A homeless man on the streets of an American city who believes he is the Son of God, A young Japanese woman who seems to be frozen her muscles refusing to move in her face showing no expression, A Russian college student whose life is deteriorating as he lives in fear that the CIA is trying to abduct him and sell his organs to interdimensional aliens. Despite sounding like these three people couldn’t be more different from each other they all share one thing in common diagnosis of schizophrenia.
Schizophrenia
It is a disease you’ve likely heard of already whether from a movie or a TV show or simply because its name is so widespread after all it’s one of the most debilitating mental illnesses in existence and there’s certainly no shortage of horror stories that have resulted from its symptoms. So perhaps it didn’t for me is well earned but the Hollywood portrayal as well as the public’s general knowledge tends to be wildly exaggerated while simultaneously seeming only to scratch the surface of this incredibly complex disorder. It is a mysterious disease that dramatically affects one’s mood Behavior personality and their very perception of reality. So today we’re gonna unravel the Twisted web of symptoms Horrors and hope for those with “Schizophrenia a true monster of the mind”.
Misconceptions
Now before we get into the symptoms that generally denote schizophrenia let’s make a couple of things clear firstly schizophrenia is not dissociative identity disorder or as you may know by its previous name multiple personality disorder this is a completely different diagnosis. But there is this common misconception that having multiple personalities and randomly switching between them is a symptom of Schizophrenia oh which it is not. I would also like to clarify that not everyone who suffers from schizophrenia is a violent person and the symptoms do not always lead to Violent actions we get deeper into this at the end of the article. But it’s important not to spread the myth that every single person with Schizophrenia is a danger to themselves and others. A final note, if you suspect that someone you know is suffering from schizophrenia don’t attempt to diagnose others or even self-diagnose yourself this should always be done by a mental health professional as many of the items we’re going to cover today overlap with other mental illnesses such as Depression or Anxiety and with that out of the way. Let’s start in.
Diagnostic Criteria
The latest models of diagnostic criteria divide the main symptoms most associated with schizophrenia into two separate categories positive and negative. But it doesn’t mean there are good and bad symptoms the terms positive and negative refer to the phenomena that are either present when they shouldn’t be in a normal individual or behaviors that are absent or when they would appear in an unaffected person.
Positive Symptoms/Present Symptoms
With the positive or present symptoms, the most well-known unwidely depicted of these is sensory hallucinations these can affect any of the body’s senses but the most commonly reported one is Auditory which usually includes the patient hearing voices in their head.
1. Hearing voices from the brain
These voices can be anything from benevolent and soft-spoken to screaming raging violent and demanding there can even be more than one voice at a time leading them to argue with each other for dominance. Sometimes the voices are even interactive meaning the patient can ask them a question and receive an answer but it’s important to remember these voices by themselves aren’t the only symptom of schizophrenia.
They’re almost always accompanied by a seriously altered state of reality if you or I suddenly hear a voice in our head demanding that we murder the person next to us during our morning commute on the train we’d be more than likely to dismiss it as a startling hallucination and then get ourselves checked out by a doctor. Hearing voices can accompany a very normal person going through something like a rough spell of Anxiety but for someone with Schizophrenia these commands they hear from the voices can be as real as the world around them and they can have a strong influence on someone’s actions as the person often feels persuaded or even compelled to obey them after some time.
Take for instance the tragic story of a 33-year-old woman from Florida whose name is unknown, In June 2010 had recently given birth to a baby girl she had been diagnosed with postpartum depression a relatively common mood disorder that affects one in every 10 mothers. But things took a serious turn for the worse when she began experiencing Viv bid auditory hallucinations and when the girl was just a few weeks old she left the house to check herself into the hospital where she reported hearing voices after this everything spiralled out of control. She checked herself out of the hospital drove home and against the wishes of the baby’s father, threw the baby into the car and sped off apparently to go instead of mother. The father had no idea what was going on and was even more confused when she called him to say that she’d met someone new and never wanted to see him again.
A couple of days later, she and the baby reappeared at the house the father was initially ecstatic that the family was being reunited but sadly this would be the last day of his baby’s life. Later that night just after 1 a.m., the woman murdered her daughter by decapitating her with a steak knife. After that, she proceeded to eat parts of her body including the brain, the toes, and the nose. After a subsequent arrest she told detectives that the devil had been speaking to her it had made her commit the atrocities a Telltale sign of Schizophrenia which it was later discovered she had been diagnosed with the year before
Now what’s particularly interesting in this case is the malevolent voice presented itself as the devil this is likely because the woman was known to be a Jehovah’s Witness and so the concept of a devil was familiar to her. This is a common theme across many types of symptoms they often reflect one’s cultural upbringing so in this case the woman thought that the devil was the entity speaking with her. Others might think they are hearing the voice of God, their ancestors, or even aliens.
2. Hallucinations
The second most common sensory Hallucination is visual these can be full-on Visions with religious figures ghosts and Vivid scenery in strange locations or they can be as simple as appearing or disappearing objects. People throughout someone’s day-to-day life some people react to these with awe and wonder believing that they are truly witnessing something extraordinary and perhaps rather pleasant.
Others are less fortunate and are subject to utter terror and fright when terrifying reality-shattering hallucinations come and go with no warning less common than auditory and visual hallucinations of those of touch smell and taste which aren’t seen with nearly the same frequency. But are still a possible symptom and interestingly patients are more likely to experience hallucinations involving two or more sensors than they are to experience events with just a single sense so you could probably imagine how convincing they can be. Another positive symptom that is a hallmark of schizophrenia is delusions.
3. Delusions
These delusions come in a variety of forms but we’ll start with delusions of Grandeur delusions. The grandeur causes the patient to believe that they are either of extreme Royal importance to the world in conceivably intelligent or in some cases even a Divine being these beliefs can also be seen in someone who has Narcissistic personality disorder or is in a manic phase of a bipolar episode. But they’re generally more extreme in patients with schizophrenia.
Someone suffering from these delusions as a symptom of schizophrenia might regard themselves as a misunderstood genius who could solve all of the world’s problems if they had enough power or in more severe cases they might even think they are an important religious figure such as the literal Reincarnation of God and itself these types of delusions might sound more like a thorn in the side of social skills and less of a danger but they can lead to violence in some cases.
There are even multiple examples of this in recent news for instance a man from Utah was recently charged with two counts of murder the people he killed in June 2022 were strangers to him and the murders took place in two different cities with him not even attempting to hide the bodies one of which he stabbed in a grocery store, parking lot. The other he assaulted and hanged with gym equipment once arrested he claimed he was doing his duty to purge the cities. Whatever he was purging them from isn’t exactly clear but he said that he knew it was his Noble responsibility to Bear bestowed upon Him by some vague higher power.
But not all delusions of grandeur pose a threat to others some of them pose the greatest threat to the one experiencing the delusions believing themselves to be the chosen one or something equally mystical patients can seriously think they’ve become invincible causing them to take immense risks like walking in front of speed and traffic. Other examples of this delusion include things like a patient believing that they’re a top-secret spy reporting directly to the president of the United States or that they are the true president and an imposter has taken their place. Again this sounds completely outlandish to most of us but no amount of casual reasoning or asking for evidence will do much to change a person’s mind when they’re suffering from one of these delusions.
But of all the delusions one can suffer from the most textbook type are persecutory delusions these are the stereotypical everyone’s out to get me types of beliefs that many people immediately associate with the disorder and for good reason during the first onset of serious symptoms known as the first episode of psychosis up to 70 of all patients experience some form of persecutory delusion. These can be anything from thinking everyone in the grocery store is carefully monitoring and reporting their every move all the way to firmly believing that the CIA’s implanted microchips in the birds that are chirping outside their house every morning.
Oftentimes this persecutory delusion as well have something specifically related to the patient’s thoughts such as the devil stealing my thoughts or on the flip side, the government implanting thoughts into their heads patients will often be extremely suspicious of everyone even those they’ve known for a long time and previously trusted. The center of these persecutions doesn’t even necessarily have to be the person with the disorder.
In March 2022 a man in the UK escaped from his Hospital Ward and tracked down his father whom he proceeded to assault by punching and kicking him and finally stomping him because he had become completely convinced that his father was planning to attack his mother despite absolutely no history of violence in the family and he decided that he had to take matters into his own hands. The father tragically died a few weeks later of his injuries. One interesting way these delusions can be discovered is when a person files a police report seeking protection from a stalker however upon investigating the police find that no such stalker even exists and that the person filing the report hasn’t even seen their place. They simply know that they’re being watched in the past.
If a patient’s main symptoms were these types of paranoid persecutory delusions they would have been diagnosed with paranoid schizophrenia. But in recent years this diagnosis has been completely removed and instead, General paranoia is merely one of the positive Symptoms under schizophrenia’s broader umbrella so that’s about it for positive symptoms usually coming down to various types of hallucinations and Illusions. These are the ones most popular in the media the ones other people are most likely to notice and often the ones that are most likely to get someone in trouble with the law but these are only one side of the schizophrenic coin.
Negative symptoms
Negative symptoms are behaviors or phenomena that are absent or diminished and they often begin emerging in someone before the positive symptoms begin to take effect. In some cases even years in advance one of the most commonly experienced negative symptoms is Abolition or extreme apathy and a Severe lack of motivation.
Abolition or extreme apathy and a Severe lack of motivation
This usually manifests itself as missing school falling behind at work and losing all interest in self-care such as showering brushing teeth or eating properly. Unfortunately to others, this behavior is often interpreted as simple laziness and not much compassion is given at a time. When it could seriously help this along with becoming increasingly asocial can damage important relationships with friends and family in someone’s life and because they lack any desire to repair them this can leave someone more and more isolated in their social withdrawal as the symptoms increase in severity. To top it all off these symptoms are often accompanied by anhedonia a total lack of pleasure or even a logia a decline in speech complexity along with being seen as just general lazy us or odd behaviour.
Some other social withdrawal lack of self-care and absent sex drive can be misinterpreted by some people as depression because these by themselves are classic symptoms of major depressive disorder. But it’s when combined with a few other negative symptoms that schizophrenia is set apart from other mental illnesses and that’s the way it causes people to express their emotions half of this is blunted affect a condition where a patient fails to express emotion at all whether it be positive or negative. Remember it’s not depression where the mood is mostly negative and it’s not a side effect of medication their mood is just overly neutral regardless of the situation.
In most serious cases something like the news of the death of a loved one would elicit no response their face would remain straight no tears would form their voice wouldn’t change pitch or volume none of the responses associated with emotional expression but it gets even stranger. Instead of showing no emotion whatsoever, schizophrenia can also cause inappropriate affect or air compared to showing nothing the person shows emotion the wrong one. Imagine being at a funeral full of people and someone suddenly begins quietly chuckling to themselves this is called Paradoxical laughter. It’s been recorded in patients with schizophrenia since the 1940s many of them report feeling tension in their heads as they try to work out which emotion will surface and end up laughing as a way to relieve the tension. While others are completely unable to explain why they’re suddenly amused even stronger still. Another negative symptom is a lack of normal muscle movement.
Lack of Muscle Movements
This can range from strange jerking arm motions all the way to complete Catatonia where a person is Frozen in a trance-like state and barely moves for hours. In the end, this can be so extreme that a person can resemble a statue more than a living being even in somewhat disturbing positions with their arms raised in the air that would be incredibly painful for the rest of us to hold for extended periods. If they are left undisturbed for long periods of immobility. They can cause permanent muscle issues and lung complications. Sometimes patient may even refuse to swallow food or water during an episode. If left untreated completely lately the more serious cases can even result in death even in instances where the Catatonia doesn’t last for let’s say days on end it can still appear with alarming frequency with some patients reporting having shorter Frozen States multiple times a week or even days.
Now there are a few symptoms that don’t fall neatly into this positive-negative bundle that we’ve described which are the cognitive issues that have been observed to accompany schizophrenia this includes General issues with something called neurocognition.
Neurocognition
Neurocognition is the brain’s ability to process information so patients with schizophrenia are commonly seen to have issues with things like remembering and repeating a short string of words, their reaction time could be significantly slowed and they can even have a very difficult time understanding what’s going on in optical illusions. It’s pretty clear to see how these symptoms would seriously affect someone’s day-to-day functioning and their ability to hold a job but of these cognitive issues some of the most debilitating are those regarding speech this was partly under the negative symptom. Some patients stop speaking in long sentences and instead use short quick responses, but it goes much deeper than that in severe cases speech can be reduced to something known as a word salad a seemingly random pile of unrelated words jumbled into a sentence such as, friend menu glasses ride tree blanket Jupiter.
Another form of word Salad called clanging is when someone’s speech gets randomly stuck in a loop or rhythm of rhyming such as Today I woke up and then I went to the store to floor Mordor these are rather bizarre but at least they’re words in more severe cases the person could Hub completely unintelligible muttering to themselves endlessly with little ability to communicate.
Early onset or history of schizophrenic cases
The most terrifying part of schizophrenia is it can happen to anyone generally the onset of the disease occurs between the late teens and the early 30s with males usually in their early 20s and females averaging in the late 20s less. Often it can occur before adulthood known as early onset and it can even appear as late as once 50s it may develop even later such as in the 170s but at that point, it’s difficult to tell the symptoms apart from those of other conditions that come with an aging mind. But here’s the scary part its onset has been known to be sudden in many cases the symptoms gradually develop over years before a diagnosis takes place but sometimes about 25 percent of the time it happens rapidly.
Imagine going to bed one night with the only worry on your mind being a tough exam the next week or an extra long shift at work when you wake up you have a voice in your head that narrates your every move it talks to you it argues with you and it even screams you. But most importantly it doesn’t seem to go away day after day. This, unfortunately, is a reality for many who have a sudden onset for the other 75 the signs of schizophrenia developed slowly over the years with negative symptoms and cognitive problems usually manifesting first and eventually progressing into the positive symptoms of psychosis.
Medications and Anti Psychotics
The National Institute of Mental Health estimates that schizophrenia affects around 0.5 percent of the population of the United States though other estimates often place it at a full one percent It sounds like a small number but it means that in the United States, there are as many as three million people or more living with the disorder treatments of this disorder sees mixed results. Anti-psychotics are generally prescribed and these can be quite effective at handling the hallucinations and the delusions but they don’t work for everyone and they come with a whole host of nasty side effects including an Increased risk of developing diabetes and involuntary muscle twitching about half of all patients who take Antipsychotics will respond well to them. But the symptoms rarely disappear entirely this is why the medication needs to be accompanied by another form of treatment such as cognitive behavioral therapy or family therapy to learn how to manage day-to-day life with the symptoms.
But getting someone to do all of this is another problem in itself between 30 and 50 of all people diagnosed deny that there is anything wrong with them and outright refuse treatment impatience deemed to be a danger to themselves or others. This refusal of treatment can be overridden by a court order and doctors can administer courses of forcefully injected antipsychotics which sounds like a nightmare and it’s most certainly horrifying for the person restrained to the chair. Perhaps in the future, better treatments will become available as we learn more about what causes Schizophrenia because at the moment the cause of the disorder remains pretty murky what we do know for sure is that there is some genetic component to your chance of developing the disorder goes up to 13%.
Reasons Behind Schizophrenia
The odds of this happening by a random chance without genetics at play are unfathomably slim but doctors of studies have still failed to find any specific genes that can be associated with the disorder. Consistently the best guess at the moment is that there simply isn’t a single cause it’s likely that the DNA you inherited from your parents can give you a genetic predisposition to the disorder and this vulnerability can be turned on or activated by experiences in Life or exposure to certain chemicals such as various drugs all these drugs cannabis seems to be a big one. There are lots of studies on this but one example is from Sweden where researchers found that those who use cannabis regularly are six times more likely to develop schizophrenia than the average person.
This doesn’t mean they’re liking a joint or two will set you on a path to psychosis but it does mean that if you have the elusive genetic Factor whatever it may be cannabis and other substances may make it more likely to become active in you along with substance use there are a few other things that researchers are pretty confident in linking to developing schizophrenia for example, Living in an urban environment as opposed to the countryside makes your chances of developing much higher as does a history of child abuse recent immigration to a new country and poverty all of these seem to be strongly associated with stress levels. So it’s probably a connection with high levels of stress especially in adolescence as for specific life events that can trigger the onset, giving birth seems to be one of the most commonly observed famous cases in the early 2000s.
It featured a woman who seemed to be entirely normal at least to her friends and family when she married her husband they announced they’d have as many babies as nature would allow and true to their words after just a few years they had four of them but after the fourth delivery something in the mother changed. Her husband found her shaking in the corner and chewing on her fingers oblivious took the world around her and she attempted suicide. She was put on Antipsychotics which seemed to do the trick as everything generally went back to normal but this was only temporary. She soon relapsed into a psychotic state and had to be institutionalized twice in 1999. she was originally diagnosed with Postpartum psychosis and the psychiatrist suggested she not have any more kids as it would be too high of a risk for mental health
Just seven weeks later, though they conceived the next child who was born in 2000. After this fifth birth, she stopped taking her meds, began obsessively reading the Bible, and entered catatonic states with increasing frequency which all culminated. When one day her husband left for work leaving his wife with a single hour before her other caretaker arrived. Sadly one unsupervised hour is all she needed to drown all five of her kids one by one in the bathtub she later told the court that killing them, before they lived a sinful life was the only way to save them from hell. She had experienced depression as a teenager perhaps the negative symptoms beginning long in advance. But she was stable and happy even doing her best to homeschool her kids. The positive symptoms and intense delusions seemed to all spiral out of control just after the birth of her fourth child. But again most of these correlations not just that correlations more concrete targeting dopamine receptors.
Role of Dopamine in Schizophrenia
One theory says that those with schizophrenia have too many of these dopamine receptors or other simply faulty that do a few things to their brain and will try to keep this as simple as possible. Firstly dopamine is the neurotransmitter or brain chemical associated with things like motivation reward and mood if these pathways are overloaded or not working basic day-to-day actions and reward sequences like showering or cleaning might seem. Pointless Behaviour is often noticed among the negative symptoms. Additionally, it’s thought by some researchers that these high levels of dopamine can affect our mind’s internal filter which could be responsible for many of the positive symptoms such as delusions and hallucinations. This could also be why antipsychotic medications generally work for these stronger positive symptoms as many of them reduce dopamine levels in the brain.
The links between dopamine and schizophrenia go back to the 1960s when antipsychotics were First beginning to be introduced. But it’s not the complete picture there are other neurotransmitters involved and some patients have even normal levels of dopamine. So it clearly isn’t the only cause but it is a step in the right direction and if the disorder truly does have a large biological aspect it can mean that there’s hope for a future cure.
Conclusion
It’s true that for many people medication simply doesn’t work and that for others therapy is no help either and it’s certainly true that some just refuse to be treated at all. But schizophrenia isn’t a death sentence and there is hope for those in its clutches with proper support and specialized treatment especially if the treatment occurs early on it’s possible to manage the symptoms and those affected even recover and go on to lead a fairly normal life like Eleanor Longden.
For Example, Eleana was a college student when she was suddenly subjected to terrifying voices in her head spiraling her life into hospitalizations various drugs, and the diagnosis of schizophrenia. But after three years of battling with their symptoms, Elena was able to learn to manage and cope with them and even went on to earn a master’s degree in Psychology hoping to inspire and help others with similar struggles. Eventually leading to her giving a Ted Talk on the subject it’s quite a recovery.
As mentioned at the beginning of this article not everyone with schizophrenia is violent the majority of patients diagnosed with the disease are far more likely to become the victim of violence themselves than to harm someone else. People with schizophrenia are more likely to die at a younger age from heart failure and nearly five percent of them commit suicide they’re more likely to be scammed more likely to be alone and far more likely to end up homeless or in prison. This is all along with the immense financial burden that can accompany it not only the direct costs of healthcare and medication but also the indirect cost of earning less money. Due to a lack of productivity or Difficulty holding a job, these are people that instead of being ostracized desperately need all the help that society can offer them.