Schizophrenia

Symptoms Of Schizophrenia

The symptoms of Schizophrenia can be broadly classified into the following subtypes:

1. Psychotic symptoms

• Delusions: Individuals fearing harm from nonexistent threats.

• Hallucinations: Hearing, seeing, or feeling things that do not exist

• Abnormal or disorganized behavior: Behavior can range from childlike silliness to unpredictable rage and agitation.

• Abnormal motor behavior: No eye contact, lack of facial expressions, bizarre postures, and unnecessary or excessive movements.

• Disordered thinking and speech: Unable to communicate effectively and may use meaningless words or out-of-context replies to questions.
  
  

2. Negative symptoms

• Neglect personal hygiene

• Lose interest in everyday activities 

• Lack of the ability to experience pleasure in everyday life

• Show reduced ability to express emotions

• Unable to effectively communicate thoughts and struggle to frame words.
  
  

3. Cognitive symptoms

• Difficulties in processing information to make decisions

• Difficulty in learning new things

• Unable to remember information.

Mental illness can greatly affect a person's well-being, making early detection and treatment essential. Tune in as our experts discuss key warning signs of mental health issues and how you can help yourself or someone you love.
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Causes Of Schizophrenia

• There is no single established cause of schizophrenia. 

• It can be caused by a complex interplay of genetic, environmental, and neurochemical factors.

• Imbalances in brain neurotransmitters like dopamine and glutamate, along with structural brain abnormalities, contribute to its development.

• There are several factors that can play a role in the development of this condition which are discussed in the next segment.

Risk Factors Of Schizophrenia

Certain factors increase a person’s risk of developing schizophrenia, are:

1. Non-modifiable factors

• Age

• Gender (more common in men)

• Family history of schizophrenia (though no single gene is directly linked)

• Pregnancy and birth complications.

Note: The symptoms of schizophrenia usually start between the age of 16 - 30 years.
Interestingly, men tend to experience their first episode of schizophrenia in their late teens to early 20s, whereas women typically experience their first episode in their late 20s or early 30s.

2. Environmental factors

• Stress

• Exposure to toxins or viruses that affect brain development in early life or before birth

• Infections like influenza (flu) or herpes

• Autoimmune diseases

• Consumption of psychoactive drugs during teen years or early adulthood
  
  

3. Social factors

• Childhood trauma

• Social isolation

• Stressful events in life.

Diagnosis Of Schizophrenia

Schizophrenia is suspected after a major psychotic episode with other symptoms. Diagnosis requires ruling out other psychiatric, substance-induced, or medication-related disorders. It consists of:

1. History and Clinical Examination

• A physician conducts a thorough examination, reviews the patient’s history, and checks for schizophrenia symptoms, social and occupational dysfunction, and health-related complications.

• Ruling out other conditions that may mimic schizophrenia is crucial before confirming the diagnosis.

2. Lab tests 

• Alcohol screen blood: It is to rule out alcohol intoxication as a cause of psychotic symptoms through blood tests.

• Alcohol screen urine: Done to rule out alcohol intoxication as a cause of the psychotic symptoms through urine analysis.

• Drugs of abuse panel: It detects the presence or absence of commonly abused psychotic drug abuse as a cause of the psychotic symptoms. 

• Complete blood count (CBC): Done to evaluate general health status and look for any infections. 
  
  

3. Imaging studies

• CT scan (brain): To study any structural changes in the brain.
  
  
• MRI brain: It gives an in-depth study to identify any pathology in the brain that might be causing symptoms.
  
  

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4. Psychiatric evaluation

The American Psychiatric Association has laid down criteria for diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, also known as DSM - 5. which states that a diagnosis of schizophrenia can be made if:

• Criterion A: At least two of the following indications for at least 1 month: delusions, hallucinations, disorganized speech, grossly disorganized or negative symptoms.
  
  
• Criterion B: The level of functioning has to be lowered significantly and for the long term compared to the previously achieved levels.
  
  
• Criterion C: Signs of the disturbance persist for at least 6 months, must include criterion A symptoms for at least 1 month.
  
  
• Criterion D: Schizoaffective disorder and depressive or bipolar disorder with psychotic symptoms must be ruled out.
  
  
• Criterion E: The disturbance is not caused by substance use or any medical conditions.
  
  
• Criterion F: If the individual has a history of autism or communication disorders from childhood, then schizophrenia is diagnosed based on symptoms like delusions and hallucinations lasting over six months, after ruling out other conditions, as outlined in the DSM-5.

Specialist To Visit

Doctors who can help diagnose schizophrenia and devise a treatment plan include:

• General physician
• Psychiatrist
• Psychologist
• Neurologist
  
  

A general physician can then refer the patient to specialist doctors for detailed evaluation and treatment.

A psychiatrist provides diagnosis, medication management, and therapy for schizophrenia symptoms.

A psychologist offers psychotherapy, including cognitive-behavioral therapy, to help manage thoughts and behaviors.

A neurologist assesses potential neurological factors affecting brain function and coordinates care for related disorders.

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Treatment Of Schizophrenia

Management of schizophrenia consists of:

1. Conventional antipsychotics or first-generation antipsychotics

These drugs help to control psychotic symptoms of schizophrenia such as delusions and hallucinations. They work by blocking the action of the neurotransmitter dopamine in the brain. Examples include:

• Chlorpromazine

• Haloperidol

• Fluphenazine
  
  

2. Atypical antipsychotics or second-generation antipsychotics

These are newer antipsychotic medicines with fewer body movement-related side effects.They work by blocking the receptors for neurotransmitters like serotonin (stronger blocking) and dopamine (moderate blocking). Common examples are:

• Aripiprazole

• Ziprasidone

• Sulpiride

• Asenapine

• Clozapine

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3. Long-acting injectable antipsychotics

• Certain formulations are also available as long-acting intramuscular injections that need to be given every 2-4 weeks. 

• This is useful in patients who are resistant to taking daily pills and can help with adherence.
  
  

4. Nutritional supplements

• Studies have shown that taking Vitamin B Complex and Omega-3 fatty acid supplements like fish oil capsules helps ease the symptoms of schizophrenia.

• Vitamin B complex is essential for normal functioning of the nervous system. 

• Omega-3 fatty acid supplements contain DHA and other fatty acids which are important for brain health.

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Home-Care for Schizophrenia

Support schizophrenia management at home with nutritious foods, herbal supplements, and mindful eating habits. One such diet is ketogenic. A ketogenic diet is a low-carb, high-fat diet that shifts the body into ketosis, where it burns fat for energy instead of carbs.

How can a ketogenic diet help with schizophrenia?

• May reduce symptoms: According to studies gluten-free or low-carb ketogenic diet may help ease schizophrenia symptoms.
  
  

• Boosts brain health: The diet increases GABA, a neurochemical that supports brain function and may improve schizophrenia symptoms.
  
  

• Prevents weight gain: Helps manage weight, especially for those with a sedentary lifestyle or medication-related weight gain.

Note: Always consider consulting a professional before making any dietary changes.

Complications of Schizophrenia

If left untreated, Schizophrenia may severely hamper a patient’s quality of life and can potentially cause complications like: 

• Anxiety disorder

• Depression

• Drug and alcohol abuse

• Aggressive behavior

• Social isolation

• Suicide, suicide attempts, and suicidal thoughts

Note: Severe cases may need hospitalization for treatment.

Alternative Therapies For Schizophrenia

Alternative therapies for schizophrenia can be supportive but should always be used alongside medical treatment and under a doctor's guidance. Therapies that can help include:

1. Psychosocial interventions

• In addition to medication, psychological therapy helps normalize the patient’s thought patterns and also helps cope with stress and anxiety. 

• Social rehabilitation helps the individual interact with society and participate in daily activities. 

• These are important interventional programs for managing a patient with schizophrenia.
  
  

2. Cognitive behavior therapy

• This type of psychological therapy helps teach the individuals coping skills to manage their difficult conditions. 

• The therapy focuses on the cognitive component which helps the individual to change their thinking about a particular situation.

3. Electroconvulsive therapy

• This is done in rare cases for adults who do not respond well to drug therapy, electroconvulsive therapy, or shock therapy (ECT) may be considered. 

• In this, small acceptable amounts of electric currents are passed through the brain to help regulate electrical activity in the brain.
  
  

4. Deep brain stimulation

• This is a type of elective surgical procedure in which tiny incisions are made near the brain to implant some electrodes in the brain. 

• These electrodes generate mild electrical impulses which are thought to regulate abnormal electrical activity of the brain and improve the symptoms. 

Living With Schizophrenia

Living with the condition or someone who has been diagnosed with schizophrenia may be challenging for the family and the caregivers. However, here are a few tips that can help you to take care of someone with the condition.

1. Understand the condition

• Understanding and accepting what your family member or relative is going through is the first step in managing the disease. 

• Information about the condition will help the caregivers understand the importance of therapy and recognize warning signs if the disease worsens. 
  
  

2. Stay focused on the goals of therapy

• The therapy goals are different for each patient and are adjusted to suit individual requirements.  

• Help your loved ones adjust to the therapy and encourage them to take responsibility for their goals.
  
  

3. Help the patient abstain from alcohol and substance abuse

• Alcohol and recreational drugs worsen the symptoms of Schizophrenia and make the condition difficult to treat. 

• Hence, the family or caregivers need to ensure that the patient does not indulge in such activities.
  
  

4. Try relaxation and stress management techniques

• It is not unusual for the family or caregivers to be stressed and anxious along with the patient themselves. 

• Learning relaxation techniques and stress management will help cope with the disease.
  
  

5. Join schizophrenia support groups

• Connecting with other people facing similar challenges may help a person come to terms with the disease. 
  
  

Mental illnesses are increasingly common today. Sometimes, the best way to help is simply by being there for someone in need. Want to do more?
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