What is Schizophrenia?

Schizophrenia is a chronic, severe, and disabiling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime - more than 2 million Americans suffer from the illness in a given year. Although schizophrenia effects men and woman with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in woman, who are generally effected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behavior can be so disorganized that they may be incomprehensible or frightening to others. Available treatmenst can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one is five individuals recovers completely.

Schizophrenia is found all over the world. The severity of the symptoms and longlasting, chronic pattern of schizophrenia often cause a hight degree of disability. Medications and other treatments for schizophrenia, when used regularly and as prescribed, can help reduce and control the distressing symptoms of the illness.

Even when treatment is effective, persisting consequences of the illness - lost opportunities, stigma, residual symptoms, and medication side effects - may be very troubling.

The first sign of schizophrenia often appear as confusing, or even shocking, changes in behavior. Coping with the symptoms of schizophrenia can be especially difficult for family members who remember how involved or vivacious a person was before they became ill. The sudden onset of severe psychotic symptoms is referred to as an "acute" phase of schizophrenia. "Psychosis," a common condition in schizophrenia, is a state of mental impairment marked by hallucinations, which are disturbances of sensory perception, and/or delusions, which are false yet strongly held personal beliefs that result from an inability to seperate real from unreal experiences. Less obvious symptoms, such as social isolation or withdrawal, or unusual speech, thinking, or behavior, may precede, be seen along with, or follow the psychotic symptoms.

Some people have only one such psychotic episode; others have many episodes during a lifetime, but lead relatively normal lives during the interim periods. However, the individual with "chronic" schizophrenia, or a continuous or recurring pattern of illness, often doew not fully recover normal functioning and typically requires long-term treatment, generally including medication, to control the symptoms.

Self-Advocacy / Schizophrenia

Antipsychotic drugs have proven to be crucial in relieving the psychotic symptoms of schizophrenia - Hallucinations, delusions, and incoherence - but are not consistent in releiving the behavioral symptoms of the disorder. Even when patients wich schizophrenia are relatively free of psychotic symptoms, many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Moreover, becuase patients with schizophrenia frequently become ill during the critical career-forming years of life (e.g. ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many with schizophrenia not only suffer thinking and emotional difficulties, but lack social and work skills and experience as well.

It is with these psychological, social, and occupational problems that psychosocial treatment may help most. While psychosocial approaches have limited value for acutely psychotic patients, they may be useful for patients with less severe symptoms or for patients whose psychotic symptoms are under control. Numerous forms of psychosocial therapy are available for people with schizophrenia, and most focus on improving the patient's social functioning - whether in the hospital or community, at home, or on the job. Some of these approaches are described here. Unfortunately, the availability of different formst of treatment varies greatly from place to place.

Broadly defined, rehabilitation includes a wide array of non-medical interventions for those with schizophrenia. Rehabilitation programs emphasize social and vocational training to help patients and former patients overcome difficulties in these areas. Programs may include vocational counseling, job training, problem solving amd money management skills, use of public transportation, and social skills training. These appreoaches are important for the success of the communitiy-centered treatment of schizophrenia, because they provide discharged patients with the skills necessary to lead productive lives outside the sheltered confines of a mental hospital.

Individual psychotherapy involves regularly scheduled talks between the patient and a mental health preofessional such as a psychiatrist. By sharing experiences with a trained empathic person - talking about their world with someone outside it - individuals with schizophrenia may gradually come to understand more about themselves and their problems. They can also learn to sort out the real from the unreal and distorted. REcent studies indicate that supportive, reality-oriented, individual psychotherapy, and cognitive-behavioral approaches that teach coping and problem-solving skills, can be beneficial for outpatients with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication, and it is most helpful once drug treatment first has relieved a patient's pshychotic symptoms.