July 24, 2007

Galway City Tribune

Date: Friday, July 20, 2007 Page: L 17 

Author: Dr. John Ryan

Headline: The myths about Schizophrenia

The myths about Schizophrenia Health topics Schizophrenia is a serious mental illness that causes disordered ideas, beliefs and experiences. In a sense, you lose touch with reality and do not know which thoughts and experiences are true and real, and which are not.

Some people have wrong ideas about schizophrenia. For instance, it has nothing to do with a 'split personality'. Also, the vast majority of people with schizophrenia are not violent Schizophrenia develops in about 1 in 100 people. It can occur in men and women. The most common ages for it to first develop are 15-25 in men and 25-35 in women.

What are the symptoms? There are many possible symptoms. They are often classed into 'positive' and 'negative' symptoms. 'Positive' symptoms are those that show abnormal mental functions. 'Negative' symptoms are those that show the absence of a mental function that should normally be present. 'Positive' symptoms include the following:

• Delusions. These are false beliefs that a person has, and most people from the same culture would agree that they are wrong. Even when the 'wrongness' of the belief is explained, a person with schizophrenia is convinced that they are true. For example, a person with schizophrenia may believe that neighbours are spying on them with cameras in every room, or a famous person is in love with them, or that people are plotting to Mil them, or there is a conspiracy about them. These are only a few examples and delusions can be about anything.

• Hallucinations. This means hearing, seeing, feeling, smelling, or tasting things that are not real. Hearing  voices is the most common. Some people hearvoices that provide a running commentary on their actions, argue with them, or repeat their thoughts. The 'voices' often say things that are rude, aggressive, unpleasant, or give orders that must be followed. Some people with schizophrenia appear to tails: to themselves as they respond to the voices. People with schizophrenia believe that the hallucinations are real.

• Disordered thoughts. Thoughts may become jumbled or blocked. Thought and speech may not follow a normal logical pattern. 'Negative' symptoms include the following • Lack of motivation. Everything seems an effort For example, tasks may not be finished, concentration is poor, losing interest in social activities, and often wanting to be alone. '

• Few spontaneous movements, and much time doing nothing.

• Facial expressions do not change much and the voice may sound monotonous. Changed feelings or emotions may become 'flat'. Sometimes the emotions may be odd such as laughing at something sad. Other strange behaviours sometimes occur. Negative symptoms can make some people neglect themselves. They may not care to do anything and appear to be wrapped up in their own thoughts. Other symptoms that occur in some cases include: difficulty planning, memory problems and obsessive compulsive symptoms.

How is the diagnosis made? Some of the symptoms that occur in schizophrenia also occur in other mental illnesses such as depression, mania, or after taking some illegal drugs. Therefore, the diagnosis may not be clear at first. As a rule, the symptoms need to be present for several weeks before a doctor will make a firm diagnosis of schizophrenia. Sometimes symptoms develop quickly over a few weeks or so. Family and friends may recognise that the person is ill. Sometimes symptoms develop slowly over months and the person may gradually become withdrawn, lose friends, jobs, etc, before the illness is recognised.

What is the cause of schizophrenia? The exact cause is not known. It is thought that the balance of certain brain chemicals (neurotransmitters) is altered. Neurotransmitters are needed to pass messages between brain cells. An altered balance of these may cause the symptoms. It is not clear why changes occur in the neurotransmitters. Genetic (hereditary) factors are thought to be important. For example, a close family member (child, brother, sister, parent) of someone with schizophrenia has a 10 times the normal chance developing the illness. A child born to a mother and father who both have schizophrenia has a 1 in 2 chance of developing it too. However, one or more factors appear to be needed to trigger the illness in people who are genetically prone to it. There we various theories as to what these might be. 

• Stress such as relationship problems or financial difficulties or social isolation, bereavement, etc.

• A viral infection during the mother's pregnancy, or in early childhood.

• A lack of oxygen at the time of birth that may damage a part of the brain.

• Illegal drugs may trigger the illness in some people. For example, heavy cannabis users are six times more likely to develop schizophrenia than non-users. Medication Medication is used to relieve the symptoms. Medication tends to work best to ease positive symptoms, but is often not very good at easing negative symptoms, Medication is also used to prevent recurring episodes of symptoms (relapses) . Therefore, medication is usually taken on a long term basis. The drugs used are called 'antipsychotics'. They work by altering the balance of some neurotransmitters

Dr. John Ryan, a native of salthill, is a GP in North Dublin. If you have any concerns about issues raised, in this article please take them up with your local GP