Schizophrenia Essay, Research Paper

Schizophrenia

During the 1950s, mentally disordered people who were harmful to society

and themselves could be treated with medications and were able to return safely

to their communities. During the 1980s, the cost of health care increased more

than any other cost in our national economy. As a result, strategic planning

has been made to reduce costs. ?The political decision made to

deinstitutionalize chronic mental patients started with the appearance of

phenothiazine medications. Dramatically reducing the instability influenced by

psychosis, these medications were of great significance to many individuals with

serious mental disorders. At both the state and federal levels, legislators

looked at the high cost of long-term psychiatric hospitalization. Social

scientists guaranteed them that community-based care would be in the best

interests of all concerned: the mentally ill and the general, tax-paying public

(Barry 13).? It was believed that a social breakdown syndrome would develop in

chronically mentally ill persons who were institutionalized. The

characteristics of this syndrome were submission to authority, withdrawal, lack

of initiative, and excessive dependence on the institution.

While deinstitutionalization was kindhearted in its primary logic, the

actual execution of the concept has been greatly undermined by the lack of good

community alternatives. At this time a large amount of the individuals using

community mental health treatment services are the homeless. Nearly half of the

homeless are chronically mental ill. These individuals are often separated from

their families and all alone on the dangerous street. These homeless

schizophrenics stay away from social structures such as community health

treatment centers. Since they start a new life of independence they often stop

taking their medications, become psychotic and out of place, and begin to live

on the street. Since the schizophrenics are deinstitutionalized they are thrown

into a whole new world of independence. Since their brain functions different

than the usual human being they can’t cope with the problems of life. The

schizophrenics drive themselves crazy wanting to kill themselves and others in

order to escape from this perplexing world.

Schizophrenia is the most common psychoses in the United States

affecting around one percent of the United States population. It is

characterized by a deep withdrawal from interpersonal relationships and a

retreat into a world of fantasy. This plunge into fantasy results in a loss of

contact from reality that can vary from mild to severe. Psychosis has more than

one acceptable definition. The psychoses are different from other groups of

psychiatric disorders in their degree of severity, withdrawal, alteration in

affect, impairment of intellect, and regression.

The severity of psychoses are considered major disorders and involve

confusion in all portions of a person’s life. Psychosis is seen in a wide range

of organic disorders and schizophrenia. These disorders are severe, intense,

and disruptive. A person with a psychotic disorder suffers greatly, as do those

in his or her immediate environment. Individuals suffering from withdrawal are

said to be autistic. That is, the person withdraws from reality into a private

world of his or her own. The psychotic individual is more withdrawn than a

person with a neurotic disorder or any other mental disorder. The affect, mood,

or emotional tone in a person with a psychotic disorder is immensely different

from that of normal affect. In the mood disorders, one observes the

exaggeration of sadness and cheerfulness in the form of depression and mania.

In the schizophrenic disorders, affect may be exaggerated, flat, or

inappropriate.

In psychotic disorders, the intellect is involved in the actual

psychotic process, resulting in derangement of language, thought, and judgment.

Schizophrenia is called a formal thought disorder. Thinking and understanding

of reality are usually severely impaired. The most severe and prolonged

regressions are seen in the psychoses, regression. There is a falling back to

earlier behavioral levels. In schizophrenia this may include returning to

primitive forms of behavior, such as curling up into a fetal position, eating

with one’s hands, and so forth. The symptoms of schizophrenia usually occur

during adolescence or early adulthood, except for paranoid schizophrenia, which

usually has a later onset. The process of schizophrenia is often slow, with the

exception of catatonia, which may have an abrupt onset. As an adolescent, a

person who later develops schizophrenia is often antisocial with others, lonely,

and depressed. Plans for the future may appear to others as vague or

unrealistic.

It is possible that there may be a preschizophrenic phase a year or two

before the disorder is diagnosed. This phase may include neurotic symptoms such

as acute or chronic anxiety, phobias, obsessions, and compulsions or may reveal

dissociative features. As anxiety mounts, indications of a thought disorder may

appear. An adolescent may complain of difficulty with concentration and with

the ability to complete school work or job-related work. Over time there is

severe deterioration of work along with the deterioration of the ability to cope

with the environment. Complains such as mind wandering and needing to devote

more time to maintaining one’s thoughts are heard. Finally, the ability to keep

out unwanted intrusions into one’s thoughts becomes impossible. As a result,

the person finds that his or her mind becomes so confused and thoughts so

distracted, that the ability to have ordinary conversations with others is lost.

The person may initially feel that something strange or wrong is going

on. He or she misinterprets things going on in the environment and may give

mystical or symbolic meanings to ordinary events. The schizophrenic may think

that certain colors hold special powers or a thunderstorm is a message from God.

The person often mistakes other people’s actions or words as signs of hostility

or evidence of harmful intent. As the disease progresses, the person suffers

from strong feelings of rejection, lack of self-respect, loneliness, and

feelings of worthlessness. Emotional and physical withdrawal increase feelings

of isolation, as does an inability to trust or sociate with others. The

withdrawal may become severe, and withdrawal from reality may be noticeable from

hallucinations, delusions, and odd mannerisms. Some schizophrenics think their

thoughts are being controlled by others or that their thoughts are being

broadcast to the world. Others think that people are out to harm them or are

spreading rumors about them. Voices are usually heard in the form of commands

or belittling statements about his or her character. These voices may seem to

appear from outside the room, from electrical appliances, or from other sources.

There are many different factors that lead to schizophrenia. The main

way to acquire schizophrenia is through heredity. A person has a 46% chance of

getting schizophrenia if his or her mother and father has it. One identical twin

has a 46% chance of getting schizophrenia if the other twin acquires it (Coon

546). There are also some environmental factors that lead to schizophrenia.

One is if the mother gets the flu during the second trimester of pregnancy

causing brain damage to the unborn child. Another factor is complications at

birth that could affect the child mentally. Another factor causing

schizophrenia is stress because the mind is overworked and eventually can’t

function properly. An important factor concerning schizophrenia is how a child

is raised. If the child has abusive parents, he or she will have serious mental

problems in the future.

Early in this disease, there may be obsession with religion, matters of

the supernatural, or abstract causes of creation. Speech may be characterized

by unclear symbolisms. Later, words and phrases may become puzzling, and these

can only be understood as part of the person’s private fantasy world. People

who have been ill with schizophrenia for a long time often have speech patterns

that are disoriented and aimless and deficient of meaning to the casual observer.

Sexual activity is frequently altered in mental disorders. Homosexual concerns

may be associated with all psychoses but are most prominent with paranoia.

Doubts concerning sexual identity, exaggerated sexual needs, altered sexual

performance and fears of intimacy are prominent in schizophrenia. The process

of regression in schizophrenia is accompanied by increased self-fixation,

isolation, and masturbatory behavior.

The schizophrenic person finds himself or herself in a painful dilemma.

He or she retreats from personal intimacy or closeness because of the intense

fear that closeness will be followed by ensuing rejection or harm. This retreat

from intimacy leaves the person lonely and isolated. This dilemma often becomes

the nurse’s dilemma. The nurse wishes to form a productive emotional bond but

at the same time seeks to lessen the client’s anxiety. For the schizophrenic

person, moves toward emotional closeness will eventually increase anxiety.

The dopamine theory of schizophrenia is based on the action of the

neuroleptic drugs, better known as antipsychotic drugs. Neuroleptics are the

drugs of choice for treating the symptoms of schizophrenia. The neuroleptics

are believed to block the dopamine receptors in the brain, limiting the activity

of dopamine and reducing the symptoms of schizophrenia. Amphetamines, just the

opposite, enhance dopamine transmission. Amphetamines produce an excess of

dopamine in the brain and can provoke the symptoms of schizophrenia in a

schizophrenic client. In large doses, amphetamines can simulate symptoms of

paranoid schizophrenia in a nonschizophrenic person. Some symptoms of

schizophrenia are due basically to hyperdopaminergic activity. Other symptoms,

such as apathy and poverty of thought, are related to neuronal loss.

Drugs reduce most of the disturbing, disorganizing, and destructive

aspects of the schizophrenic person’s behavior. Drugs, however, do not improve

or affect the fundamental stupor, unresponsiveness, lack of ambition, and

symbolic defects. Group therapy is especially useful for clients who have had

one or more psychotic breaks. It has been shown that groups can benefit the

client in the development of interpersonal skills, resolution of family problems,

and the effective use of community supports. Groups allow opportunities for

socialization in safe settings, the expression of tensions, and sharing problems.

The most useful types of groups for schizophrenics are groups that help the

client develop abilities to deal with such issues as day-to-day problems,

sharing consistent experiences, learning to listen, asking questions, and

keeping topics in focus. Groups available on an outpatient basis over a long

period of time allow for individual growth in these areas. It would help

greatly if better rehabilitation programs were offered after hospital treatment.

One such approach is the use of half-way houses, which can ease a patient’s

return to the community. The half-way houses offer patients supervision and

support, without being as restrictive as hospitals. They also keep people near

their families. Most important, half-way houses can reduce a person’s chances

of being readmitted to a hospital.

Although the therapy and drugs help the schizophrenics deal with their

problems tremendously there is not enough to go around because states are

closing their mental institutes for financial reasons. Even though the cost of

mental institutes are high, the schizophrenics are better off being kept in them

because they could cause a huge uproar on the streets. Without the mental

institutes the schizophrenics will get worse because they are unable to live

independently. Many schizophrenics might even be harmful to society because

their brain is out of control. The paranoid schizophrenics could go on a

rampage and try to kill everyone in sight because they think that everyone is

out to hurt them. This could be the future of our world if we don’t take time

to treat these schizophrenics who desperately need it no matter what the cost.

Works Cited Barry, Patricia D. Mental Health and Mental Illness. Philadelphia:

J. B. Lippincott,

1994. Coon, Dennis. Introduction to Psychology. New York: West

Publishing Company, 1995 McCuen, Gary E. Treating the Mentally Disabled.

Hudson, Wisconsin: Gary E.

McCuen, 1988. Varcarolis, Elizabeth M. Psychiatric Mental Health

Nursing. Philadelphia: W. B.

Saunders, 1990.