Schizophrenia is one of the most common mental illnesses. About 1% of the world population has schizophrenia. In the United States, there are about 2.5 million people with the disease. Schizophrenia is the cause of more hospitalizations than almost any other illness. Schizophrenia most commonly begins between the ages of 15 and 25. Although it strikes men and women equally, the symptoms may appear later in women than in men. Very rarely, the symptoms of schizophrenia can appear before the age of 12. Childhood schizophrenia has a more chronic disease course and involves poor early language development.
People with schizophrenia can have a variety of symptoms. Sometimes, these symptoms come on suddenly. Usually, though, the illness develops slowly over months or even years. At first, the symptoms may not be noticed or may be confused with those of other conditions. For example, people with schizophrenia may feel tense, be unable to concentrate, or have trouble sleeping. They often become increasingly isolated and withdrawn as their grip on reality loosens. They do not make or keep friends. They may stop caring about the way they look. Dropping out of school or doing badly at work are other early signs of schizophrenia. As the illness progresses, symptoms of psychosis develop. The person starts to act strangely and talk nonsensically. People with schizophrenia may develop paranoid delusions. Examples of this would be that they might see, feel, smell, or hear things that are not really there. They may have physical symptoms, like frowning or unusual movements, and may stand or sit in strange positions. Some people become almost motionless. Others move around constantly. The severity of symptoms will vary from one person to another. The symptoms also tend to worsen and improve. When the symptoms are improved, the person may appear to behave relatively normally, but usually there will be repeated episodes of the illness that will cause symptoms to reappear.
Schizophrenia is a complex and puzzling illness. Even the experts are not sure exactly what causes it. Some doctors think that the brain may not be able to process information correctly. People without schizophrenia usually can filter out unneeded information: for example, the sound of a train whistle in the background or a dog barking next door. People with schizophrenia, however, cannot always filter out this extra information. One possible cause of schizophrenia may be heredity, or genetics. Experts think that some people inherit a tendency to schizophrenia. In fact, the disorder tends to “run” in families, but only among blood relatives. People who have family members with schizophrenia may be more likely to get the disease themselves. If both biologic parents have schizophrenia, there is nearly a 40% chance that their child will get it, too. This happens even if the child is adopted and raised by mentally healthy adults. In people who have an identical twin with schizophrenia, the chance of schizophrenia developing is almost 50%. In contrast, children whose biological parents are mentally healthy – even if their adoptive parents have schizophrenia – have about a 1% chance of getting the disease. That is about the same risk as for the general population of the United States. Some researchers believe that events in a person’s environment trigger schizophrenia. Some studies have shown that influenza infection or improper nutrition during pregnancy and complications during birth may increase the risk that the baby will develop schizophrenia later in life. Many believe that schizophrenia is likely caused by a complex combination of genetic and environmental factors. Certain people are born with a tendency to develop the disease. But the disease only appears if these people are exposed to unusual stresses or traumas.
Schizophrenia is usually treated with antipsychotic medication. Some people with schizophrenia also benefit from counseling and rehabilitation. They may need to go to the hospital during an acute attack. The goal of treatment is to reduce symptoms during acute attacks and to help prevent relapses. At this time, there is no cure for schizophrenia. Antipsychotic medications are very effective in controlling the symptoms of schizophrenia. These medications first became available in the mid-1950’s. They have greatly improved the lives of thousands of people. Before that time, people with schizophrenia spent most of their lives in crowded hospitals. With anti-psychotic medication, however, many people with schizophrenia are able to live in the outside world. Because each person with schizophrenia has a unique mix of symptoms, no single medication works best for all people.
The ideal medication for one person may not be the best choice for another. Although antipsychotic medications do not cure the disease, they can reduce hallucinations and delusions and help people with schizophrenia regain their grip on reality. Medication also reduces the risk of they symptoms returning. If the person does have a relapse of symptoms, medications may make the symptoms less severe. People with schizophrenia can have a hard time communicating with other people and carrying out ordinary tasks. Counseling and rehabilitation can help people with schizophrenia build the skills they need to function outside the sheltered setting of a hospital. However, these treatments are not very helpful during acute attacks. Rehabilitation programs may help people with schizophrenia develop skills such as money management, cooking, and personal grooming, for example, needed for ordinary life. They may also prepare the person to go or return to work. Individual psychotherapy may help person with schizophrenia learn to sort out the real from the unreal. Group therapy may help them learn to get along with others. Self-help groups may help persons with schizophrenia feel that others share their problems. The best way to prevent relapses is to continue to take the prescribed medication.
People with schizophrenia may stop taking their medications for several reasons. Side effects are one of the most important reasons that people with schizophrenia stop taking their medication. It is hard for people to put up with unpleasant side effects for months or years. It is especially hard when the person feels well. It is very important to find the medication that controls symptoms without causing side effects. Convenience is also important. Some medications need to be taken two, three, or even four times a day. Others may be taken just once a day. People are more likely to remember to take a medication once a day than several times a day. Some people prefer to get injections every month of long-lasting medication. Taking medications regularly is the best way to prevent repeated illness and hospitalization.