What Kind Of Thoughts Do Bipolar People Have
Racing thoughts are often one of the first symptoms to develop when someone with bipolar disorder is entering a hypomanic or manic episode. 4 It can bebut is not alwaysa debilitating experience. Some people describe it as having excessive thoughts that move quickly, but with a sense of fluidity and pleasantness.
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Diagnosing And Treating Late
The process of diagnosing schizophrenia can be complicated. Often, people use drugs or alcohol to cope with their untreated symptoms, and some of these substances can lead to temporary drug-induced psychosis that alters or worsens schizophrenia symptoms. Moreover, lack of information about schizophrenia makes many people with this condition unwilling to believe that they have it, which makes it harder for people to get help.
Unfortunately, there is no objective, biological way to tell if someone has schizophrenia. However, a health care provider can record and evaluate symptoms to make an informed diagnosis. This is especially easy if the symptoms are ongoing, which typically means lasting at least six months. However, six months of untreated schizophrenia is enough to derail someones life, so there is a clear need for early identification of symptoms and treatment.
Once a diagnosis has been acquired, schizophrenia treatment can begin. Each treatment plan will be different depending on the individual, but antipsychotic medications are often a cornerstone of treatment. These may be especially important for people with late-onset schizophrenia, since they are more likely to deal with psychotic symptoms like hallucinations and delusions.
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What Is Childhood Schizophrenia
Childhood schizophrenia is a severe mental health disorder in children younger than age 13 that affects the way they deal with reality. They might have unusual thoughts, feelings, or behaviors. Itâs also called childhood-onset or very early onset schizophrenia.
The disorder is rare — less than 1% of children are diagnosed with it — and may be hard to spot. Thereâs no cure, but treatment can help.
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Negative Symptoms Of Schizophrenia: Things That Might Stop Happening
Negative symptoms refer to an absence or lack of normal mental function involving thinking, behavior, and perception. You might notice:
- Lack of pleasure. The person may not seem to enjoy anything anymore. A doctor will call this anhedonia.
- Trouble with speech. They might not talk much or show any feelings. Doctors call this alogia.
- Flattening: The person with schizophrenia might seem like they have a terrible case of the blahs. When they talk, their voice can sound flat, like they have no emotions. They may not smile normally or show usual facial emotions in response to conversations or things happening around them. A doctor might call this affective flattening.
- Withdrawal. This might include no longer making plans with friends or becoming a hermit. Talking to the person can feel like pulling teeth: If you want an answer, you have to really work to pry it out of them. Doctors call this apathy.
- Struggling with the basics of daily life. They may stop bathing or taking care of themselves.
- No follow-through. People with schizophrenia have trouble staying on schedule or finishing what they start. Sometimes they can’t get started at all. A doctor might call this avolition.
Depression has some of the same symptoms, too. They can be hard to spot, especially in teens, because even healthy teens can have big emotional swings between highs and lows.
Hope For The Patient And Family
A diagnosis of schizophrenia is life-changing for those affected and everyone who loves them. But, with hard work and dedication, you can help your loved one enjoy a meaningful life.
People with schizophrenia can finish college, work jobs, get married, have families and enjoy a reasonably healthy life, stresses Dr. Bowers.
But it requires a combination of good medication, supportive counseling and being connected to community resources.
The National Alliance on Mental Illness offers support groups for the mentally ill and their families. And organizations like Recovery International and Emotions Anonymous are excellent resources for patients, she says.
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What Is Schizophrenia Or Paranoid Schizophrenia
Schizophrenia is a challenging brain disorder that often makes it difficult to distinguish between what is real and unreal, to think clearly, manage emotions, relate to others, and function normally. It affects the way a person behaves, thinks, and sees the world.
The most common form is paranoid schizophrenia, or schizophrenia with paranoia as its often called. People with paranoid schizophrenia have an altered perception of reality. They may see or hear things that dont exist, speak in confusing ways, believe that others are trying to harm them, or feel like theyre being constantly watched. This can cause relationship problems, disrupt normal daily activities like bathing, eating, or running errands, and lead to alcohol and drug abuse in an attempt to self-medicate.
Many people with schizophrenia withdraw from the outside world, act out in confusion and fear, and are at an increased risk of attempting suicide, especially during psychotic episodes, periods of depression, and in the first six months after starting treatment.
Take any suicidal thoughts or talk very seriously
If you or someone you care about is suicidal, call the National Suicide Prevention Lifeline in the U.S. at 1-800-273-TALK, visit IASP or Suicide.org to find a helpline in your country, or read Suicide Prevention.
Possibility Of Schizophrenia Treatment Targeting Neuroinflammation
If neuroinflammation contributes to the pathophysiology of schizophrenia, the effect of anti-inflammatory therapy is naturally expected. Non-steroidal anti-inflammatory drugs, antioxidants, anti-cytokine therapy targeting the inflammatory cytokines TNF-, and IL-6, or minocycline, which has an inhibitory effect on microglial activation, are added as an adjunctive therapy and it has a certain effect. Regarding the subtypes or stages for which anti-inflammatory therapy is effective, treatment-resistant cases, severe cases, and cases showing suicide-related behavior are assumed. Accumulation of further knowledge including the biomarkers for detecting neuroinflammation is essential for clinical application of anti-inflammatory therapy . Oxidative stress by redox dysregulation, a disturbance of balance between oxidants and antioxidant species, is known to play an important role in the pathophysiology of schizophrenia and it is closely related to neuroinflammation through microglial activation . Whether or not the effect of anti-inflammatory or anti-oxidant therapy is different among EOS, LOS, and VLOS should also be clarified.
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Can A Person With Bipolar Disorder Be A Senior
However, if the behaviors or moods become extreme this could indicate the onset of bipolar disorder later in life. 1Bipolar disorder symptoms typically manifest in teens and young adults, ages 15 to 24, but in some cases it can also appear in seniors. Researchers are also discovering that bipolar disorder doesnt disappear with advanced age.
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Common Causes Of Death
While issues related to psychosis may first come to mind with conditions like schizophrenia, the disorder can also take a physical toll. Physical diseases are linked to cause of death in about 60 percent of people with schizophrenia.
The elevated risk of cardiovascular disease in people with schizophrenia may be partly genetic, but its also largely affected by behavioral and lifestyle choices. People with schizophrenia are more likely to have certain lifestyle habits that increase the risk of cardiovascular disease, like smoking or a sedentary lifestyle.
Other physical or medical conditions known to increase the risk of death in people with schizophrenia include:
- visit a local emergency department
- reach out to a support group or emergency line
The National Suicide Prevention Lifeline is a 24-hour confidential service available by phone 7 days a week. This lifeline can connect you to crisis and emergency specialists for free. To learn more, call 800-273-TALK .
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Schizophrenia In Later Life: Patient Characteristics And Treatment Strategies
Tarek K. Rajji, MDPsychiatric Times
With the prevalence of schizophrenia in older adults set to double and reach 1.1 million people in the US by 2025, greater attention to research and policy regarding this population is needed.
A global health crisis is emerging because of the changing demographics and care of older adults with schizophrenia. Individuals aged 55 years and older will soon account for 25% or more of the total population of patients with schizophrenia worldwide.1 Among persons aged 60 years and older with mental and substance-use disorders, schizophrenia ranks third in causes of disability-adjusted life-years.2 Older adults with schizophrenia also have a substantial impact on health care costs, with an estimated greater expenditure per person compared with most other medical and psychiatric disorders.
Research on older patients with schizophrenia has been neglected roughly 1% of the schizophrenia literature focuses on this population.2 With the prevalence of schizophrenia in older adults set to double and reach 1.1 million people in the US by 2025 and 10 million worldwide by 2050, greater attention to research and policy regarding this population is needed.
Morbidity and mortality
Positive and negative symptoms
Nonpharmacologic psychosocial interventions
What Is The Main Cause Of Bipolar Disorder
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: Having a first-degree relative, such as a parent or sibling, with bipolar disorder. Periods of high stress, such as the death of a loved one or other traumatic event. Drug or alcohol abuse.
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Informed Consent And Decisional Capacity
Patients with schizophrenia are routinely asked to provide informed consent for their antipsychotic medication treatment. However, because of the cognitive deficits, as well as insight, deficits, which are sometimes present among those with schizophrenia,9,20 some schizophrenia patients may lack the capacity to provide independent consent for treatment. On the other hand, empirical data document considerable heterogeneity among older as well as younger schizophrenia patients in terms of the level of decisional capacity,21–23 and age is not itself a strong predictor of the level of decisional capacity among such patients.23–25 Nonetheless, due to the increased likelihood of medical comorbidity and polypharmacy present, in the older population,26,27 together with the increased physical frailty of some elderly persons, and the still relatively limited empirical database on the safety and efficacy of antipsychotic medications for use with realworld elderly patients, the very nature of treatment decisions and consent may be particularly complex in the context of treating older patients with schizophrenia, and thus consent, issues are particularly salient.
Planning For The Future
Relapse prevention plan
A relapse is when, after you recover from an episode of psychosis, your symptoms return and you experience another episode.
A relapse prevention plan is a powerful tool for staying well and avoiding a worsening of your mental health issue. Making a plan involves:
- identifying your triggers: what events or situations could set your symptoms off?
- identifying your warning signs: what changes in your thinking, emotions and behaviour signal the early signs of psychosis?
- planning responses: what will you do to cope or seek help when you experience triggers & warning signs?
- listing support people: who will you call when you experience triggers & warning signs?
Having a relapse prevention can make you and the people who care for you feel more secure, even if you never have to use it.
Advance care directives
Because of the way schizophrenia affects thinking, feeling and behaviour, if your symptoms worsen at some time in the future, you may not be able to make good decisions about your care. It can also be hard for the people around you to know whats best for you when the situation is intense and confusing.
An advance care directive is your instructions for what you want to happen if you cant make your own choices, and who you authorise to make decisions for you.
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When To See A Healthcare Provider
As schizophrenia usually develops gradually, it can be difficult to pinpoint when changes in behavior start or know whether they are something to worry about. Identifying that you are experiencing a pattern of concerning behaviors can be a sign you should consult with a professional.
Symptoms may intensify in the run-up to an acute episode of psychosis in schizophrenia. The warning signs include:
- A worrying drop in grades or job performance
- New difficulty thinking clearly or concentrating
- Suspiciousness of or uneasiness with others
- Withdrawing socially, spending a lot more time alone than usual
- Unusual, overly intense new ideas, strange feelings, or having no feelings at all
- Difficulty telling reality from fantasy
- Confused speech or trouble communicating
While these changes might not be concerning by themselves, if you or a loved one are experiencing a number of these symptoms, you should contact a mental health professional. It can be difficult for those with schizophrenia to want to get help, especially if they are experiencing symptoms such as paranoia.
If you or your loved one is thinking of or talking about harming themselves, contact someone who can help right away. You can call the toll-free, 24-hour National Suicide Prevention Lifeline at 800-237-8255.
If you require immediate emergency care, call 911 for emergency services or go to the nearest hospital emergency room.
Age At Onset Cutoff Points
The available data suggest that categorization by specific age at onset ranges is relatively arbitrary. Although consensus was achieved, members of the group could not reach unanimity on either the presence of age cutoffs or where they should be set. There was general agreement that cutoffs have clinical utility and act to stimulate research effort. Epidemiological evidence is strongest for a cutoff at age 60 to define the very-late-onset group. Some clinical studies support another cutoff at age 40, although epidemiological data suggest that this age point may be too high for the middle-age onset group .
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Can Lifestyle Habits Increase The Risk Of Bipolar Disorder
Lack of sleep increases the risk of having an episode of mania in someone with bipolar disorder. In addition, antidepressants, particularly when taken as the only medication, may also trigger a switch into a manic state.
Excessive use of alcohol or drugs can also trigger bipolar symptoms. Research has shown that about 50% of bipolar sufferers have a substance abuse or alcohol problem. Sufferers often use alcohol or drugs in an effort to reduce unpleasant feelings during low mood periods, or as part of the recklessness and impulsivity associated with manic highs.
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Keep Body And Mind Active
, MD, a psychiatrist with Mindpath Health who is based in San Jose, California, says the advice he would give a person with schizophrenia who is getting older is the same advice he would give to someone who has a family history of dementia:
- exercise frequently
- maintain a healthy diet
Taking these steps will help get the brain adequate blood flow and also reduce psychosocial stressors, which is a trigger for schizophrenia, he says.
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Why Do Men Develop Schizophrenia Before Women
This is not an easy question to answer. Scientific researchers have come up with a few possibilities, though nothing has been proven as the main reason why men develop schizophrenia earlier than women do. Research, though, is showing a connection between DNA modifications and early brain development.
Other research suggestsa link between estrogen, a female sex hormone, and schizophrenia. Some women are first diagnosed with schizophrenia after menopause, the same time their estrogen levels drop. Estrogen also seems to have a protective effect, shielding women from the severity of this illness.
Researchers are conducting randomized clinical trials to study how well estrogen works in conjunction with antipsychotic medication in both men and women with schizophrenia.
Does Schizophrenia Get Worse If Untreated
Symptoms of schizophrenia rarely get better without treatment. Without the proper treatment, symptoms can occur more often and increase in intensity.
With each untreated psychotic episode, the brain becomes more vulnerable to having a more severe or prolonged attack that could be resistant to medication, says Kennedy.
Also, untreated symptoms can contribute to other mental health difficulties, such as depression or suicidal ideation, she adds. Because of this, Kennedy tries to instill hope in her clients diagnosed with schizophrenia.
There are plenty of new medications with fewer side effects, including longer-acting injectables that can help older clients manage symptoms without the hassle of having to remember to take a pill every day, she says. Its still possible to manage symptoms and meet your long-term goals.
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Managing Life With Schizophrenia
Some people living with schizophrenia find that the following strategies can help prevent episodes of psychosis, help them feel better in between episodes, or feel more in control:
- learning more about schizophrenia
- finding an individual definition of recovery, whether its reducing symptoms or working on other parts of life like relationships or employment
- looking after physical health including getting regular check-ups
- accessing peer support
- learning strategies to minimise stress
- developing a Relapse prevention plan including identifying early warning signs, what to do when these occur, and who to contact
- advance care planning may also be an option for times when a person doesnt have decision-making capacity. The nature of these statements varies between states.
Every person will need to find what works for them and its normal for this to take time. Check out our lived experience tips for managing life with schizophrenia.
Treatment And Support For Schizophrenia
The best place to start in getting a diagnosis is a GP. They can make an assessment and provide a referral to a psychiatrist for full diagnosis and treatment if needed.
Schizophrenia takes time to diagnose some people might receive a predicted diagnosis of schizophrenia quickly, but it can take six months or longer to be confirmed. A diagnosis may also change over time. For example, after new information or experiences are identified. This is normal.
Early intervention can be helpful. Although the process can be scary, it can be very useful to identify a risk of developing schizophrenia early to develop a care plan. This may include case management, support for families and carers, group programs, and minimising disruptions to school and work .
If someone develops schizophrenia, antipsychotic medications are usually a first line of treatment. Psychological therapies can also be beneficial, including cognitive behavioural therapy, psychodynamic therapy, and open dialogue . Community support programs are also available to help with social connection, physical health, accommodation, and work or school.
It is important that people experiencing symptoms of schizophrenia collaborate with their healthcare providers and are empowered to make their own treatment choices, wherever possible. Though not always easy, sticking with treatment and medication is important, especially for people experiencing paranoia.
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