Friday 28 August 2015

Schizophrenia

Schizophrenia


What is schizophrenia?
Schizophrenia is an illness, a medical condition that affects the normal functioning of the brain and interferes with a person's ability to think, feel and act. Overtime symptoms do improve and sometimes people who are battling schizophrenia do recover from it completely. However, for many it is an on going illness which can involve numerous years of distressing symptoms and disabilities.

Many believe that those affected by schizophrenia have a 'split personality', however this is a myth, those affected have one 'personality', just like everyone else.




Symptoms
Physical Symptoms of Schizophrenia
  • A blank, vacant facial expression. 
  • Overly acute senses- lights are too bright, sounds are too loud.
  • Staring, while in deep thought, with infrequent blinking.
  • Clumsy, inexact motor skills
  • Sleep disturbances- insomnia or excessive sleeping
  • Involuntary movements of the tongue or mouth 
  • Parkinsonian type symptoms - rigidity, tremor, jerking arm movements, or involuntary movements of the limbs
  • Eye movements- difficulty focusing on slow moving objects
  • Unusual gestures or postures
  • Movement is speeded up- i.e. constant pacing 
  • Movement is slowed down- staying in bed (in extreme cases, catatonia)


Emotional Symptoms of Schizophrenia
  • The inability to experience joy or pleasure from activities
  • Sometimes feeling nothing at all 
  • Appearing desire less - seeking nothing, wanting nothing
  • Feeling indifferent to important events
  • Feeling detached from your own body (depersonalisation)
  • Hypersensitivity to criticism, insults, or hurt feelings


Mood Symptoms of Schizophrenia
  • Sudden irritability, anger, hostility, suspiciousness, resentment
  • Depression- feeling discouraged and hopeless about the future
  • Low motivation, energy, and little or no enthusiasm
  • Suicidal thoughts or suicidal ideation
  • Rapidly changing mood - from happy to sad to angry for no apparent reason
  • Severe anxiety


The most common symptoms are:
Delusions. These are false beliefs that are not based in reality. For example, you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; a major catastrophe is about to occur; or your body is not functioning properly. Delusions occur in as many as 4 out of 5 people with schizophrenia. 
Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination. 
Disorganised thinking (speech). Disorganised thinking is inferred from disorganised speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad. 

Extremely disorganised or abnormal motor behaviour. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. Behaviour is not focused on a goal, which makes it hard to perform tasks. Abnormal motor behaviour can include resistance to instructions, inappropriate and bizarre posture, a complete lack of response, or useless and excessive movement. 


The behaviour of those affected and the affect of it on their lives
The behaviour of those with schizophrenia varies.
These are some of the changes in behaviour associated with schizophrenia:
  • Dropping out of activities and life in general
  • Inability to form or keep relationships
  • Social isolation- few close friends if any. Little interaction outside of immediate family.
  • Increased withdrawal, spending most of the days alone.
  • Becoming lost in thoughts and not wanting to be disturbed with human contact
  • Neglect in self-care- i.e. hygiene, clothing, or appearance
  • Replaying or rehearsing conversations out loud- i.e. talking to yourself (very common sign)
  • Finding it difficult to deal with stressful situations
  • Inability to cope with minor problems
  • Lack of goal-directed behaviour. Not being able to engage in purposeful activity
  • Functional impairment in interpersonal relationships, work, education, or self-care
  • Deterioration of academic or job-related performance
  • Inappropriate responses- laughing or smiling when talking of a sad event, making irrational statements.
  • Catatonia- staying in the same rigid position for hours, as if in a daze.
  • Intense and excessive preoccupation with religion or spirituality 
  • Drug or alcohol abuse
  • Smoke or have the desire to want to smoke (70-90% do smoke) - note: this is a very normal behaviour for people who do not have schizophrenia also! 
  • Frequent moves, trips, or walks that lead nowhere


The behaviours of schizophrenia can impact home and social life dramatically. Relationships can be challenged due to the tendency to withdrawal from others and the inappropriate mood behaviours. When hearing voices or being delusional, people with schizophrenia is most likely not able to participation in home and family life and chores is, in fact, a family typically begins to revolve around the person with schizophrenia, this is due to the symptoms of schizophrenia taking so much effort to manage. 

The effects of schizophrenia can become severe and harmful if schizophrenia is ignored or improperly treated. Some of the possible effect include:

Relationship problems
Relationships suffer because people suffering fro, schizophrenia often withdrawal and isolate themselves from those around them. Paranoia can also cause a person with schizophrenia to be suspicious of friends and family.
Schizophrenia not only influences people to withdrawal from others, but others may withdrawn from those suffering schizophrenia due to the severe symptoms.

Disruption to normal daily activities
Daily functions are disrupted significantly due to schizophrenia as daily tasks becomes difficult, if not impossible to do. A schizophrenic person's delusions, hallucinations, and disorganized thoughts often prevent him or her from doing normal activities such as bathing, eating, or running errands.

Alcohol and drug abuse
People with schizophrenia frequently develop problems with alcohol or drugs, which are often used in an attempt to self-medicate, or relieve symptoms. In addition, they may also be heavy smokers, a complicating situation as cigarette smoke can interfere with the effectiveness of medications prescribed for the disorder.

Increased suicide risk
People with schizophrenia have a high risk of attempting suicide. Any suicidal talk, threats, or gestures should be taken very seriously. People with schizophrenia are especially likely to commit suicide during psychotic episodes, during periods of depression, and in the first six months after they’ve started treatment.


Treatment
While long-term treatment may be required, the outlook for schizophrenia is not hopeless. When treated properly, many people with schizophrenia are able to enjoy life and function within their families and communities. Schizophrenia does however require lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. 

A psychiatrist usually guides treatment. There is a treatment team which may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.

Medications
Medications are the easiest and most common way to treat schizophrenia. However, because medications for schizophrenia can cause serious but rare side effects, people with schizophrenia may be reluctant to take them.

Antipsychotic medications are the most commonly prescribed drugs to treat schizophrenia. They control symptoms of schizophrenia by affecting the brain neurotransmitters dopamine and serotonin. 

Willingness to cooperate with treatment may affect medication choice. Someone who is resistant to taking medication consistently may need to be given injections instead of taking a pill. Someone who is agitated may need to be calmed initially with a benzodiazepine such as lorazepam (Ativan), which may be combined with an antipsychotic.

There is no solid pathway regarding medications as each person is different and requires different medications. 

Atypical antipsychotics
These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do conventional medications. They include:
Aripiprazole (Abilify)
Asenapine (Saphris)
Clozapine (Clozaril)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Paliperidone (Invega)
Quetiapine (Seroquel)
Risperidone (Risperdal)
Ziprasidone (Geodon)
Make sure to always ask your doctor about the benefits and side effects of any medication that's prescribed.

Psychosocial interventions
Psychosocial interventions are important to put people back on track. Some include:
Individual therapy. Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness.
Social skills training. This focuses on improving communication and social interactions.
Family therapy. This provides support and education to families dealing with schizophrenia.
Vocational rehabilitation and supported employment. This focuses on helping people with schizophrenia prepare for, find and keep jobs.
Most individuals with schizophrenia require some form of daily living support. Many communities have programs to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. A case manager or someone on the treatment team can help find resources. With appropriate treatment, most people with schizophrenia can manage their condition.


Who does it effect and who are most at risk?
Schizophrenia is a disease that typically begins in early adulthood usually between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms later on in there life around 30.
schizophrenia is approximately 1.1% of the population over the age of 18, or at one time as many as 51 million people worldwide suffer from schizophrenia.
Numerous people around the world suffer from schizophrenia.
6 to 12 million people in China
4.3 to 8.7 million people in India
2.2 million people in USA
285,000 people in Australia
Over 280,000 people in Canada
Over 250,000 diagnosed cases in Britain


Help services
  • eheadspace.com
    • Online chat counselling service
    • Available 7 days a week
  • Kids Helpline’s web-based and email counselling service
    • Available 24/7 for people up to 25 
    • Email: http://www.kidshelp.com.au 
    • Tel: 1800 55 1800
  • Lifeline’s online chat counselling service
    • Available 7:30-10:30pm Monday-Thursday
    • Location- 148 Lonsdale St, Melbourne VIC 3000 
    • Tel: (03) 9666 1244
  • Mind Australia
    • Lots of centres available that help you with basic things that is difficult with schizophrenia 
    • www.mindaustralia.org.au
  • Schizophrenia fellowship
    • Helpline and a clinic located in NSW
    • Tel: 9879 2600



Bibliography 
  • http://au.reachout.com/help-services-for-schizophrenia-and-other-psychotic-disorders
  • http://www.schizophrenia.com/szfacts.htm#
  • http://www.healthyplace.com/thought-disorders/schizophrenia-symptoms/schizophrenia-symptoms-and-the-impact-on-everyday-life/
  • http://www.helpguide.org/articles/schizophrenia/schizophrenia-signs-types-and-causes.htm
  • http://www.webmd.com/schizophrenia/ss/slideshow-schizophrenia-overview
  • https://www.sane.org/information/factsheets-podcasts/187-schizophrenia
  • http://hanbleceya.com/intensive-treatment/treatment-specializations/schizophrenia/?gclid=CIaBofn6s8cCFREAvAodsSYEKQ
  • http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/treatment/con-20021077
  • http://www.schizophrenia.com/earlysigns.htm
  • http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/symptoms/con-20021077
  • http://psychcentral.com/lib/schizophrenia-treatment/
  • http://www.helpguide.org/articles/schizophrenia/schizophrenia-signs-types-and-causes.htm
[All last accessed on 17th August 2015]

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