Part I
Understanding Schizophrenia
In this part . . .
We kick things off by giving you an overview of schizophrenia — a no-fault, equal-opportunity disease of the brain that strikes teenagers and young adults in the prime of their lives. Here we dispel some of the myths and misunderstandings associated with the disorder, which have led to unnecessary blame and social stigma. We also show you how to recognize the early warning signs of the disease, outline its risk factors, and cover the range of symptoms and behaviors that characterize schizophrenia. Finally, we tell you how doctors are able to differentiate schizophrenia from other mental disorders with seemingly overlapping symptoms, and discuss the fact that — although treatments have vastly improved the lives of people with schizophrenia and their families — much more remains to be learned.
Chapter 1
Understanding Schizophrenia: The Big Picture
In This Chapter
Understanding what schizophrenia is, who gets it, and what the symptoms are
Looking at how schizophrenia is treated
Getting the support you need
Schizophrenia. If someone you know has been recently diagnosed with schizophrenia, the very word may evoke a cascade of intense feelings: sadness, fear, confusion, shame, and hopelessness. You may ask yourself, how did this happen? Why did it happen to my loved one? It’s natural to have these emotions. But take a deep breath. You need to know that the diagnosis isn’t as catastrophic as it first appears to be.
Most people know very little about schizophrenia until it hits home, and what they do know is likely to be based on old myths and misperceptions. They need to find out as much accurate information as they can about this complex and misunderstood disease. Knowledge is power — and knowing what schizophrenia is (and isn’t) is the first step toward moving beyond your worst fears.
In this chapter, we give you an overview of the brain disorder known as schizophrenia: what it is, who gets it, and what treatments are available. We dispel some common myths about the disorder and tell you how schizophrenia differs from other mental illnesses. Finally, we tell you the good news about the disorder and why you and your loved one have every reason to remain hopeful that recovery is possible.
Schizophrenia is a serious, long-term, life-altering illness, so it’s natural to be stunned upon hearing the diagnosis. You may even feel paralyzed, not knowing what to do next. But the first step is clear: You need to gather all the information you can to make sure your loved one is getting the best possible treatment and supports available to him.
Defining Schizophrenia
You’re reading this book, which means you probably have a personal interest in schizophrenia — either you or someone close to you has been diagnosed with the disease or you’re worried about someone showing signs or symptoms. In this section, we fill you in on what’s currently known about schizophrenia and the way the disorder affects the people who have it, as well as their loved ones.
What schizophrenia is
Schizophrenia is a brain disorder characterized by a variety of different symptoms, many of which can dramatically affect an individual’s way of thinking and ability to function. Most scientists think that the disorder is due to one or more problems in the development of the brain that results in neurochemical imbalances, although no one fully understands why schizophrenia develops.
People with schizophrenia have trouble distinguishing what’s real from what’s not. They are not able to fully control their emotions or think logically, and they usually have trouble relating to other people. They often suffer from hallucinations; much of their bizarre behavior is usually due to individuals acting in response to something they think is real but is only in their minds.
Unfortunately, because of the way schizophrenia has been inaccurately portrayed in the media over many decades, the illness is one of the most feared and misunderstood of all the physical and mental disorders.
Schizophrenia is a long-term relapsing disorder because it has symptoms that wax and wane, worsen and get better, over time. Similar to many physical illnesses (such as diabetes, asthma, and arthritis), schizophrenia is highly treatable — although it isn’t yet considered curable.
But the long-term outcomes of schizophrenia aren’t as grim as was once believed. Although the disorder can have a course that results in long-term disability, one in five persons recovers completely. Some people have only one psychotic episode, others have repeated episodes with normal periods of functioning in between, and others have continuing problems from which they never fully recover.
Who gets schizophrenia
No group is risk-free when it comes to schizophrenia, but some people are more likely than others to develop the disorder. The following statistics may surprise you:
Schizophrenia is more common than you might think. About 1 out of 100 people develop schizophrenia over the course of their lifetime. Schizophrenia is twice as common as Alzheimer’s disease or HIV/AIDS, five times as common as multiple sclerosis, and six times as common as Type 1 (insulin-dependent) diabetes.
Although new cases of schizophrenia are somewhat rare, the number of individuals with the disorder remains relatively high because schizophrenia is a chronic disorder that often lasts for an extended period of time.
Schizophrenia affects both sexes equally and is found among people of all races, cultures, and socioeconomic groups around the world.
Although schizophrenia is more likely to affect people between the ages of 17 and 35 (the onset tends to be earlier in men than in women), it can begin in children as young as age 5 or have a late onset in a person’s 50s, 60s, or 70s.
Childhood-onset schizophrenia is extremely rare, affecting about 1 in 40,000 children. Only 1 in 100 adults now diagnosed with the disorder had symptoms before the age of 13. Because the disorder tends to surface more gradually in children, it often goes unnoticed. Chapter 2 lists some of the early red flags to watch for if you suspect that something may be wrong.
An earlier onset is often indicative of poorer outcomes because the disorder can interfere with education, development, and social functioning. On the other hand, early recognition can help improve outcomes and minimize disability.
Famous people with schizophrenia
Many accomplished and successful people are reported to have had schizophrenia. Here’s a short list:
Lionel Aldridge (1941–1998), professional football player on the Green Bay Packers in the 1960s
Syd Barrett (1946–2006), founding member of the band Pink Floyd
Jim Gordon (1945–), drummer and member of Derek and the Dominoes
Peter Green (1946–), guitarist and founder of the band Fleetwood Mac
Tom Harrell (1946–), jazz musician
Jack Kerouac (1922–1969), author of On the Road
Mary Todd Lincoln (1818–1882), first lady of the United States, wife of Abraham Lincoln
John Nash (1928–), mathematician, Nobel Prize winner, subject of the film A Beautiful Mind
Vaslav Nijinsky (1889–1950), ballet dancer
Brian Wilson (1942–), bass player and singer in the band The Beach Boys
Comparing the schizophrenic brain to the normal one
New imaging techniques — like magnetic resonance imaging (MRI) and positron emission tomography (PET) — have opened virtual windows into the brain. Scientists have been able to visualize the living brain and discern some of the differences in the structure and function of the brains of people with schizophrenia and the brains of their normal peers.
Some of the differences observed in the brains of people with schizophrenia are
Enlarged ventricles: Fluid-filled cavities within the brain
A loss of gray matter: Brain tissue that is comprised of nerve cells
Abnormalities in white matter: Myelin-covered nerve fibers that serve as “wiring” connecting different parts of the brain
In the rare cases where schizophrenia first appears in early childhood, differences have been found in the cortex of the developing brain. The cortex forms the surface of the brain.
Functional magnetic imaging studies have enabled scientists to observe the brain while it’s performing various tasks. These studies have found that the brains of people with schizophrenia work differently — either harder or less efficiently — than those of people without the disorder.
All these variations are meaningful, but when it comes to diagnosing a particular individual, science is not yet at the point where a diagnosis can be made based on imaging data.
What causes schizophrenia
Schizophrenia is a no-fault, equal-opportunity illness most likely caused by a number of factors, both genetic and environmental. Most scientists now accept a two-hit theory for the cause of schizophrenia, which suggests that the genetic susceptibility is compounded by one or more environmental factors:
Genetic susceptibility: Based on family genetic history, some people are more vulnerable to the disorder than...
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