By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
The last century has seen great progress in understanding and treating medical problems. There was a time when the stigma of diseases such as cancer stifled discussion, even to the point of having physicians withhold the diagnosis from patients.
Such was the case with schizophrenia and other mental illnesses. Before modern times, people with hallucinations or delusional behavior were often thought to be possessed by demons. Until the late 18th century, the usual approach to dealing with severe mental illness was the asylum -- more like a jail than a hospital. Beginning with physician Philippe Pinel and associates at Asylum Bicetre in France, restraints were removed and more humane methods of treatment in France and other countries began. May 24, 1793, is believed to be the day Pinel ordered these changes. To raise public awareness and promote understanding of this illness, Schizophrenia Awareness Week is held beginning May 24.
Peoples' thoughts, moods and understanding are the result of the chemical signals in their brains that allow them to process sensory data. These chemical signals are called "neurotransmitters." Research has identified which brain areas are affected by imbalances in various neurotransmitters in many types of mental illness. Schizophrenia may develop when the brain areas dedicated to thinking and personality are not working properly. About 1 percent of the U.S. population is affected by schizophrenia. There appears to be a genetic basis, though psychosocial stressors may trigger it.
Men and women are equally affected, with symptoms typically starting in the teens and 20s in men and in the 20s to 30s in women. Severity can vary from person to person, but may include hallucinations (hearing, seeing or smelling things that are not there), delusions (believing something to be true that could not be possible, e.g., paranoia), disorganized thoughts (inability to connect thoughts and ideas logically or making up words) and movement disorders (unusual mannerisms, facial expressions or repetitious movements or lack of any movement).
These symptoms are disturbing to the affected individuals and to those around them. Psychotic behaviors continue to be misunderstood by the general public, despite improvements in public education and the availability of mental-health information on the Internet. When a spectacular murder in which the perpetrator claims insanity as a defense is in the news, it reinforces the idea that mental illness leads to violence. In reality, violent behavior is unrelated to schizophrenia; people either have the ability to be violent or not without regard to any mental illness. If someone who is violent develops schizophrenia, their violence is more often directed to themselves or family than to anyone else.
Over the last 50 years, many medications have been developed that treat and stabilize problems related to imbalances of brain neurotransmitters. In combination with psychotherapy and support from family and social service networks, schizophrenia often is manageable. The days of long-term hospitalization for schizophrenia are past. Unfortunately, there is, as yet, no cure.
Individuals affected with schizophrenia are not necessarily limited in their ability to get an education and hold jobs, even highly technical ones. There may be little effect on intellectual functioning. As with many chronic illnesses, family and social support is very important since relapses can occur.
As much as is known today about the brain, there still is much to learn about schizophrenia. When people are confronted with a friend or family member whose ideas and perceptions are illogical or disordered, it can be disturbing. Since the affected person's brain is not processing information properly, he or she thinks everything is fine and will continue to act upon what they perceive even though it is incorrect. Getting help for them can be tricky. Unless they are in danger of hurting themselves or others, their legal rights prevent forcible treatment, so it's best to consult a mental-health professional for help.
More information on schizophrenia is available at Penn State Hershey Medical Center at http://www.hmc.psu.edu/childrens/healthinfo/s/schizophrenia.htm and the National Institutes of Mental Health at http://www.nimh.nih.gov/publicat/schizoph.cfm and at the National Schizophrenia Foundation Web site at http://www.nsfoundation.org/ online.