Tuesday, January 31, 2023

Why Do People Get Schizophrenia

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Schizophrenia is a condition that has severe effects on a persons physical and mental well-being. This is because it disrupts how your brain works, interfering with your thinking ability, memory, how your senses work and more.

Because your brain isnt working correctly, having schizophrenia often causes you to struggle in many parts of your day-to-day life. Schizophrenia often disrupts your relationships . It can also cause you to have trouble organizing your thoughts, and you might behave in ways that put you at risk for injuries or other illnesses.

Disturbances Of Early Development

Prospectively collected measures of premorbid function have consistently revealed neuromotor abnormalities and developmental delays. In the British 1946 Birth Cohort pre-schizophrenic children were found to have delayed motor and speech development by the age of 2 years. In the Northern Finland 1966 Birth Cohort the ages that children learned to stand, walk and become potty-trained were related to subsequent risk for schizophrenia and other psychoses earlier milestones reduced the risk, whereas later milestones increased it. Cannon et al.showed, in a birth cohort from New Zealand, that children who went on to develop schizophreniform disorder had persistently poor motor function over repeated measurements in childhood. In an innovative study using home movies filmed during childhood, pre-schizophrenic individuals could be differentiated from their healthy siblings by viewers who were blind to the psychiatric outcomes.

What If I Am Not Happy With My Treatment

If you are not happy with your treatment you can:

  • talk to your doctor about your treatment options,
  • ask for a second opinion,
  • get an advocate to help you speak to your doctor,
  • contact Patient Advice and Liaison Service and see whether they can help, or
  • make a complaint.

There is more information about these options below.

Treatment options

You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.

Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.

Second opinion

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.

You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.

Advocacy

An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.

There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.

The Patient Advice and Liaison Service

Complaints

You can find out more about:

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When Should I See My Doctor

Some people with schizophrenia do not realise they have a problem or avoid health professionals if they have paranoid thoughts. Its important to get professional help to manage schizophrenia. If you or someone you know seems to be experiencing signs of schizophrenia, see your doctor as soon as possible.

It can be hard to recognise signs of schizophrenia at first, but over time the changes in someones thinking and behaviour may get worse.

See a doctor if you or someone you know:

  • gets very preoccupied with something
  • starts talking or writing very fast, or is talking much less than normal
  • seems muddled, irrational or is hard to understand
  • withdraws from normal activities
  • is hyperactive or starts behaving recklessly
  • laughs or cries inappropriately, or cannot laugh or cry or express happiness
  • doesnt look after their personal hygiene
  • develops depression or anxiety

Although the majority of people with schizophrenia are not violent, severe symptoms can cause some people to have thoughts of suicide or harming others. If you think someone may be at risk of suicide or violence, call triple zero .

Medication And Schizophrenia Patients

What are some facts about schizophrenia?

Schizophrenia medication is extremely effective for treating many of the symptoms of schizophrenia, like hallucinations and delusions. In fact, when treated, about 80% of people who experience their first psychotic episode will never have another.

The problem, though, is that many schizophrenia patients stop taking their medication this is known as medication noncompliance. A schizophrenia patient may stop taking their medication for a variety of reasons, medication side effects being one. Just some of the medication side effects include:2

  • Muscle movement disorders
  • Blood sugar problems
  • Blood pressure problems

Its unfortunate that patients with schizophrenia stop taking their medication because this often sends them into psychosis, making it impossible for them to work with a doctor or therapist to find a better treatment for them.

Other reasons a schizophrenia patient may not take their medication include:

  • Reemergence of symptoms

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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.

Private therapists

Other services

What To Watch For

Keep an eye out for signs that the person feels hopeless or that they have suffered a loss.

You might think that someone whoâs in the hospital is going to be OK. But sometimes, suicide risk goes up when the person leaves the hospital. This can happen if they see staffers and other patients as the central people in their life, and then feel hopeless without them.

Whenever anyone has schizophrenia, itâs important to pay close attention to feelings of hopelessness and suicidal thoughts and behaviors. This is especially true for people who start to realize how serious their condition is.

Becoming more aware of their illness can prompt some people to take better care of themselves. But it can lead to suicidal thoughts in others. Thatâs especially likely in younger people who used to have healthy lives and now recognize how much they’ve lost.

Keep in mind that many antidepressants and antipsychotic drugs carry warnings of increased risk for suicidal thinking and behavior in young adults, adolescents, and children.

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Brain And Body Risk Factors

Developmental theories of schizophrenia suggest that something goes wrong when the brain is developing. Brain development, from the earliest stage of fetal development, the early years of life and through adolescence, is an extremely complicated process. Millions of neurons are formed, migrate to different regions of the forming brain, and specialize to perform different functions.

The something that goes wrong might be a viral infection, a hormonal imbalance, an error in genetic encoding, a nutritional stress, or something else. The common element in all developmental theories is that the causal event occurs during the brains development.

Even though these potential causes may be rooted in very early development, symptoms of schizophrenia typically emerge in late adolescence or early adulthood.

Planning For The Future

Things Not To Say To Someone With Schizophrenia

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.

You can read more about relapse prevention plans at Orygen and Here to Help.

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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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.

How Is It Treated And Is There A Cure

Schizophrenia isnt curable, but it is often treatable. In a small percentage of cases, people can recover from schizophrenia entirely. However, this isnt a cure because there isnt a way of knowing who will have a relapse of this condition and who wont. Because of that, experts consider those who recover from this condition in remission.

Treating schizophrenia usually involves a combination of medication, therapy and self-management techniques. While therapy alone is often effective for treating most mental health conditions, managing schizophrenia usually requires medication. Early diagnosis and treatment are important because they increase the chances of a better outcome.

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Rehabilitation And Living With Schizophrenia

Treatment can help many people with schizophrenia lead highly productive and rewarding lives. As with other chronic illnesses, some patients do extremely well while others continue to be symptomatic and need support and assistance.

After the symptoms of schizophrenia are controlled, various types of therapy can continue to help people manage the illness and improve their lives. Therapy and psychosocial supports can help people learn social skills, cope with stress, identify early warning signs of relapse and prolong periods of remission. Because schizophrenia typically strikes in early adulthood, individuals with the disorder often benefit from rehabilitation to help develop life-management skills, complete vocational or educational training, and hold a job. For example, supported-employment programs have been found to help people with schizophrenia obtain self-sufficiency. These programs provide people with severe mental illness competitive jobs in the community.

For many people living with schizophrenia family support is particularly important to their health and well-being. It is also essential for families to be informed and supported themselves. Organizations such as the Schizophrenia and Related Disorders Alliance of America , Mental Health America and the National Alliance on Mental Illness offer resources and support to individuals with schizophrenia and other mental illnesses and their families .

What Treatment Should The Nhs Offer Me

Red Flags for Early Stage Schizophrenia

The National Institute for Health and Care Excellence recommend that you should be offered antipsychotic medication and talking therapy if you experience psychosis. If you decide not to take medication you should still be offered talking therapy.

NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at www.nice.org.uk.

Your GP may refer you to a specialist mental health team such as the early intervention team , community mental health team , or crisis team.

Medication

Antipsychotic medication can help with psychosis. Your doctor should give you information about antipsychotics including side effects. You and your doctor should choose the medication together.

Some people find they do not start to recover until they get the right medication. It is important to take the medication every day to help your symptoms.

Try not to be too upset if the first antipsychotic that you try doesnt help. There are lots of different antipsychotics to try because people respond better to different medications. Some may not improve your symptoms and may cause side effects.

You can discuss your medication with your doctor if your medication is not working. Or you are finding the side effects hard to deal with. There might be another medication that will suit you better.

There is a high risk of relapse if you stop taking medication within the first 1 to 2 years, following your first episode of psychosis.

Talking therapies

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How Do I Take Care Of Myself

People with schizophrenia should do the following to help care for themselves and manage their condition:

  • Take medications as prescribed. One of the most critical things a person with schizophrenia can do to help themselves is to take their medications. If you have schizophrenia, you should not stop your medication without talking to your healthcare provider. Sudden stopping of medication often speeds up the return of psychosis symptoms. Side effects are common with antipsychotics. However, there are many antipsychotic medications, so its often possible to work with your healthcare provider to find one that both works well for you and has minimal or no side effects.
  • See your healthcare provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your condition.
  • Dont ignore or avoid symptoms. Schizophrenia is more likely to respond and have a good outcome with early diagnosis and treatment.
  • Avoid alcohol and recreational drug use. Alcohol and drug use can make schizophrenia symptoms worse and can lead to other issues. This includes using prescription medications in a way other than prescribed.
  • Consider seeking support. Organizations such as the National Alliance on Mental Illness can offer resources and information that can help.

What Is The Outlook For People With Schizophrenia

With proper treatment, most people with schizophrenia can lead productive and fulfilling lives. Depending on how severe the condition is and how well they get and stick with treatment, they should be able to live with their families or in community settings rather than in long-term psychiatric hospitals.

Ongoing research on the brain and how brain disorders happen will likely lead to more effective medicines with fewer side effects.

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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.

Articles On Schizophrenia Overview

Life with Schizophrenia, According to a Psychiatrist

Schizophrenia is a chronic, severe mental disorder that affects the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Though schizophrenia isnât as common as other major mental illnesses, it can be the most chronic and disabling.

People with schizophrenia often have problems doing well in society, at work, at school, and in relationships. They might feel frightened and withdrawn, and could appear to have lost touch with reality. This lifelong disease canât be cured but can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia involves a psychosis, a type of mental illness in which a person canât tell whatâs real from whatâs imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. Their behavior may be very strange and even shocking. A sudden change in personality and behavior, which happens when people who have it lose touch with reality, is called a psychotic episode.

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