Schizophrenia and Schizoaffective Disorder

 

Max was sitting on the bus coming home from school when, out of nowhere, he heard a voice telling him to get off the bus. Off the bus? He wasn’t even halfway home yet. He dismissed the command, thinking maybe he’d overheard someone else’s conversation. Later that night, watching TV, he heard someone tell him he’d been chosen. Chosen for what? Who was talking to him? Be patient, the voice said, and I will explain everything…

Max’s friends were wondering what was wrong with him. In class, during lunch, on the bus he’d sit staring into space. When he did talk it was in rambling and disconnected sentences that made no sense. Sometimes it even seemed like he was talking to himself. After a while he took to staring at them and watching every move that they made. It was as if he was paranoid or something. His hair was long and scraggly and he didn’t seem to care about how he looked anymore. His friends started leaving him alone – maybe he was into drugs and not telling them. Maybe it was a phase.

The rate of violent behavior from someone with schizophrenia is no higher than a person without schizophrenia. In fact, those with schizophrenia are more often the victims of violence than the perpetrators. This may be due to the fact that many people fear what they do not understand or view as different.

Source: AMIQuébec

“…My illness is part of me, sometimes a small part, sometimes a big part, but it doesn’t define who I am.”Wendy Matthews

Schizophrenia is usually “triggered,” for example by a traumatic event (death of someone close, involvement in serious car accident). The cause can also be linked to genetic vulnerability and environmental conditions (e.g. stress). The incidence of this mental illness is of 1.5/100. Marijuana can be a trigger for schizophrenia. That is to say, while it is not a cause for schizophrenia in those who are not vulnerable to developing schizophrenia, it can be dangerous to those who already have a predisposition to the disorder. This is because of the chemical contained in marijuana (THC).

Characterized by

  • MEN : onset of schizophrenia is on average between 15-25 years old, with one peak.
  • WOMEN : onset of schizophrenia has two peak periods, 25-30 years and 40-45 years.
  • Researchers are trying to decipher why there are 2 peaks in onset for women, as oppose to the one peak period with men. It may be possible this is due to aging and changes in progesterone levels.
  • About as many women as men have a lifetime diagnosis, although it is episodic with periods of remission.
  • With every psychotic episode, it is harder to return to the level the person was at before, so health professionals try to minimize recurrence.
  • Prodromal: The first phase of schizophrenia, which can last days, months or years.

Early signs can include: deterioration of personal hygiene, social withdrawal, isolation and/or reclusiveness, a shift in basic personality, inappropriate laughter, dropping out of activities.

Positive symptoms

These symptoms are characteristics that are added to the personality:

  • Hallucinations (visual and auditory). Sometimes think their thoughts are being broadcast i.e. others can read their mind; or something heard on the radio or something heard/seen on TV was meant for them only – i.e. a specific message for that individual.
  • Accompanied by disorganized thinking (difficulty to plan)
  • Agitation
  • Grandiosity (believing themselves to be very powerful, famous or having special powers).
  • Suspiciousness (fear they are being watched, feeling persecuted, conspired against)
  • Hostility
  • Delusions (false belief, but one that is unshakeable, and one that they do not believe to be false, even when presented with evidence that contradicts the belief).
  • Inaccurate memories of past events: Some individuals may seem to have forgotten events, or their version of what happened does not seem to match what may have happened, even though they are not experiencing delusions now. It is possible that the individual was suffering at the time from an acute delusional episode. Therefore, even when they are no longer in the delusional episode, they will continue to remember events from that time through the “lens” through which they saw them. This is because their memory recorded the event the way they perceived things at the time.

Negative symptoms

These symptoms are characteristics that are taken away from the personality:

  • lack of hygiene
  • lack of motivation (things once cared about no longer matter, no motivation to pursue the plans or dreams they once had).
  • social withdrawal (lack of interest in seeing anyone)
  • lack of emotion (known as flat affect), neither happiness nor sadness or inappropriate emotions for the situation (e.g. laughing at a funeral).
  • lack of spontaneity (speech and movements may seem unnatural or slow).
  • difficulty with abstract thinking (may have trouble seeing underlying meaning of things).
  • poor communication skills (monotone voice or may appear bored or cold. May not speak unless spoken to, or may reply with one word sentences – referred to as “poverty of speech” or “alogia”).
  • stereotyped thinking (strong attitudes/beliefs that may seem unreasonable to others)
When symptoms last 1 month, it is called a brief psychotic episode. When symptoms last 1-6 months it is called a schizophreniform episode. When symptoms last 6 months, the diagnosis of schizophrenia will be given.

Schizoaffective Disorder

Characterized by:

  • features of bipolar disorder and schizophrenia together.
  • from bipolar: mania, grandiose, high energy levels or depression
  • from schizophrenia: psychotic features and delusions

Book Recommendation

“I Am Not Sick, I Don’t Need Help!” By Dr. Xavier Amador. Dr. Amador explains how lack of insight can be a symptom of psychosis. This book describes the LEAP approach (Listen, Empathize, Agree & Partner). Dr. Amador explains how to use this technique to communicate with your loved one who may be lacking awareness, and how to help them seek help despite.

Mental Health Estrie offers support groups for friends and family who have a loved one coping with mental illness. For more information, click here

Mental Health Estrie offers support groups for individuals coping with a lived experience of mental illness. For more information, click here.