Treatment Of Schizophrenia In The Elderly
With proper treatment individuals with schizophrenia can live a normal life and, even though there is no cure, symptoms can be well-managed. Medications are often diagnosed to relieve hallucinations and delusions. Antipsychotics, in particular, can help with any chemical imbalances in the brain. Unfortunately, as with any medication there is the risk of side effects especially in the elderly.
Common side effects experienced by the elderly due to the use of antipsychotic drugs are:
- Uncontrolled movements
- Low white blood cell count
- Sexual dysfunction
There are non-drug treatments, too, like seeking out therapy, either one-on-one or group-based. Different types of therapy to treat schizophrenia include:
- Cognitive behavioral therapy
- Integrated substance abuse treatment
Emily Lunardo studied medical sociology at York University with a strong focus on the social determinants of health and mental illness. She is a registered Zumba instructor, as well as a Canfit Pro trainer, who teaches fitness classes on a weekly basis. Emily practices healthy habits in her own life as well as helps others with their own personal health goals. Emily joined Bel Marra Health as a health writer in 2013.
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Schizophrenia Diagnosis: Rule Out Other Conditions
A diagnosis involves what someone is experiencing as well as what he is not. Some disorders have some features or symptoms that are shared with schizophrenia therefore, doctors check to see if something else fits better than schizophrenia. Some of the conditions that, according to criteria in the DSM-5, have some similarities with schizophrenia are
- Mood disorders with psychotic features
How Can I Help
You can help by being around to talk, by being positive, by giving sincere compliments and by gently encouraging your brother or sister to do things theyre good at.
Doing one-on-one things with your brother or sister will be better than doing things in crowds. They are likely to be giving themselves a hard time about their illness. You can help by being encouraging and reminding them its an illness and they will get better.
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What The Warning Signs Look Like
You may notice changes in yourself before your friends and family do. Once your loved ones do become aware, they might try to explain these changes as “just a phase” you’re going through or due to something stressful in your life. Because of that, many people don’t seek help until later on, when more severe symptoms start to emerge.
Signs that you may be in a prodrome include trouble with your memory or problems with paying attention and staying focused.
Mood swings and depression can happen. You may have anxiety and feel guilty about things or mistrust others. You could even have thoughts of suicide.
Another sign is lack of energy. You could have weight loss or no interest in meals. Sleep problems could crop up.
You might lose interest in things you once cared about and back away from socializing with family and friends. There could be a drop-off in your level of achievements at work or school.
Your friends may notice changes in how you look. You might not be keeping up with hygiene like you used to.
Some other things that you or others might become aware of:
- Hearing or seeing something that’s not there
- A strange way of writing or talking
- An angry, scared, or bizarre response to loved ones
- Extreme interest in religion or the occult
Other Considerations In Diagnosing Schizophrenia
The DSM-5 includes other things that can help determine schizophrenia. Theyre not necessary diagnostic criteria, but their presence points to this serious mental illness.
- Inability to understand someones intentions
- Thinking insignificant things are highly, personally meaningful
- Manic behavior
In addition to these, people with schizophrenia often experience what is known as neurological soft sign, subtle abnormalities that arent severe enough to fit into any disorder but are problematic and indicative of a bigger problem, like schizophrenia. They can include:
- Coordination problems
- Left-right confusion
- Difficulty with complex movement
To diagnose schizophrenia, professionals examine all of the symptoms and features that are present . They also must look at what is not present.
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Its Easy To Live In Denial
Even though your loved one isnt functioning well, isnt meeting their own expectations in life, and is using alcohol or drugs to cope, they may not see theres a problem.
Because of the natural urge to protect those you love, families can stay in denial, as well.
Its often the college that sends a young adult to the hospital for the first time because of erratic behavior or an overdose. The parents get involved only because the college requests their child be evaluated by a psychiatrist.
Families often dont seek help on their own, says Dr. Bowers.
They may continue to struggle try to understand their loved ones symptoms. Or ignore those symptoms until they escalate, sometimes into violent behavior.
But early, continuous treatment is critical, she stresses. Without help, a young adults problems will continue especially if they use drugs or alcohol.
If you find them up all hours of the night, or painting their room black, or too irritable without their meds, or scaring their little sister, call the doctor, she says. And encourage them to keep their appointments.
Risk Factors For Schizophrenia
Different factors combine to heighten the risk of schizophrenia, says Dr. Bowers:
- Genetics: Having a relative with schizophrenia or one who displays schizophrenic behaviors increases risk.
- Life stressors: Extreme poverty homelessness traumatic events early in life early isolation or deprivation or a constant fight for survival heighten risk.
- Hallucinogens: The use of crystal meth, LSD, PCP or psilocybin mushrooms increases risk in the vulnerable.
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How Do We Diagnose Schizophrenia
A mental health clinician will make the diagnosis following a comprehensive evaluation with you and your child. During the assessment, well ask you to describe your childs symptoms and provide an overview of your childs family history, medical history, school life, and social interactions.
Typically, a child is diagnosed with schizophrenia if he or she:
- displays positive or negative symptoms for a period of at least one month
- is experiencing a worsening decrease in the ability to function on a day-to-day basis
Child And Adolescent Brain Development
The increased spatial resolution available with magnetic resonance imaging allows a reliable, automated quantitative measurement of several brain regions, which combined with periodic rescanning in pediatric and adult populations, allows us to examine trajectories of brain change longitudinally. Over the past 20 years, longitudinal anatomic brain imaging of children and adolescents has established the trajectories of brain gray matter and white matter volumes, cortical thickness, along with finer maps of GM and WM development across time.
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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.
What Complications Are Associated With Childhood Schizophrenia
Childhood schizophrenia may cause difficulties throughout a childs life, and can affect learning, memory, relationships and productivity.
There is no cure for schizophrenia. Even when they are adults, these children will have various symptoms of the condition. They need continuous treatment to help them live a safe, productive life.
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How Is Schizophrenia Diagnosed Dsm
Schizophrenia is a serious mental illness that deeply affects people. Because a correct schizophrenia diagnosis can improve someones quality of life, its important that it be made as soon as possible after the symptoms of schizophrenia appear.
Currently, no tests can provide a schizophrenia diagnosis. To determine whether someone has the disorder, doctors follow established criteria for a schizophrenia diagnosis.
What Are The Treatments For Schizophrenia
Ninety-nine percent of patients with schizophrenia need lifelong treatment with antipsychotic drugs, counseling and social rehabilitation, says Dr. Bowers.
This will reduce their symptoms and help them get to a place of stability in their lives, she says.
Antipsychotics are given orally or by injection. Depending on the type of schizophrenia, other medications may be needed as well:
- People with paranoid schizophrenia usually respond well to antipsychotics, which decrease paranoid thinking and help them readjust to their environment.
- People with catatonic schizophrenia require benzodiazepines to relax their muscles, allowing them to become more active and to react to the environment.
- People with undifferentiated schizophrenia are slower to respond to antipsychotics because thinking is disturbed across the board. The medication makes them more alert and able to care for themselves, but it doesnt always clear their thinking, she says.
- People with schizoaffective disorder require a combination of antipsychotics and antidepressants or mood stabilizers.
Despite significant side effects, its important to keep taking these medications.
When people go on and off their meds, their symptoms return, and they often end up back in the hospital, says Dr. Bowers. Also, the more episodes you have, the further you get from your healthy baseline.
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Managing Life With Schizophrenia
Schizophrenia an require longer-term treatment. It takes at least six months of symptoms to be diagnosed and treatment may be recommended after symptoms have reduced.
While your mental health issue is being treated, life continues. How can you live the best life you can with schizophrenia?
Doctors can provide medication. They can give you recreational activities and advice. But the desire to get better has to come from you
Description And Risk Factors For Schizophrenia
Part of what makes schizophrenia so terrifying is that it can affect anyone. Theres no single cause of the disorder. However, some risk factors can increase a persons likelihood of developing schizophrenia, including:
- Having a biological relative with the disorder
- Having an overactive immune system, including an autoimmune disorder
- Taking psychoactive and/or psychotropic drugs during the teen years or early 20s
- Having a biological mother who had certain complications during pregnancy, including malnutrition and specific viruses
- Having a biological father who was older than most fathers at the time of conception
IF your teen has several of these risk factors, be sure to remain keenly aware of any signs of schizophrenia. However, even parents of children with none of these risk factors should know the symptoms of schizophrenia in teenagers.
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Childhood Schizophrenia Signs And Symptoms
Some children who develop schizophrenia first go through a period called the prodrome or the prodromal phase. They might withdraw from daily life, with more anxiety and less interest in school or friends. Not all children who show these signs will have a psychotic disorder, so itâs important to talk to your doctor if you notice any issues.
Early childhood schizophrenia symptoms
A baby or toddler may have signs of schizophrenia that are different from those in older children, teens, and adults.
The disorder affects how your child develops. You may notice things like:
- Long periods in which theyâre sluggish or not active
- Floppy arms or legs
- Delays in crawling, walking, or talking
- Odd movements such as rocking or flapping their arms
- A limp or slumped posture
Some of these symptoms show up in children with other problems besides schizophrenia. And some happen in kids without any mental health conditions. Only your child’s doctor can figure out what’s really going on.
Later childhood schizophrenia symptoms
In older kids, you might notice the behavior changes of schizophrenia over time or suddenly, as if out of nowhere. Your child may act withdrawn and clingy, or they may talk about strange and disturbed ideas and fears.
Tell your doctor as soon as you see symptoms of schizophrenia. It’s important to get a diagnosis and start treatment before your youngster shows signs of a break from reality, called psychosis.
Symptoms in older children include:
Concerned Your Child May Have Schizophrenia
Take our 2-minute Schizophrenia quiz to see if he or she may benefit from further diagnosis and treatment.
Naturally, there is typically a high level of parental distress and confusion when a young child demonstrates what appear to be the symptoms of schizophrenia, says Peter L. Klinger, MD, assistant professor in the Departments of Psychiatry and Pediatrics at the University of Arizona in Tucson and psychiatrist for the Early Psychosis Intervention Center at Banner University Medical Group.
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Symptoms Of Schizophrenia In A Teenager
Adolescence is generally a difficult stage of development. When schizophrenia is in the picture, the challenges of teenhood skyrocket. In large part, the schizophrenia symptoms for a teenager are close to those of an adult. They can experience any of the defining symptoms of schizophrenia:
- Disorganized or catatonic behavior
- Negative symptoms
While teens can experience all of these, they are less likely than adults to have delusions, and, as in childhood, their hallucinations are more likely to be visual than multi-sensory.
Negative symptoms of schizophrenia arent uncommon in adolescence in general. Many of these are frequently noticeable:
- Withdrawal from family, friends, and activities
- Drop in school performance
- Behavior that seems off or strange
- Apathy, loss of interest in things formerly enjoyed
- Substance use
Diagnosing schizophrenia in non-adults is complex. Just as important as knowing what the symptoms are is knowing what they are not.
Cognitive Symptoms & Thinking Problems
These symptoms reflect how well the personâs brain learns, stores, and uses information.
Someone with schizophrenia might have a hard time with their working memory. For example, they may not be able to keep track of different kinds of facts at the same time, like a phone number plus instructions.
Along with having trouble paying attention, it can be hard for them to organize their thoughts and make decisions.
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How Is Schizophrenia Diagnosed
While many of the symptoms can be controlled over time with proper treatment, symptoms of schizophrenia may be severe, and schizophrenia can be difficult to diagnose. Thats partially because people with schizophrenia symptoms often dont believe they have it and may not take themselves to a doctor for treatment.
Early Intervention Programs For Young People
Schizophrenia most often develops for the first time between the late teens and early twenties. Identifying young people in the early stages of a psychotic illness and providing them with specialised support and treatment can make a huge difference to their future health.
Specialist Child and Adolescent Mental Health Services are also available across Australia talk to your GP about finding a service near you. You can also contact your local headspace or their online support service, eheadspace to enquire about early intervention for psychosis.
Your public hospital
The treatment available through a public community mental health team ranges from acute inpatient care, where you are admitted and stay in hospital, to outpatient treatment in the community. The type of service provided can differ a lot from state to state and hospital to hospital.
Your state or territory Department of Health can help you identify your local community mental health services, or you can use the National Health Services Directory.
Treatment in a private hospital
With private health insurance, its also possible to get treatment in a private hospital. To ensure your money is well spent, research the different types of cover available and the treatment programs offered by hospitals in your area.
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Positive Symptoms Of Schizophrenia: Things That Might Start Happening
Positive symptoms are highly exaggerated ideas, perceptions, or actions that show the person canât tell whatâs real from what isnât. Here the word “positive” means the presence of symptoms. They can include:
- Hallucinations. People with schizophrenia might hear, see, smell, or feel things no one else does. The types of hallucinations in schizophrenia include:
- Auditory. The person most often hears voices in their head. They might be angry or urgent and demand that they do things. It can sound like one voice or many. They might whisper, murmur, or be angry and demanding.
- Visual. Someone might see lights, objects, people, or patterns. Often itâs loved ones or friends who are no longer alive. They may also have trouble with depth perception and distance.
- Olfactory and gustatory. This can include good and bad smells and tastes. Someone might believe theyâre being poisoned and refuse to eat.
- Tactile. This creates a feeling of things moving on your body, like hands or insects.