrenia is characterized by thought disorder, chaotic language, silliness,

and giggling (Eysenck, Arnold, and Meili 961-962). In the catatonic form, the

person may sit, stand, or lie in fixed postures or attitudes for weeks or months

on end. The person may also have a symptom known as “waxy flexibility” in which

the victim will maintain positions of the body in which he is put for long

periods of time, even if they are uncomfortable (Arieti). There have been many

theories to explain what causes schizophrenia. Heredity, stress, medical

illness, and physical injury to the brain are all thought to be factors but

research has not yet pinpointed the specific combination of factors that produce

the disease (Sinclair). While schizophrenia can affect anyone at any point in

life, it is somewhat more common in those persons who are genetically

predisposed to the disease (Torrey 3). Studies have shown that approximately

12% of the offspring will be schizophrenic if one parent has the disorder and

50% if both parents have the disorder. This may be due to the fact that the

offspring are reared in an environment other than normal. Although statistics

from adoption agencies show that these rates are more affected by genes rather

than environment (Chapman). Three-quarters of persons with schizophrenia

develop the disease between 16 and 25 years of age. Onset is uncommon after age

30, and rare after age 40 (Torrey 3). Psychiatric patients are generally

insulted by contentions that their trouble was brought on by bad parenting,

childhood trauma, or week character (Willwerth 79). Sigmund Freud has suggested

that schizophrenia is developed from a lack of affection in the mother-infant

relationship in the first few weeks after birth. Increased levels of the

neurotransmitter dopamine in the brain’s left hemisphere and lowered glucose

levels in the brain’s frontal lobes have been coupled to schizophrenic episodes

(Chapman).

Treatment for schizophrenia includes electroconvulsive treatment (shock therapy),

psychosurgery, psychotherapy, and the use of antipsychotic medications (Torrey

5). Shock therapy is the application of electrical current to the brain (Long).

In 1937, shock therapy was first introduced and was the popular mode of

treatment until the late 1950’s (Chapman). It is effective in the most severe

catatonic forms of schizophrenia, but its use in other forms is debatable

(Eysenck, Arnold, and Meili 964-965). Psychosurgery became common in the 1940’s

and 1950’s but is now in disrepute. Lobotomies, most often removal of the

frontal lobes, was the most widespread form of psychosurgery. Scientists have

since found that by artificially creating lesions in the area of the frontal

lobes, one’s personality can seriously be modified (Baruk 196-197). For the

most part, society has condemned this form of treatment as inhumane.

Psychotherapy achieves the best results when the physician listens carefully to

his client’s symptoms, diagnosis promptly and accurately, advises the person of

the diagnosis, and then prescribes a successful treatment program (Humphrey and

Osmond, 189). Psychotherapy can offer understanding, reassurance, and

suggestions for handling the emotional problems of the disorder and help to

alleviate stressful living situations (Long). The majority of mental health

professionals believe that psychotherapy combined with drug therapy produce the

best treatment of schizophrenia (Walsh 103-104). Since the late 1950’s,

schizophrenia has been treated primarily with medications. Most of these drugs

block the action of dopamine in the brain (Chapman). These drugs can help a

great deal in lessening hallucinations and delusions, and in helping to maintain

coherent thoughts. But, they usually have serious side effects that contribute

to people not taking their medication, and relapse (Long). Haldol is the most

commonly prescribed antipsychotic drug to treat schizophrenia. Abbott

Laboratories is presently in the process of testing the safety and efficiency of

a new drug, sertindole (Torrey 8). Nearly ten years ago the first studies of

clozapine opened up a new line of medical research and it was hailed as a

miracle drug. Unfortunately, a small percentage of patients on clozapine

develop a blood condition known as agranulocytosis and have to stop taking the

medication (Long). Agranulocytosis is a disorder noted by a massive reduction

in the number of white blood cells which usually results in the occurance of

infected ulcers on the skin and throat, intestinal tract, and other mucous

membranes. Agranulocytosis may cause a bacterial infection to become fatal

since white blood cells are an important defense against microorganisms

(Chapman). A new medication, olanzapine, may be the next miracle drug on the

market. Recent studies have shown that olanzapine offers many of the same

benefits of clozapine but apparently without the side affects (Torrey 8-9).

Hospitalization is often necessary in cases of acute schizophrenia to ensure

safety of the affected person, while also allowing initiation of medication

under close supervision (Torrey 10-11). In milder cases, family therapy has

been to be found helpful. With this type of therapy, family members learn to

live with the person in an understanding and accepting manner (Chapman). In the

following excerpts from her life story, Esso Leete describes her 20-year battle

with schizophrenia and her growing acceptance of her illness. She has committed

herself to leading the fullest life her disease will allow and to educating

others about mental illness. She’s employed full time as a medical records

transcriptionist at a hospital where she was once committed (Long).

“It has been 20 years since I first became mentally ill. As I approach 40, I

find myself still struggling with the same symptoms, still crippled by the same

fears and paranoia. I am haunted by an evasive picture of what my life could

have been, whom I might have become, what I might have accomplished. My

schizophrenia is a sad realization, a painful reality, that I live with every

day. Let me tell you a little about my history. I probably inherited a

predisposition to mental illness; my uncle was diagnosed as having dementia

praecox”, an earlier term for schizophrenia. In my senior year of high school,

I began to experience personality changes. I did not realize the significance

of the changes at the time, and I think others denied them, but looking back I

can see that they were the earliest signs of illness. I became increasingly

withdrawn and sullen. I felt alienated and lonely and hated everyone. I felt as

if there were a huge gap between me and the rest of the world; everybody seemed

so distant from me. I reluctantly went of to college, feeling alone and totally

unprepared for life away from home. I was isolated and had no close friends.

As time went on, I spoke to virtually no one. Increasingly during classes I

found myself drawing pictures of Van Gogh and writing poetry. I forgot to eat

and began sleeping in my clothes. Performing even the most routine activities,

such as taking a shower, rarely even occurred to me. Toward the end of my first

semester, I had my first psychotic episode. I did not understand what was

happening and was extremely frightened. The experience left me exhausted and

confused, and I began hearing voices for the first time. I was admitted to a

psychiatric hospital, diagnosed as having schizophrenia, treated with

medications and released after a few months. During my late teens and early 20s,

when my age demanded that I date and develop social skills, my illness required

that I spend my adolescence on psychiatric wards. To this day I mourn the loss

of those years. It was not until much later that I made a conscious effort to

develop a sense of control, realizing that I had the power to decide what form

my life would take and who I would be. For the next ten years, I did not require

hospitalization. During that time, I was divorced from my first husband and

married a community mental health center psychiatrist. Although I experienced

some acute flare-ups of symptomatology during that period, I had no recurrence

of persistent, disabling symptoms. When more serious symptoms returned about ten

years later, I denied their existence. Having discontinued medications years

earlier and now withdrawing from other forms of support, I experienced more

symptoms. I decided to investigate a private psychiatric residential halfway

house that one of the nurses at the hospital had told me about. I sought and

gained admission to the program. Staff at this facility believed in my

potential, and I began to develop confidence in myself. I was now ready to take

control of my life. My estranged second husband and I moved into an apartment

together, and I threw myself into the task of finding employment. None of these

steps were accomplished easily, but the pieces of my periodically disrupted life

were coming back together. Like those with other chronic illnesses, I know to

expect good and bad times and to make the most of the good. I take my life very

seriously and do as much as I can when I am feeling well, because I know that

there will be bad times when I am likely to lose some of the ground I have

gained. Professions and family members must help the ill person set realistic

goals. I would entreat them not to be devastated by our illnesses and transmit

this hopeless attitude to us. I would urge them never to lose hope, for we will

not strive if we believe the effort is futile.”

As one can see, schizophrenia is a highly disruptive disease that has no regard

for who it affects. Researchers and mental health professionals are committing

vast amounts of time and energy to finding its cause and refining its treatment.

Health care and lost resources cost approximately $33 billion per year in the

United States alone (Torrey 2). Organizations of schizophrenic patients and

families across the country offer their members support and comfort.

Schizophrenia doesn’t affect one person-it affects whole families.

Works Cited

Arieti, Silvano. “Schizophrenia.” Encyclopedia Americana. 1992 ed. Baruk,

Henri. Patients Are People Like Us. New York: William Morrow and Company,

1978. Chapman, Loren J. Grolier Multimedia Encyclopedia. Release 6. Computer

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W. Arnold, and R. Meili. Encyclopedia of Psychology. New York:

Continuum Publishing Company, 1982. Hoffer, Abram and Osmond, Humphrey. How to

Live with Schizophrenia. Secaucus: Carol Publishing Group, 1992. Honig,

Albert. The Awakening Nightmare. Rockaway: American Faculty Press, 1972.

Long, Phillip W. Schizophrenia: Youth’s Greatest Disabler. Internet:

Internet Mental Health, 1996. Sinclair, Lawrence. High Performance Consultants.

Psyrix Corporation, 1995. Torrey, E. Fuller. Surviving Schizophrenia: A Family

Manual. National Alliance for the Mentally Ill Pamphlet. Arlington, VA:

Wilson, 1993. Walsh, Maryellen. Schizophrenia: Straight Talk for Family

Friends. New York: William Morrow and Company, Inc., 1985Willwerth, James.

“The Souls that Drugs Saved.” Time Oct. 1994: 78-81.