Social Construction Of Schizophrenia
Social constructionism, a branch of sociology, queries commonly held views on the nature of reality, touching on themes of normality and abnormality within the context of power and oppression in societal structures.The concept of a social construction of schizophrenia, within a social construction of health and illness notary form, denotes that the label of ‘schizophrenia’ is one that has been socially constructed through ideological systems, none of which are truly empirical especially as currently there is no definitive evidence as to the cause of schizophrenia.
Activism For Mental Health
Today, the stigma surrounding mental illness has lessened with the new knowledge we have on the subject. This has partly stemmed from the mental health advocates who saw the benefits of offering hospitalization for mentally ill patients.
Dorothea Dix was a revolutionary leader in the mental health movement that started during the 19th and 20th centuries. Although she based herself in the United States, Dix traveled around the world to deliver her message. She even managed to convince Pope Pius IX to examine the unjust ways people with mental illnesses were treated.
Dix believed in hospitalizing people with mental illnesses who needed treatment. However, she demanded better conditions in these institutions. Additionally, Dix worked to advocate for womens rights, which directly helped to decrease the cases of hysteria diagnosed as we moved to the 20th century and beyond.
Dixs work didnt end there. It continued throughout and past her lifetimeas more institutions changed their treatment approaches to ensure that a patients chance of success after discharge would increase.
History does not necessarily highlight one singular, effective form of treatment for people with mental illnesses. Yet,it does illustrate how our ideas on mental health have evolved alongside our approaches for it.
Science Of Schizophrenia And Comorbid Conditions
Whilst the definitive cause of schizophrenia remain unknown, research has indicated strong links between genetic make-up, social predisposing factors or stressors and environmental conditions in relation to the development and onset of schizophrenia and other conditions. International geneticists are working towards identifying a gene for Schizophrenia, combined efforts are at the SzGene database. In the course of this research geneticists have identified specific genes or copy number variants or alleles that may explain the comorbidity of various conditions.
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How Does Schizophrenia Affect Families
Schizophrenia takes an enormous toll on afflicted families. Many people with schizophrenia have difficulty maintaining a job or living independently, though it is important to recognize that treatment, especially at the onset of symptoms, allows individuals with a diagnosis of schizophrenia to lead meaningful, productive lives.
Charities Committed To Changing Public Perception
Charities that disagree with the notion of the schizophrenia label in the U.K. include Mind and Rethink. Mind state on their website “Because of differences of opinion about schizophrenia, it’s not easy to identify what might cause it.” Mind have previously published an explanatory leaflet, prefaced by Michael Palin that gives a definition of schizophrenia as people ‘who think outside the normal range of human experience’. The National Alliance on Mental Illness says:
“By changing the name, consumers with the symptoms of what actually may be a spectrum of disorders would have a more accurate and descriptive name attached to their diagnosis. Ideally, they would also experience less stigma, as they left behind a name with Greek origins that roughly translates to “shattered mind” and which is often used in popular culture to mean “multiple personality disorder” or “split personality.”
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What Are The Types Of Schizophrenia
There are different types of schizophrenia. The International Classification of Diseases manual describes them as below.
- Pranks, giggling and health complaints.
- Usually diagnosed in adolescents or young adults.
- Unusual movements, often switching between being very active and very still.
- You may not talk at all.
- Negative symptoms are prominent early and get worse quickly.
- Positive symptoms are rare.
Your diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesnt obviously fit into one of these types alone.
This type of schizophrenia is diagnosed in the later stages of schizophrenia. You may be diagnosed with this if you have a history of schizophrenia but only continue to experience negative symptoms.
There are other types of schizophrenia according to the ICD-10, such as.
- Cenesthopathic schizophrenia. This is where people experience unusual bodily sensations.
- Schizophreniform. Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia. But symptoms last for a short period.
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
Further Resources And Information
The Equality Advisory and Support Service can help and advise you if youve been discriminated against.
Advisory Conciliation and Arbitration Service can advise you if you think youve been discriminated against at work.
Civil Legal Advice can tell you if youre eligible for legal aid if youre making a legal challenge.
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Are People With Schizophrenia Dangerous
Popular books and movies often depict people with schizophrenia and other mental illnesses as dangerous and violent. This usually isnât true. Most people with schizophrenia are not violent. More typically, they prefer to withdraw and be left alone. When people with mental illness do take part in dangerous or violent behaviors, itâs generally a result of their psychosis and the fear that theyâre being threatened in some way by their surroundings. Drug or alcohol use can make it worse.
On the other hand, people with schizophrenia can be a danger to themselves. Suicide is the top cause of premature death among people with schizophrenia.
I’m Being Discriminated Against
The Equality Act 2010 protects you from discrimination and lets you challenge it. It makes it illegal to discriminate against people with mental health problems when you:
- are at work, applying for a job, or leaving one
- use services such as hotels, restaurants, public transport, hospitals, local councils and places of worship
- deal with organisations carrying out public functions such as tax collection or law enforcement
- buy or rent property.
To be protected, you need to show your mental health problem is a disability. You may not think of yourself as disabled, but the Equality Act could still protect you if you fit its definition of disability. You need to show you have a long-term mental health problem that makes your everyday life substantially difficult. Mind has more information on what this could mean for you.
There are different ways you can experience discrimination, including:
- direct discrimination: if youre treated worse than others because of your mental health problem
- indirect discrimination: if a person or organisation has arrangements in place that put you at an unfair disadvantage
- discrimination arising from your disability: if youre treated badly because of something that happens because of your mental health problem, for example if youre given a warning at work for taking time off for medical appointments
- harassment: if youre intimidated, offended or humiliated
- victimisation: if youre treated badly because youve made a complaint.
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Having A Mental Illness And How Its Seen From Society
Psychreg on Mental Health Stories
Having suffered with a mental illness myself, I have been on the receiving end of the comments and the stigma which surrounds mental health and related illnesses. I feel that, in the world we live in at present, there isnt enough understanding or acceptance of mental illness.
While suffering from anxiety and low mood, I received comments such as incapacitated making me feel that, because I had anxiety and low mood, I wasnt able to function as I did previously. I was also told to wait until I was better before making decisions in my life. Again, this made me feel worthless and that I was not capable of normal functions. I felt written off and as though I was damaged goods.
The point which I would like to make is that there needs to be more awareness and understanding when it comes to mental health illness, as its still looked upon as it was in Victorian times. One of the major issues which I had was because people could not see what was wrong with me, therefore, they felt it was alright to say: you will get over it, chin up, its just a bad day.
There were days I much preferred to be on my own because I felt no one was listening to how I felt. Because they could not see a cut, or a gash, or a physical injury they assumed I was fine, it was brushed off as nothing.
Dale Burden is a correspondent for Psychreg. He holds a dual honours degree in psychology and neuroscience from Keele University.
Positive Symptoms Of Schizophrenia
In this case, the word positive doesnât mean good. It refers to added thoughts or actions that arenât based in reality. Theyâre sometimes called psychotic symptoms and can include:
- Delusions: These are false, mixed, and sometimes strange beliefs that arenât based in reality and that the person refuses to give up, even when shown the facts. For example, a person with delusions may believe that people can hear their thoughts, that they are God or the devil, or that people are putting thoughts into their head or plotting against them.
- Hallucinations: These involve sensations that aren’t real. Hearing voices is the most common hallucination in people with schizophrenia. The voices may comment on the person’s behavior, insult them, or give commands. Less common types include seeing things that aren’t there, smelling strange odors, having a funny taste in your mouth, and feeling sensations on your skin even though nothing is touching your body.
- Catatonia: In this condition, the person may stop speaking, and their body may be fixed in a single position for a very long time.
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Negative Perceptions Of Schizophrenia A Barrier To Treatment Social Support
Perhaps unsurprisingly, societys negative perceptions about people with schizophrenia can stop individuals with the disorder from getting the help they need, in terms of both treatment and social support.
NAMI report that only 46% of people say they would tell a friend if they had been diagnosed with schizophrenia, while 27% say they would be embarrassed to tell others if one of their own family members had been diagnosed with the disorder.
Stalter told MNT:
Someone who hears the negative and pejorative comments about people with severe mental illness will not admit to having any symptoms and then will not seek help even when they are in the early stages and recognize that their thoughts might be inappropriate.
Not only do the symptoms cause isolation, but people abandon their friends and the families, leaving them without the support that they need.
And for many individuals with schizophrenia, a sense of normality comes with the ability to work. But employment is challenging for people with the disorder.
Only around 15% of people with schizophrenia in the US are employed. This figure is even lower in the UK, at 8%.
But aside from these challenges, Dr. Crepaz-Keay noted that there is a great deal of employer prejudice at play, which is echoed in a report from The Working Foundation at the University of Lancaster in the UK.
Emerging Treatments In The 19th And 20th Centuries
In the following centuries, treating mentally ill patients reached all-time highs, as well as all-time lows. The use of social isolation through psychiatric hospitals and insane asylums, as they were known in the early 1900s, were used as punishment for people with mental illnesses.
In addition to isolation, the 19th and 20th century brought new forms of addressing mental health concerns, including:
- Freudian therapeutic techniques, such as the talking cure.
- Electroshock, a.k.a electroconvulsive therapy
- Antipsychotic drugs and other medications
- Lobotomy and other forms of psychosurgery
Many of these treatment methods came about as a way to fix societys perception of those with mental illnesses, rather than actually helping. Treatments like the lobotomy started to be viewed as morally wrong. In turn, harmful psychosurgery methods became less popular and eventually stopped being used.
However, other treatments simply evolved to become more effective and less harmful. In fact, patients with mental illness to this day still use ECT to treat severe cases of mood disorders. Some celebrities, including Carrie Fisher, have sworn that the modernversion of ECT is the most effective treatment for disruptive mental illness symptoms.
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Schizophrenia: 100 Years Of Bad Treatment
Imagine for a minute what life might have been like if you’d been diagnosed with schizophrenia in 1911. Shunned by society, you would have been treated with fear and suspicion by many.
With no known cure, you would be subjected to treatment by trial and error, some of which would have gruesome side-effects. Detained by the state, you could expect to be monitored by overworked, underpaid staff and going to church might have been suggested as a way to calm your chaotic mind.
A lot has changed in the 100 years since the term “schizophrenia” was first coined, but perhaps not quite as much as you might think. People living with schizophrenia still experience many of the same problems today.
In 1910, Winston Churchill summed up contemporary attitudes when he wrote to the prime minister, Herbert Asquith, arguing for the mass sterilisation of people with severe mental illness.
Churchill warned that the “feeble-minded and insane classes” constituted a “danger which it is impossible to exaggerate”, and that “the source from which the stream of madness is fed should be cut off and sealed up before another year has passed.”
While views like these are no longer part of mainstream debate, the stigma and discrimination people with schizophrenia still face can be worse than the symptoms of the illness itself. Sensationalist media reporting has helped paint a picture of “schizos” who are wild, dangerous and need to be controlled.
Reactions To Mental Disorders
Socio-cultural reactions to mental disorders, which are generally spontaneous or unplanned, can have profound consequences for sufferers. Labelling, stigma, discrimination and the adoption of the sick role may negatively affect the patients life.17
While the majority of those with mental disorders want to work, their employment rate is usually very low.18,19,20,21 Despite European Union and International Labour Organisation policies to reduce unemployment, social stigmatizing is multidimensional and requires a multifaceted approach to overcome.
Socio-cultural reactions can differentially impact prognosis. A WHO collaborative study showed that while newly-diagnosed patients from different cultural backgrounds were similar in their symptom profile, the course of the disease over two years was more favourable in those from developing rather than developed countries.1
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People With Schizophrenia Feared
Unfortunately, there is still a great deal of misunderstanding around schizophrenia, Brian Semple, of UK charity Rethink Mental Illness, told MNT. Many people assume that it means having a split personality or that it makes you violent, neither of which is true.
The National Alliance on Mental Illness claim that 64% of people believe a split personality frequently switching between normal and bizarre behavior is a symptom of schizophrenia. This promotes a perception that people with schizophrenia are unpredictable, which causes society to fear them.
- Schizophrenia runs in families. It affects around 1% of the general US population, but around 10% of people who have a first-degree relative with the disorder
- Onset is most common between the ages of 16 and 30
- Around 50% of people with schizophrenia have received no treatment for the disorder.
I think people with a diagnosis of schizophrenia are still feared and perceived as dangerous, said Dr. David Crepaz-Keay, head of empowerment and social inclusion at UK charity the Mental Health Foundation, who has lived with a diagnosis of schizophrenia for around 35 years.
There is no significant evidence to support the notion of a link between a diagnosis of schizophrenia and violence, but the perception persists.
This is echoed in a 2009 study from the University of Oxford in the UK, which compared the risk of violent crime in people with schizophrenia with more than 80,000 controls.
Psychopathology And Quality Of Life
Stigma leads to negative psychological outcomes among the mentally ill, including lowered self-esteem,, diminished self-efficacy, and more depressive symptoms.,
In a qualitative study by Dinos et al, the most common consequences of feelings of stigma revolved around anger, depression, fear, anxiety, feelings of isolation, guilt, embarrassment, and prevention from recovery or avoidance of help seeking. Around 1 in 3 patients with a diagnosis of schizophrenia has a social anxiety disorder, and it has been suggested that stigma may be closely related to social anxiety in schizophrenia. Thus, presence of social anxiety was predicted by greater experience of shame related to the psychotic diagnosis. This finding is highly relevant, given that higher levels of anxiety are associated with more hallucinations, withdrawal, depression, hopelessness, better insight, and poorer function and outcome., Finally, there is evidence that prejudice and discrimination related to schizophrenia result in an increased probability of misuse of alcohol and drugs.
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Schizophrenia: A Brief History
Early references to schizophrenia
Schizophrenia has been around for a long time. References to people who are clearly insane appear in classical writings and the bible, for instance in Mark 5 we hear of the Gerasene Demoniac who, All day and all night among the tombs and in the mountains he would howl and gash himself with stones. In fact the oldest recorded description of an illness like schizophrenia dates back to the Ebers Papyrus of 1550BC from Egypt.1
Descriptions of episodes of madness involving hearing voices, seeing visions and erratic and unruly behaviour start to appear in the literature from the 17th century. It is interesting to note that even then madness was seen as a medical problem rather than some possession by evil spirits although they were denied the effective remedies that we have today.7
Dr Emil Kraepelin who first described schizophrenia in 1896.
Schizophrenia was first described by Dr Emil Krapelin in the 19th century. He was director of the psychiatric clinic at the university in Estonia. He first used the term Dementia Praecox or premature dementia and he believed that the condition always had a steadily worsening course or if there was any improvement over time it would only be partial.
Although Krapelins understanding of schizophrenia was still incomplete his work was pioneering in the way that he distinguished the condition from the other psychotic disorders such as bipolar disorder.5
The Victorian Asylums