Introduction
Today, mental health disorders continue to be a topic of utmost importance. Among them, schizophrenia stands as one of the more complex mental health conditions and is often misunderstood. Schizophrenia affects millions of individuals worldwide, making it crucial to shed light on this disorder, its symptoms, potential causes, available treatments, and the impact it has on individuals and their families. This blog aims to provide an in-depth understanding of schizophrenia, fostering empathy and knowledge about this often-stigmatized condition.
Defining Schizophrenia
Schizophrenia is a chronic mental disorder that profoundly impacts a person’s perception of reality, thoughts, emotions, and behaviour. It usually emerges in late adolescence or early adulthood, affecting men and women equally. While the precise cause of schizophrenia remains elusive, research suggests that a combination of genetic, environmental, and neurochemical factors contributes to its development.
Onset and Symptoms
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. Its symptoms can vary widely, but they are typically classified into three categories: Positive symptoms, negative symptoms, and cognitive symptoms.
Psychotic Symptoms
Positive symptoms, also known as psychotic symptoms, are characterized by an excess or distortion of normal functioning. These include hallucinations, where individuals may hear, see, smell, or feel things that are not actually present. The most common hallucination of schizophrenia is auditory hallucinations. Visual hallucinations and olfactory hallucinations referring to what they see or what they smell are very rare and it could be indicative of other disorders. Delusions are another common positive symptom, where individuals hold false beliefs that are often grandiose or paranoid in nature. Disorganized thinking and speech patterns, such as incoherence or jumping between unrelated topics, are also observed. Positive symptoms are a result of psychotic disorders, including, but not limited to, schizophrenia.
Negative Symptoms
Negative symptoms refer to a loss or reduction of normal functioning. These include diminished emotional expression, social withdrawal, reduced motivation, and a decline in personal hygiene and self-care. Negative symptoms can often make individuals appear apathetic or disinterested in their surroundings, leading to significant impairment in their daily functioning and relationships.
One aspect of voice-hearing that many do not understand, is why a person who hears voices would want to keep hearing voices? The reason why this occurs, is because if a person hears positive voices, they are more likely to want to keep them because of the sense of closeness they feel. If people feel that they have positive company all the time when they are lonely, they are less likely to seek medical attention.
Unfortunately, sometimes even the most positive voices can turn mean or get commanding, increasing the necessity for medical assistance. Voices do not also always build up gradually, sometimes they sneak up on people either through initial floating thoughts, gapping out, daydreaming or losing sense of time. It varies for everyone.
What Are Some Coping Mechanisms?
Although the experience of hearing voices can vary by person there are ways to cope. Some of the common ways of coping with hearing voices is through listening to music or audio through headphones, increasing physical activity, changing their location, avoiding substance misuse, resting, taking medications or reciting positive affirmations. Individuals may also benefit from booking specific times to meet with their voices in private, thereby reducing interference with other activities throughout the day.
If a person hears more than one voice, they may need to employ different strategies for each of them. For example, if they hear a voice of a girl that’s sad, calming her down may be helpful for the individual, whereas another voice may require discipline.
Additionally, keeping a journal of the time a voice occurs, who it was and what was said, can help an individual to find a common pattern and determine what coping strategy that is best for them. A person may find that some voices exist only when they are home alone at night, whereas others may occur specifically when they are in public places, such as a supermarket. By keeping track of the who, what, where and how, a person will more easily be able to determine the coping strategy that works best for them.
As mentioned before, sometimes the voices that a person hears are positive. Some examples of positive voices may include angels or spirits that tell them positive things about themselves. In these cases, experiencing grief after they no longer hear these voices is completely normal.
How Do I Help Someone if They Tell Me They’re Hearing Voices?
If someone tells you that they are hearing voices, first ensure that the person is safe, while listening non-judgmentally. Ask them if they are in control of their voices, what the voices are saying, if they are commanding the person to engage in unsafe behaviours, etc. Look for a pattern and help the person to find supports.
Are There Support Groups at CMHA York Region and South Simcoe?
CMHA York Region and South Simcoe offers a Hearing Voice Support Group, for those who experience voice-hearing and/or alternate realities. Currently the group is offered virtually through Zoom as part of Community Connections. You can also reach out to central intake at 1-866-345-0183, ext. 3321 or check out our program offerings our website for additional help.
Cognitive Symptoms
Cognitive schizophrenia symptoms can impact a person’s attention, memory, and decision-making abilities. These symptoms can be subtle but can significantly affect an individual’s ability to perform tasks that require concentration and organization. Difficulties in focusing, problem-solving, and remembering information are common cognitive impairments associated with schizophrenia.
It’s important to note that the symptoms of schizophrenia can vary from person to person and may change over time. The severity and combination of symptoms also differ among individuals, making it a complex disorder that requires careful evaluation and management.
Risk Factors
Understanding the risk factors associated with schizophrenia is crucial for identifying individuals who may be more susceptible to developing the disorder. While the exact cause of schizophrenia remains unknown, research suggests that it is likely a result of a combination of genetic, environmental, and neurochemical factors.
Genetics
Genetic factors play a significant role in developing schizophrenia. Studies have shown that individuals with a family history of the disorder are at a higher risk of developing it themselves. In fact, having a first-degree relative (such as a parent or sibling) with schizophrenia increases the risk by about 10%. Researchers have identified specific gene variations that are associated with an increased susceptibility to schizophrenia, although it’s important to note that having these genetic markers does not guarantee the development of the disorder.
Environment
Environmental factors also contribute to the risk of developing schizophrenia. Prenatal exposure to viral infections, complications during pregnancy or birth, and exposure to certain toxins or substance abuse, have been linked to an increased risk. Additionally, growing up in urban environments, experiencing childhood trauma or abuse, and social isolation have been identified as potential environmental risk factors.
Brain Structure & Function
Neurochemical imbalances, specifically involving the neurotransmitters dopamine and glutamate, are thought to play a role in the development of schizophrenia. Dysfunction in these neurotransmitter systems can disrupt the brain’s communication pathways, leading to the characteristic symptoms of the disorder. However, the precise mechanisms underlying these imbalances and their relationship to schizophrenia are still being investigated.
It is important to remember that having one or more risk factors does not guarantee the development of schizophrenia, nor does the absence of risk factors rule out the possibility. Schizophrenia is a complex condition, and further research is needed to fully understand its etiology and identify additional risk factors.
Treatments and Therapies
Antipsychotic Medications
Treating schizophrenia typically involves a combination of medication, psychotherapy, and psychosocial interventions. The primary and most commonly prescribed class of medications for schizophrenia are antipsychotics. Antipsychotic medications help reduce the intensity of hallucinations, delusions, and disordered thinking. There are two types of antipsychotics: typical and atypical antipsychotics. Atypical antipsychotics are often preferred due to their lower risk of side effects, such as movement disorders. However, the choice of medication depends on various factors, including the individual’s symptoms, medical history, and response to treatment.
This article was reviewed by CMHA’s Assertive Community Treatment Team and Southlake Regional Health Centre’s Chief of Psychiatry.
Psychosocial Treatments
Psychotherapy is an important component of schizophrenia treatment. Cognitive Behavioral Therapy (CBT) is commonly used to help individuals manage their symptoms, challenge delusional beliefs, and develop coping strategies. CBT can also address social skills deficits and improve functioning in daily life. Family therapy is another valuable approach, as it involves educating family members about the disorder, enhancing communication, and providing support for both the affected individual and their loved ones.
Family Education & Support
Family therapy is another valuable approach, as it involves educating family members about the disorder, enhancing communication, and providing support for both the affected individual and their loved ones.
Psychosocial interventions are crucial for helping individuals with schizophrenia navigate various aspects of their lives. Supported Employment programs can assist in finding and maintaining employment, promoting independence and self-esteem. Social skills training can help individuals develop interpersonal skills, improve relationships, and enhance their social functioning. Additionally, case management services can provide ongoing support, assistance with accessing resources, and coordination of care.
Coordinated Specialty Care
Coordinated Specialty Care (CSC) is an evidence-based treatment approach specifically designed for individuals experiencing their first episode of psychosis, including those diagnosed with schizophrenia. CSC emphasizes early intervention and comprehensive, coordinated care to address the unique needs of individuals during this critical phase of their illness. The model involves a treatment team of healthcare professionals working collaboratively to provide a range of services. By intervening early and comprehensively, CSC aims to reduce the impact of psychosis on individuals’ lives, promote recovery, and enhance overall functioning and quality of life.
Assertive Community Treatment
Assertive Community Treatment (ACT) is a specialized and intensive approach to providing community-based care for individuals with schizophrenia. ACT teams consist of a multidisciplinary group of professionals, including psychiatrists, nurses, social workers, and vocational specialists, who work together to deliver comprehensive and coordinated services directly to individuals in their own community settings. The primary goal of ACT is to provide continuous support, treatment, and rehabilitation to individuals with severe and persistent mental illness, promoting their recovery and integration into the community. The ACT model emphasizes a strengths-based, person-centred approach, with an emphasis on building a therapeutic alliance and fostering a supportive and trusting relationship between the treatment team and individuals receiving care.
It is important to note that the treatment approach for schizophrenia is highly individualized, and the effectiveness of schizophrenia treatments may vary among individuals. Close collaboration between healthcare providers, including psychiatrists, therapists, and other professionals, is essential to develop a comprehensive treatment plan tailored to the individual’s unique needs and goals. Regular monitoring, medication adjustments, and ongoing support are crucial elements in managing schizophrenia effectively and promoting long-term recovery.
Living With Schizophrenia
Coping strategies play a vital role in helping individuals with schizophrenia manage their symptoms, reduce stress, and improve overall well-being. Some effective coping strategies include:
Medication Adherence:
Consistently taking prescribed medications as directed by healthcare professionals can help manage symptoms and stabilize mood. Adhering to medication regimens is crucial for long-term symptom management.
Psychoeducation:
Learning about schizophrenia, its symptoms, and treatment options can empower individuals to better understand their condition. Psychoeducation helps individuals and their family members develop strategies to cope with symptoms, recognize warning signs, and seek timely support.
Stress Management:
Engaging in stress-reducing activities, such as practicing relaxation techniques (deep breathing, meditation, progressive muscle relaxation), engaging in hobbies, or participating in physical exercise, can help alleviate stress and improve mental well-being.
Social Support:
Maintaining a strong support network of family, friends, and support groups can provide emotional support, reduce feelings of isolation, and foster a sense of belonging. Sharing experiences, discussing concerns, and seeking advice from others who understand can be beneficial.
Self-Care:
Prioritizing self-care activities, such as maintaining a balanced diet, getting regular exercise, ensuring sufficient sleep, and practicing good hygiene, can contribute to overall physical and mental well-being.
Individuals with schizophrenia may find that different coping strategies work best for them, and it may take time to discover which strategies are most effective. Working closely with healthcare professionals and participating in therapy can assist in developing and refining coping skills tailored to individual needs and circumstances.
Research & Latest Developments
Schizophrenia research continues to evolve, with ongoing efforts to deepen our understanding of the disorder and explore innovative treatment approaches. Some recent developments include:
Genetic and Molecular Studies: Advances in genetics have identified several genetic variations associated with an increased risk of developing schizophrenia. Researchers are studying these genetic markers to unravel the underlying biological mechanisms and potential targets for new treatments. Additionally, molecular studies are shedding light on the complex interplay of neurochemical pathways and neurotransmitter imbalances involved in schizophrenia.
Brain Imaging and Biomarkers: Neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), provide insights into the structural and functional brain abnormalities associated with schizophrenia. Researchers are exploring biomarkers that could aid in early detection, diagnosis, and personalized treatment approaches.
Personalized Medicine: Researchers are exploring the concept of personalized medicine in schizophrenia, considering factors such as genetic profiles, biomarkers, and individual response to treatment. The goal is to develop targeted interventions that are tailored to the specific needs and characteristics of each individual, improving treatment outcomes and minimizing side effects.
While there is still much to learn about schizophrenia, these recent developments highlight the multidisciplinary nature of research, integrating genetics, neuroscience, psychosocial approaches, and technological advancements. These advancements hold promise for improving early detection, developing more effective treatments, and ultimately enhancing the lives of individuals living with schizophrenia.
Conclusion
In conclusion, delving into the complex world of schizophrenia has provided us with a deeper understanding of this enigmatic disorder. We have explored its symptoms, risk factors, different types, and treatment approaches. While schizophrenia presents significant challenges, it is crucial to remember that recovery is possible, and individuals can lead fulfilling lives with the right support and treatment. Ongoing research continues to shed light on the biological, genetic, and environmental factors involved in schizophrenia, offering hope for more personalized and effective interventions in the future. It is equally important to foster empathy, reduce stigma, and promote awareness to create a supportive environment for individuals living with schizophrenia and their loved ones. By enhancing our understanding, advancing research, and providing comprehensive care, we can strive toward a future where individuals with schizophrenia can thrive and achieve their full potential in all aspects of their lives.
Get Support
Canadian Mental Health Association (CMHA) York Region South Simcoe is here for you.
For more information, contact us at 1-866-345-0183 or visit our Get Support page.
If you or someone you know is experiencing psychosis or schizophrenia, reach out for support or check out the programs offered by CMHA York Region South Simcoe.
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H.O.P.E Early Psychosis Intervention Program (14-35)
Helps those who are experiencing the first episode of psychosis get their lives back on track and stay well. The program is client-centered and recovery-oriented and works to promote early identification and treatment of psychosis. The program helps individuals achieve their goals at work, at school and within their social networks, minimizing the impact of psychosis.
Read More About H.O.P.EAssertive Community Treatment Teams (18+)
(ACTT) is a client-centered, recovery oriented mental health service which offers a broad range of intensive community supports to individuals experiencing mental health concerns to reach their recovery goals.
Read More About ACTTHearing Voices Support Group offered virtually through Zoom as part of Community Connections. Our Peer Support Specialists help clients learn to cope with hearing voices and other forms of psychosis and “alternate realities.”
Schizophrenia FAQ
What are the early signs and symptoms of schizophrenia?
Early signs of schizophrenia can be complicated, as it often shows itself in adolescence. Many of the signs of schizophrenia are also signs of difficulties in adolescent behaviour. Signs/symptoms of schizophrenia may include:
- Hallucinations (sensations, like hearing voices, that aren’t real)
- Delusions (fixed, false beliefs that cannot be reasoned out or convinced)
- Changes in mood, motivation, and the ability to complete tasks
- Social withdrawal
How can I manage the symptoms of schizophrenia?
Schizophrenia (and other forms of psychosis) is a lifelong journey and individuals living with schizophrenia can live happy, meaningful lives by managing symptoms. In addition to seeking professional help, consider adding the following into your routine to help manage symptoms of schizophrenia:
- Getting enough sleep (8+ hours)
- Getting plenty of fresh air and spending time outdoors
- Eating well
- Limiting alcohol and other drugs, which can make symptoms worse
- If you’ve been prescribed medication, ensure you’re following your doctor’s guidance and instructions
- Connect with a peer who shares similar experiences and may be able to relate to what you’re going through
How can I inquire about receiving a diagnosis?
If you or someone you know is experiencing signs of schizophrenia, speak with your family doctor and ask about your options for receiving an assessment. CMHA’s Rapid Access Psychiatry team, for example, takes referrals for psychiatric assessments.
