Schizophrenia can be one of the most misunderstood mental illnesses. Although it affects around 1% of adults in the United States, many people don’t know much about it. Or they think they do, but their ideas about it are incorrect.
“The image of schizophrenia in popular culture is usually of the severely disabled patient who often shows himself to be violent, and by and large they are not at all,” said Ben Weinstein, MD, Chair of Psychiatry at Houston Methodist Hospital. Nor does schizophrenia mean that someone has a split personality.
It’s not a one-size-fits-all-set of experiences. “When someone with schizophrenia has had good treatment and it’s well under control, they may seem a little ‘fallen off’ at times, but you may not even know they have it,” says Weinstein. But for those who do not have access to the drugs and care they need, or those who drop out of treatment, schizophrenia is devastating.
The exact mix of symptoms and their severity can vary widely from person to person. It depends on their genetics, their environment, and whether they’re taking medication or receiving other treatments like therapy, Weinstein says. But there are some common things people with this condition go through.
Help can be delayed
Tina Collins, 53, of Baltimore says she was extremely anxious as a child and had her first breakdown at age 14, especially among young people, “she says. She says it took decades to get diagnosed because of the stigma that comes with the condition. “Nobody wanted to talk about it. Since I always had anxiety and other symptoms, my family said, ‘Oh, she’s always like that, she’ll be fine.’ ”
Matthew Dickson, now 47, of New Brunswick, Canada, started having symptoms at 17 (Schizophrenia usually starts in the late teenage years or early 20s, but it can appear later). He didn’t know what was happening to him. “I told people about some of my feelings, but I had no idea what mental illness was. I still managed to go to class and even ride a bike in Canada, but it hit me hard at the end of the final semester of my senior year. ”When Dickson began to worry that he would kill himself, he eventually sought help and began treatment.
Since there is no schizophrenia test, the first step in diagnosis is getting rid of other conditions, says Dr. Russell Margolis, director of the Johns Hopkins Schizophrenia Center. He notes that some of the symptoms may be similar to those of depression and dementia, or that a different illness could be to blame. “There can be a mood disorder or delirium caused by an acute medical problem,” he says.
To be diagnosed with schizophrenia, someone must have problems in daily life – at work or school, in relationships, or with tasks like dressing and taking care – and also have a group of three types of symptoms: positive, negative, and cognitive . And in this case, “positive” and “negative” don’t mean what you might think.
What positive schizophrenia symptoms look like
These simply mean experiences someone with schizophrenia has, such as hallucinations, delusions, unusual physical movements, and illogical thoughts. “These are as real to the person with schizophrenia as if someone walks in the room and starts talking to you,” says Weinstein.
Collins describes her hallucinations before starting treatment. “The room went dark and people would become distorted and look demonic,” she recalls. “If I look in the mirror my face would look demonic – I thought I was the ugliest person in the world.” Her eyesight and hearing began to change, making it extremely difficult to understand the world. “It was like Alice in Wonderland,” says Collins. “Everything got bigger, smaller, louder, quieter; my ability to process information that came in through my senses began to break down. “
Dickson says he never saw visions, but he felt so much “static” in his brain that he could neither concentrate nor concentrate. “It’s like watching a movie where it’s a war zone and bombs go off and it’s total chaos.”
Both Collins and Dickson describe lives with constant noise in their heads. “I heard a lot of clicks and popping noises. I took it for granted that the world was like this and everyone else knew how to work in it, but I couldn’t, ”says Collins. She also remembers seeing a “shadow man,” a common hallucination.
Hallucinations are “often acoustic” [something you hear] but can be accompanied by smells, visions and tastes, ”says Margolis. When the brain tries to understand all of these false inputs, it can create a narrative that some outside force – like the government, a family member, or even a chip implanted in the brain – is out to get it. although none of it is true.
Positive symptoms can also be “trippy” delusions. “I remember going for a walk in my worst year and thinking, if I just stop walking here, then stand still and turn around and go the other way, I can go back in time,” says Dickson.
What negative schizophrenia symptoms look like
While schizophrenia thinks of the positive symptoms, the negative symptoms are often the weakest and cause people to drop out of work, school, and everything else that matters to them in life, Weinstein points out.
“Negative symptoms are a lack of momentum in life, a lack of normal interest, drive, and motivation,” says Margolis. “In the extreme case it can be someone who hardly speaks, who just sits at home and does little or nothing.”
“When I was looking at the world around me, it was like watching TV,” says Dickson. “It feels like you’re totally cut off.” He remembers reading a description of the 2001 film A Beautiful Mind about mathematician John Nash, who fought schizophrenia for decades: “It said that Nash lived a ‘ghostly existence’ and I can definitely assign that. You feel helpless, you lose your self-esteem. “
For Collins, her inability to interact with the world was linked to her perceptual problems. “When I tried to walk across the room, it felt like my feet were falling through the floor,” she says. “The boundaries are constantly shifting and dissolving, so that your ability to function physically, cognitively and emotionally has completely disappeared. I couldn’t even speak for years. It was like my voice was being swallowed deep inside me. I called it “in the black box”: I wanted to get out, but I couldn’t get out of the traffic jam in my head. “
What the symptoms of cognitive schizophrenia look like
Someone with these symptoms may have difficulty concentrating, concentrating, absorbing new information, and using that information. Their brains process information more slowly, their memories deteriorate, and they often have difficulty reading and understanding social cues, Weinstein says. Although positive symptoms can make these symptoms worse with the brain’s “circulation”, cognitive decline is a symptom on its own, says Margolis.
“Even getting dressed was a very complicated process for me,” says Collins. “It’s like a jam of information going in and out of your brain, so it’s like everything is always new, you don’t remember the process.”
Dickson describes the feeling that his brain is under constant attack. “My analogy is if you are playing a tackle football game with some friends and the ball comes to you, can you really do algebra in your head right now? I was a pretty smart guy, but when you’re fed up with what I had, you really can’t do a lot of deep intellectual thinking. “
Recovery through treatment
Although there is no cure for schizophrenia, medication and therapy can manage the symptoms. Consistency is the key: Without treatment, symptoms return immediately. This can create an extreme downward spiral for those who are without the medication and care that they need.
After many years of treatment, both Collins and Dickson came out on the other side.
“I was fortunate enough to find doctors who believed I could be better,” says Collins. “It took a good 10 years of therapy and medication to really develop the skills of everyday life, but you can do it. I still have residual symptoms, but I no longer have hallucinations. “
Dickson says his recovery was a long, slow process, aided by the fact that he was desperate to get well and was careful to always take his medication. “I’ve seen gradual improvements in my health every week for the past 25 years and I’ve finally gotten back on my feet,” says Dickson. He decided to keep paying it by creating a nonprofit to provide mental health resources to people in third world countries.
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