Schizo means split, and phrenic, in this case, refers to the mind. Even though schizophrenia can be interpreted to mean “splitting of the mind”, it does not refer to a split personality, as some media sources might portray, but rather schizophrenia describes a scattered or fragmented pattern of thinking. Schizophrenia’s actually a syndrome, meaning there’re all sorts of symptoms that might be associated with it and different patients might experience different symptoms, although the symptoms can be broadly categorized into three major areas.
Positive symptoms, negative symptoms, and cognitive symptoms. Alright taking a step back, most human symptoms from any illness are extreme versions of a normal physiologic process (for example everyone has a heartbeat and tachycardia is a fast heartbeat, everyone has a normal body temperature, but during a fever that temperature is higher). In schizophrenia, patients have positive symptoms that aren’t positive in the sense that they’re helpful but positive in the sense that they’re some new feature that doesn’t have some “normal” or physiologic counterpart.
These are the psychotic symptoms, so delusions, hallucinations, disorganized speech, and disorganized or catatonic behavior; none of which occur physiologically. Delusions are false beliefs that the patient might feel very strongly about, so much so that they won’t change their mind, even if you give them evidence against it. There are all sorts of different delusions, like, for example, a delusion of control, where somebody thinks that some outside force or person or thing is controlling their actions.
They could also be delusions of reference, where someone might think that insignificant remarks are directed at them, like a newscaster speaking directly to them through the TV. Hallucinations are the second type of positive symptom and can be any kind of sensation that’s not actually there, including visual but also including auditory sensations, like hearing voices or commands. A third type is disorganized speech An example being something like a “word salad”, which seems like just a random jumbling of words or phrases, like “pencil dog hat coffee blue”.
Disorganized behavior on the other hand could be like if they exhibit bizarre or silly behavior that sort of context and doesn’t seem to have much of a purpose, like for example wearing multiple layers of jackets on a hot summer day. Also sometimes the behavior is described as “catatonic”, which has to do with their movements, posture, and responsiveness. So like they might be super resistant to moving or be in an unresponsive stupor.
Negative symptoms are like when there this reduction or removal of normal processes. and this is like a decrease in emotions they can express or a loss of interest in things they once found interesting. One type of a negative symptom is called flat affect, where they don’t respond with emotion or reaction that would seem appropriate like if they saw something very unexpected like a small monkey playing in their living room, they might simply sit and watch idly as if nothing was happening. Another type is alogia, or poverty of speech, which is a lack of content in speech.
The third type of negative symptom is avolition, which is this decrease in motivation to complete certain goals, so someone might stay at home for long periods of time, without trying to reach out to friends or find work. Cognitive symptoms include things like not being able to remember things, learn new things, or understand others easily. These symptoms are more subtle though, and more difficult to notice and might only be detected if they have really specific tests performed.
An example might be somebody not being able to keep track of several things at once, like a phone number and an address. People with schizophrenia seem to cycle through three phases, typically in order. During the prodromal phase, patients might become withdrawn and spend most of their time alone, and often this seems similar to other mental disorders like depression or anxiety disorders. During the active phase, patients experience more severe symptoms like delusions, hallucinations, disorganized speech, disorganized behavior, or catatonic behavior.
Following an active phase, patients often enter into a residual phase, where they might exhibit cognitive symptoms like not being able to concentrate becoming withdrawn again, as with the prodromal phase. For an official diagnosis of schizophrenia, patients need to be diagnosed with two of the following symptoms—Delusions, hallucinations, disorganized speech, disorganized behavior or catatonic behavior, or negative symptoms, and at least one of them has to be either delusion, hallucinations, or disorganized speech.
So basically they couldn’t have just disorganized behavior and negative symptoms. Even though some patients have cognitive symptoms as well, they aren’t specifically needed for a diagnosis. Also though, for a diagnosis, signs of these disturbances must be ongoing for at least 6 months, meaning they’re likely in one phase or another for 6 months, but there must be at least one month of active-phase symptoms. And finally, those symptoms can’t attributable to another condition, like substance abuse.
Now that we’ve diagnosed it…why does it even happen in the first place? What causes schizophrenia? Well we don’t really know, since it seems like the signs and symptoms of schizophrenia are pretty unique to humans, or at least they’re hard to imagine or notice in animal models like mice or rats. One clue is that the majority of antipsychotic medications that improve schizophrenia symptoms block the dopamine receptor D2, which reduces dopamine levels in neurons. This suggests that maybe schizophrenia has something to do with increased levels of dopamine.
The symptoms that I talked with a psychiatrist and became aware of what was taking place. My psychiatrist told me about a mental illness called schizophrenia. Schizophrenia is a serious mental health disorder. It can significantly impact how someone acts, thinks, and feels. It interferes with the logic that they would typically use and they can begin to act in ways that seem strange to other people. For example, I really believed that I was seeing objects move on their own and I could talk to them.
I now know that I was having hallucinations and delusions, some of the symptoms of schizophrenia. Everyone with schizophrenia has their own unique experience but the condition includes a few specific types of symptoms. One symptom is hallucinations. When your senses perceive something that isn’t really happening. Hallucinations can happen with any of our senses. Like seeing things that aren’t there, known as visual hallucinations. Or feeling something is on or happening to your body that isn’t really there called tactile hallucination.
Hallucinations can even extend to one’s sense of smell, referred to as olfactory hallucinations. Auditory hallucinations like hearing voices are the most common kind of hallucination in schizophrenia. The voice I heard from the painting was so clear, just like someone was standing next to me talking to me. I had no control over the voice. I couldn’t make it go away on my own. People living with schizophrenia might also have delusions or strong beliefs in things that are not true. This might be a belief that another person or group is out to harm you or is controlling you or your thoughts.
Another example of delusion is that you may think you’re a famous person from history or that you’re in a relationship with a famous person. People living with schizophrenia may also have symptoms that impact their ability to think clearly. This is called disorganized thinking and is typically seen in the way a person talks. For me, I would talk about things that did not quite fit reality. People living with schizophrenia might also have a hard time focusing or paying attention.