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Schizophrenia: Facts and Myths

separator About 2 million Americans are suffering from schizophrenia in any given year. It’s a severe and disabling brain disease that affects men and women equally. It usually appears in the late teens or 20s for men, and in the 20s to early 30s for women.

Schizophrenia is terrifying to the people who have it. They hear voices nobody else hears, or believe that other people are reading their minds, controlling their thoughts or making plans to harm them. Schizophrenia can be frightening for loved ones as well. A person who used to be productive, happy, and an active participant in life can suddenly become someone who is tormented by things it’s almost impossible for others to understand. Often, it might look as if the person is “high” on drugs. This drastic behavior change is highly disturbing for people to see.

What are the actual symptoms?

  • Hallucinations (the most common for schizophrenics is hearing voices that others do not hear)
  • Delusions (these are false beliefs that the person holds because of an inability to separate the real from the unreal)
  • Social isolation
  • Unusual speech, thinking or behavior

When you see people who look like they live on the street, who appear not to have bathed in a long time and who are often muttering to themselves or looking as if they’re having a conversation with someone else, chances are they’re suffering from schizophrenia.

The street people are the ones we see, so that’s what many of us think of when we think of schizophrenia. But there are many people with schizophrenia who stay on their treatment plans, stay in touch with their doctors and manage their symptoms in such a way that they can live productive lives.

What schizophrenia is NOT
Over the years, it’s become common for people to say that schizophrenia means “split personality,” a sort of Jekyll and Hyde behavior. This is not true. There is, however, a disturbance called dissociative identity disorder, in which one person appears to be two or more completely different people.

It’s also not true that people with schizophrenia are more violent than other people. Most people with schizophrenia are not violent, although violence is more likely in those who abuse substances. When schizophrenics do commit an act of violence, it’s most typically directed at friends or family members and takes place at home.

Substance abuse, suicide greater risks
People with schizophrenia are at great risk of substance abuse. Abut three quarters of them smoke cigarettes. Besides the usual health problems associated with smoking, it’s particularly detrimental to schizophrenics because it often decreases the effectiveness of their medications. To complicate things further, quitting smoking may make the symptoms of schizophrenia worse. Schizophrenics who either smoke or quit smoking should be carefully monitored by a doctor.

Alcohol abuse is also common among schizophrenics, with a rate of about 30 to 50 percent. Marijuana and cocaine abuse are common as well, with abuse rates of 15 to 25 percent. Patients with schizophrenia report using substances to reduce feelings of depression and anxiety and to gain pleasure. But schizophrenics who abuse substances have poorer prognoses (in other words, they’re expected to do less well) than those who don’t.

What’s the risk of getting schizophrenia?
Schizophrenia tends to run in families. People with close relatives who have the disorder are more likely to get it than those who don’t. For example:

  • Someone who has an identical twin with schizophrenia has a 40 to 50 percent chance of getting it too
  • A child with a parent who has schizophrenia has a 10 percent chance
  • Someone with no family history has a 1 percent chance

Researchers believe other factors may influence the development of schizophrenia as well, such as viral infections, complications that arise during birth, starvation before birth and other “nonspecific stressors.”

Compliance with treatment is the best hope
People who have schizophrenia need to take their medications regularly and attend regularly scheduled appointments with their doctors. Medication regimens can be difficult. They often come with undesirable side effects. But without the drugs, symptoms usually do return.

There is currently a great deal of research being done into the genetic aspects of schizophrenia, the way brain chemistry plays a role and the influence of physical abnormalities in the brain. And new drugs, with fewer side effects than those currently available, are also in development.

Read this month’s article about what friends and family members can do to help and support a loved one with schizophrenia.

The American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington, D.C., 2000; H. Kaplan, B. Sadock, J. Grebb, Synopsis of Psychiatry, Williams and Wilkins, 1994; National Institute of Mental Health.
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