Schizophrenia Personality Definition Essay

Schizophrenia is a brain disease that interferes with normal brain functioning. It causes affected people to exhibit odd and often highly irrational or disorganized behavior. Because the brain is the organ in the body where thinking, feeling and understanding of the world takes place (where consciousness exists), a brain disease like schizophrenia alters thinking, feeling, understanding and consciousness itself in affected persons, changing their lives for the worse.

Schizophrenia symptoms include difficulty thinking coherently, interacting with others normally, carrying out responsibilities and expressing emotions appropriately. Even simple everyday tasks like personal hygiene can become unmanageable and neglected. The disease can thus impact every aspect of affected people's work, family, and social life. Though not affected directly, family members also frequently become distressed and overwhelmed by the difficulties involved in providing care and in coming to terms with the transformation of their loved one into a patient with a serious chronic illness.

Psychosis and the loss of reality

A defining feature of schizophrenia or paranoid schizophrenia is psychosis. Psychosis occurs when a person loses the ability to discriminate between real and 'imagined' experiences, and therefore loses touch with reality.

People with schizophrenia commonly experiencehallucinations, which are phantom sensations that only they perceive (such as voices speaking to them that only they can hear), and delusions, which are fixed, mistaken ideas (sometimes quite outlandish and illogical ideas) concerning themselves and their surroundings.

Both hallucinations and delusions are involuntary in nature, occurring spontaneously and without premeditation on the part of the patients who experience them. Typically, attempts to correct patients' delusions are met with resistance and defensiveness. From their internal perspective, patients' delusions seem to be true.

While the hallucinations and delusions characteristic of psychosis are 'imagined' in the sense that they do not have a solid, consistent basis in reality, they are nevertheless unavoidable and appear as real as other more reality-based perceptions to the people who experience them.

Schizophrenic persons have little choice but to take their hallucinations seriously as their malfunctioning brains cause them to experience hallucinations uncontrollably with the force of real sensations. Hallucinations are thus a sort of 'virtual reality' that schizophrenic people become trapped within, and the delusions that form around these hallucinations are a natural response to this unintentionally altered perception.

People with schizophrenia tend to think and act differently than other people because the occurrence of hallucinations, delusions and other symptoms characteristic of schizophrenia causes them to experience reality very differently than other people. This loss of reality can be terrifyingfor both schizophrenic people, who struggle mightily to make sense of their inner perceptual chaos, and for the people around them who grapple with trying to understand why their loved ones are acting in such odd and seemingly disorganized ways.

Treatment for schizophrenia focuses on eliminating the symptoms of the disease. Treatments include anti-psychotic medications, psychotherapy, and various treatments.

It is important to note that people with schizophrenia are at high risk for suicide, 5-6 percent of people with schizophrenia die by suicide and 20  percent attempt suicide at least once. Seeking help for this treatable condition is particularly important to minimize the risk of suicide. 

Hospitalization

Hospitalization may be necessary during the acute phase of the illness. An inpatient stay becomes necessary when a person may be a danger to themselves or others, or is unable to care for themselves. Hospitalization may be necessary to stabilize the person on their medication, which will help improve their psychotic symptoms. 

Medication

Anti-psychotics have greatly improved the outlook for individual patients as they reduce psychotic symptoms and usually allow the patient to function more effectively and appropriately. Anti-psychotic drugs are currently the best treatment available, but they do not cure schizophrenia or ensure that there will be no further psychotic episodes. The dosage of medication is individualized for each patient; the amount of drug needed to reduce symptoms may vary.

A large majority of people with schizophrenia show substantial improvement when treated with anti-psychotic drugs. Some patients, however, are not helped by medication. Doctors and patients often collaborate to figure out which medication is best for each patient, as some drugs may have unwanted side effects. The large majority of patients do benefit from treatment with anti-psychotic drugs.

People with schizophrenia may be treated with first-generation or second-generation (atypical) anti-psychotics. Second-generation medications are generally preferred by clinicians and patients because they have a lower risk of serious side effects than first-generation anti-psychotics.

Anti-psychotic drugs are often very effective in treating the positive symptoms of schizophrenia, particularly hallucinations and delusions. They are typically not as helpful, however, with negative symptoms, such as reduced motivation and emotional expressiveness. Older anti-psychotics (neuroleptics) such as haloperidol or chlorpromazine may produce side effects that resemble symptoms that are more difficult to treat, such as dullness and movement disorders. Often, lowering the dose or switching to a different medicine may reduce these side effects. The newer medicines, including olanzapine, quetiapine, risperidone, ziprasidone, aripiprazole and paliperidone appear less likely to have this problem. Sometimes when people with the illness become depressed, other symptoms can appear to worsen. The symptoms may improve with the addition of an anti-depressant medication.

Patients and families sometimes become worried about the anti-psychotic medications used in treating this disease both in terms of side effects and possible addiction. However, anti-psychotic medications do not produce euphoria or addictive behavior in people who take them.

Another misconception about anti-psychotic drugs is that they act as a kind of mind control, or a chemical straitjacket. Anti-psychotic drugs used at the appropriate dosage do not knock people out or take away their free will. While these medications can produce a sedative effect that can be beneficial when treatment is initiated, the utility of the drugs is not due to sedation but to their ability to diminish the hallucinations, agitation, confusion, and delusions of a psychotic episode. Thus, anti-psychotic medications should eventually help an individual to deal with the world more rationally.

Response to Medication

Anti-psychotics are usually in pill or liquid form. Some anti-psychotics are in an injectable form that is given once or twice a month.

Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement.

However, people respond in different ways to anti-psychotic medications, and no one can tell beforehand how a person will respond. Sometimes a person needs to try several medications before finding the right one. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.

Some people may have a relapse, meaning their symptoms may come back or get worse. Usually, relapses happen when people stop taking their medication, or when they take it inconsistently. Some people stop taking the medication because they feel better or they may feel they don't need it anymore. No one should stop taking an anti-psychotic medication without talking to his or her doctor, at the risk of experiencing a relapse of symptoms. 

Side Effects of Medication

Anti-psychotic drugs, like virtually all medications, have unwanted side effects. Side effects include drowsiness, restlessness, muscle spasms, dry mouth, tremor, blurred vision, rapid heartbeat, sun sensitivity, skin rashes or menstrual problems for women. Atypical anti-psychotic medications can cause major weight gain and changes in a person's metabolism. This may increase a person's risk of getting diabetes and high cholesterol. A person's weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical anti-psychotic medication. Typical anti-psychotic medications can cause side effects related to physical movement, such as rigidity, persistent muscle spasms, tremors, or restlessness. Most side effects go away after a few days and often can be managed successfully by adjusting the dosage or by using other medications. For many people, however, the benefit they receive from the medication they take outweighs the side effects they experience. 

One long-term side effect may pose a more serious problem. Tardive dyskinesia (TD) is a disorder characterized by involuntary movements most often affecting the mouth, lips, and tongue, and sometimes other parts of the body. TD happens to fewer people who take the atypical anti-psychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication.

Anti-psychotics can produce unpleasant or dangerous side effects when taken with certain medications. For this reason, all doctors treating a patient need to be aware of all the medications that person is taking. Doctors need to know about prescription and over-the-counter medicine, vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other drug use with their doctor. Nevertheless, the newer anti-psychotics are a significant advance, and their optimal use in people with schizophrenia is a subject of current research.

Psychotherapeutic Treatment

Therapeutic treatments can help people with schizophrenia who are already stabilized on anti-psychotic medication. These treatments help people deal with the everyday challenges of their illness, such as difficulty with communication, self-care, work, and forming and keeping relationships. Learning and using coping mechanisms to address these problems allow people with schizophrenia to socialize and attend school and work.

Patients who receive regular treatment also are more likely to keep taking their medication, and they are less likely to have relapses or be hospitalized. A therapist can help patients better understand and adjust to living with schizophrenia. The therapist can provide education about the disorder, common symptoms or problems patients may experience, and the importance of staying on medications.

Illness management skills

People with schizophrenia can take an active role in managing their own illness. Once patients learn basic facts about schizophrenia and its treatment, they can make informed decisions about their care. If they know how to watch for the early warning signs of relapse and make a plan to respond, patients can learn to prevent relapses. Patients can also use coping skills to deal with persistent symptoms.

Integrated treatment for co-occurring substance abuse

Substance abuse is the most common co-occurring disorder in people with schizophrenia. Many substance abuse treatment programs, however, do not usually address the specific needs of people with schizophrenia. When schizophrenia treatment programs and drug treatment programs are used together, patients get better results.

Rehabilitation

Rehabilitation includes a wide array of non-medical interventions emphasizing social and vocational training to help patients and former patients overcome difficulties. Because schizophrenia usually develops in people during the critical career-forming years of life (ages 18 to 35), and because the disease makes normal thinking and functioning difficult, most patients do not receive training in the skills needed for a job. Rehabilitation programs work well when they include both job training and specific therapy designed to improve cognitive or thinking skills. Programs may include vocational counseling, job training, problem-solving, money management skills, use of public transportation, and social skills training. Programs like this help patients hold jobs, remember important details, and improve their functioning.

Individual Psychotherapy

Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. A positive relationship with a therapist gives the patient a reliable source of information, sympathy, encouragement, and hope, all of which are essential for managing the disease. The therapist can help patients better understand and adjust to living with schizophrenia by educating them about the causes, symptoms or problems they may be having. However, psychotherapy is not a substitute for anti-psychotic medication.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on thoughts and behavior. CBT helps patients with symptoms that do not go away even when they take medication. The therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to "not listen" to their voices, and how to manage their symptoms overall. CBT can help reduce the severity of symptoms and reduce the risk of relapse.

Family Education

People with schizophrenia are often discharged from the hospital into the care of their family, so it is important that family members understand the difficulties associated with the illness. With the help of a therapist, they can learn ways to minimize the person's chance of relapse by having an arsenal of coping strategies and problem-solving skills to support their ill relative. In this way, the family can help make sure their loved one sticks with treatment and stays on his or her medication. Additionally, families should learn where to find outpatient and family services.

Self-Help Groups

Self-help groups for people with schizophrenia and their families are becoming increasingly common. Although not led by a professional therapist, these groups may be therapeutic because members provide continuing mutual support as well as comfort in knowing that they are not alone. Self-help groups may also serve other important functions. Families working together can more effectively serve as advocates for research and more hospital and community treatment programs. Also, groups may be able to draw public attention to the discrimination many people with mental illnesses face.

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