Understanding schizophrenia

Mental health problems are generally stigmatised and considered taboo subject in many communities. Although the life-long disease cannot be cured, it still can be controlled with proper treatment, writes Dr Kizito Lubano

Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. People with schizophrenia — the most chronic and disabling of the major mental illnesses, often have problems functioning in society, at work, at school, and in relationships. Schizophrenia can leave its sufferer frightened and withdrawn.

There are several sub-types of schizophrenia based on symptoms:

Paranoid schizophrenia: People with this type are preoccupied with false beliefs (delusions) about being persecuted or being punished by someone. Their thinking, speech and emotions, however, remain fairly normal.

Disorganised schizophrenia: People suffering from this condition are often confused and incoherent. They also have jumbled speech. Their outward behaviour might be emotionless, flat, inappropriate, even silly or childlike. They oftenly have disorganised behaviour that may disrupt their ability to perform normal daily activities such as showering or preparing meals.

Catatonic schizophrenia: The most striking symptoms of this type are physical. People with catatonic schizophrenia are generally immobile and unresponsive to the world around them. They often become very rigid and stiff, and unwilling to move. Occasionally, these people have peculiar movements like grimacing or assume bizarre postures. Or, they might repeat a word or phrase just spoken by another person. People with catatonic schizophrenia are at increased risk of malnutrition, exhaustion, or self-inflicted injury.

Undifferentiated schizophrenia: This sub-type is diagnosed when the person’s symptoms do not clearly represent one of the other three subtypes.

Residual schizophrenia: In this type of schizophrenia, the severity of schizophrenia symptoms has decreased. Hallucinations, delusions, or other symptoms may still be present but are considerably less than when the schizophrenia was originally diagnosed.

Symptoms of schizophrenia

People with schizophrenia may have a number of symptoms involving changes in ability and personality.  They may display different kinds of behaviour at different times. When the illness first appears, symptoms usually are sudden and severe.

The most common symptoms of schizophrenia can be grouped into three categories: Positive symptoms, disorganised symptoms, and negative symptoms.

Positive symptoms of schizophrenia

In this case, the word positive does not mean “good.” Rather, it refers to obvious symptoms that are not present in people without schizophrenia. These symptoms, which are sometimes referred to as psychotic symptoms, include:

•Delusions: Strange beliefs that are not based in reality and that the person refuses to give up, even when presented with factual information.

•Hallucinations: These involve perceiving sensations that aren’t real, such as seeing things that aren’t there, hearing voices, smelling strange odours, having a “funny” taste in your mouth, and feeling sensations on your skin even though nothing is touching your body. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person’s behaviour, insult the person, or give commands.

Negative symptoms of schizophrenia

In this case, the word negative does not mean “bad,” but reflects the absence of certain normal behaviours in people with schizophrenia. Those who suffer from schizophrenia exhibit a lack of emotion, thoughts, and moods that do not fit with situations, or events (for example, crying instead of laughing at a joke); withdrawal from family, friends, and social activities; reduced energy and lack of motivation.