Essay/Term paper: Schizophrenia: explained and treatments

Essay, term paper, research paper:  Medicine

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
Software. Creative Technology, 1993. IBM PC-DOS 3.3, 4MB, CD-ROM. Eysenck, H.,
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.