Schizophrenia – A Brain in Trouble

Schizophrenia - A Brain in Trouble. What is real, what is not?
Schizophrenia – A Brain in Trouble. What is real, what is not?

Explosion and Revolution in Schizophrenia Knowledge and Research

The explosion and revolution in schizophrenia knowledge and research is such that it is hard for us to contain ourselves. Examination of childhood signs far before it starts, the newly seen signs just before it can be seen as psychosis, and the evolution of the disorder after that first episode all add to a whole new view. Schizophrenia – a brain in trouble.

Wipe Out Schizophrenia

The plan is to eliminate schizophrenia altogether.  Wipe it out.  It’s the goal of the entire medical neuroscience research community working on psychosis.  And we’re getting close.  See our page on Treating Schizophrenia.

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Schizophrenia and its Causes are Complicated and Varied  

Schizophrenia is caused by a mixture of genetic and environmental factors (for example, experiences of the developing baby during pregnancy; see below).  As these several factors come into play, schizophrenia in one person might well be different from schizophrenia in another individual.  So, if we consider this biology fact, “schizophrenia” refers to many different disorders.  While these different schizophrenias might look similar, they are not alike.  The schizophrenias are actually a varied group of medical conditions.

The Baby in the Womb and Schizophrenia

We have no control over what happens to us while our mothers are pregnant with us.  Many things that affect the developing baby can occur.  Damage to a developing baby is one possible cause of schizophrenia even though the disorder does not appear until adolescence or young adulthood.  These bad effects on a baby’s well-being include a mother’s temporary diabetes while she is pregnant, any bleeding that she has during pregnancy, and labor and delivery complications like too little oxygen, emergency C-section, and low birth weight.  Infections that a mother has during the middle part of her pregnancy and/or a mother’s high stress levels during this time might lead to additional problems for the baby.  These 2nd trimester effects on the forming baby could double the risk of developing schizophrenia in adulthood.

It Does At Times Run in Families

Schizophrenia can and sometimes does run in families.  Families with one family member with schizophrenia are more likely to have other family members with it.  Adopted children born to biological parents with a genetic risk for schizophrenia seem to have this same risk for developing schizophrenia in their new, adoptive home as they would have had if they had stayed in the home of their biological parents.  Schizophrenia also runs in families that have family members with bipolar disorder (manic depression).  So, these two conditions are biologically linked in some way.

Schizophrenia is a Brain-based Condition

Schizophrenia is a condition that affects the brain.  As is discussed on our page Spiritual Splattered Brains (formerly Your Mind & Your Brain,) all our body areas are connected to each other.  So, in addition to the brain, schizophrenia affects many other organ systems like the immune system and the endocrine system (endocrine as in diabetic tendencies).

It’s a Common Problem

Schizophrenia is really common.  Worldwide, about 77 million people have schizophrenia.  It equally crosses all the artificial social divisions that we human beings construct, affecting rich and poor, intelligent and challenged, all ethnicities, and any genders.  The prevalence is about equal, male to female.

It Lasts a Lifetime

Schizophrenia a chronic, life-long condition.  Though the Swiss psychiatrist and early schizophrenia researcher Eugen Bleuler believed that those with the condition showed an improvement over time, in truth, before the availability of our current medicines, when someone was sent to an asylum with a diagnosis of schizophrenia they usually stayed for life.   With today’s medicines and other treatments the condition can improve to the point of people being almost free of symptoms.  Often people feel so well that they stop their medications at times and, as a result, their clinical wellbeing falls apart.  They will improve again when they restart their medication.  But each episode of psychosis is toxic to the brain, so the improvement with restarting medication will likely not bring them back to the place they were before they stopped the medicine.

Diagnose and Treat Schizophrenia Immediately and It Might Go Away

Starting and stopping medications is an exceptionally bad idea.  (See our page on Treating Schizophrenia.)  It’s likely that the psychosis of schizophrenia makes itself worse, that is, psychosis is toxic to the brain and makes it easier for more psychosis to occur.  Allowing any psychosis to persist for very long can condemn the person to a lifetime of worse illness than need be.  This means that if the first early symptoms of schizophrenia start and the condition is quickly and aggressively treated immediately, it might go away.  At a minimum, the person is likely to quickly medically improve and have a milder course throughout his life.

Psychosis That Lasts Too Long Makes Schizophrenia Worse

The changes that cause the psychosis seem to damage the brain in a way that makes ongoing and worsening psychosis more likely.  As a result, if early signs of psychosis start and it is not treated quickly, it will get worse.  And, the longer it goes untreated, the worse the condition will become and the more difficult it is to treat.  In such a situation it certainly will likely never go away completely.

Schizophrenia is a Medical Condition

Though hopefully clear from the above discussion, but to make it crystal clear for emphasis, schizophrenia is physical.  It is as physical as a missing leg is physical.  It is real, based in tissue, brain tissue.  Here’s the problem.  Many people use the word “mental”, as in mental illness, to mean not real.  Schizophrenia is not some vague, hazy thought or emotion just floating about in someone’s mind or head.  It is corrupted brain circuitry, hard wiring and circuits gone wrong in a person’s brain.

Seeing Schizophrenia Before It Hits

People have early changes in behavior for a time before the first obvious signs of psychosis appear.  There is a debate among experts about how soon before full psychosis the early signs can be seen.  Maybe years before.  Maybe even in toddler years or infancy.  Researchers are working actively in this area.  If we could tell early enough who is going to develop it we might be able to prevent it all together.

We Need Better Medicines for Schizophrenia

Anyone with schizophrenia, and anyone who knows anyone with it, will agree that we need better medicines.  Today’s best medications are huge advances over the medicines of 10 years ago.  And those medicines were better than the ones of 20 years ago.  And those 20-years-ago medicines were again incredibly better than the ones of 50 years ago.  But today’s medicines are still not good enough.  Most people with schizophrenia never return to the way they were before the illness started.  We need to fix that.

We Do Live in our Brain

Schizophrenia is a brain problem.  That’s a big problem because we live in our brain.  Schizophrenia can be not so bad (which is unusual) or very, very bad (which is more typical).  People with schizophrenia may hear voices that others don’t hear, that is, voices that don’t exist.  They may not understand what’s going on around them.  And because their brain is working in this way they might make social mistakes that others don’t like.  So they stay away from people.  People with schizophrenia get nervous, afraid, and upset.  They might accidently upset others by talking in a way or about things that people around them think are strange or make little sense.  While there are good medications that help, being able to be in a secure, safe place also helps.

A Dangerous Trap for People with Schizophrenia – Alcoholism

When one is not able to understand what’s going on it’s more difficult to see danger coming.  So a danger that catches and traps even many clear-minded people without psychosis is an even greater risk for someone who is psychotic.  We’re talking here about alcoholism and smoking.  The two most common substance use disorders among those with schizophrenia are Alcohol Use Disorder (AUD) and Tobacco Use Disorder (TUD), and tobacco, for all its dangers and possibly even eventually causing death, is far less toxic and corrosive that alcohol.  There are estimates that about 20% to 30% of people with schizophrenia are alcoholics.

In 2011 Oliver Clark, in the UK, started a free drug and alcohol helpline.  He has a website with additional information on how alcohol does not mix with schizophrenia.  Here’s the link:

Did You Know That…  John Nash had schizophrenia?

If you have not heard of or read Sylvia Nasar’s biography of him, A Beautiful Mind, you likely have heard of the movie with Russell Crowe playing the character of John Nash.  Dr. Nash was a mathematician whose studies covered game theory, differential geometry, and partial differential equations.  Though it sounds abstract, his work explained the way ordinary people like us in everyday life make decisions and experience chance happenings.  His theories became useful for economists and were widely applied in the marketing and finance.  In 1994 he won the Nobel Memorial Prize in Economic Sciences.  His paranoid schizophrenia began in 1959 when he was 31 years old.  The initial psychotic break was followed by years of treatment in psychiatric hospitals.  During the 1970s, with treatment, he was more able to think and function and in the 1980s he was even able to return to academic work.

And Now for a Bit of Medical History

The medical diagnosis of schizophrenia is a more recent idea when compared to other disorders recognized in the ancient world such as mania and depression.  In the mid-1800s doctors began seeing and writing down a loss of the ability to think in young adults that was chronic and progressive.  It was called by different names by doctors in some European countries, such as adolescent insanity or premature dementia.  The name for it that stuck lumped all the others into one.  It was called “dementia praecox”, a name invented by Dr. Emil Kraepelin in 1893.  The various names lumped together, however, described medical conditions that were quite different from each other.  Dr. Kraepelin tried to deal with this dilemma by naming nine different forms of his dementia praecox.  He was stumped to go any further, and recognized his problem, saying later research might find the cause of dementia praecox.

Inventing the Term Schizophrenia

The term “schizophrenia” was invented by Dr. Eugen Bleuler in 1908 to replace the name dementia praecox.  By “schizophrenia” he meant scattered thinking, with emotions and thought jumbled.  Dr. Bleuler said that schizophrenia was not one disorder but a group of medical conditions, and that the term should be plural, the schizophrenias.  He named all the different schizophrenias of Dr. Kraepelin and added several more.  In the following decades of the 20th century prominent academic psychiatrists continued sorting and naming one or another “type” of schizophrenia.

Helpful links:

National Institutes of Health, National Institute of Mental Health

The NIH/NIMH on Schizophrenia

National Library of Medicine, MedlinePlus

MedlinePlus on Schizophrenia

The Mayo Clinic on Schizophrenia

American Psychiatric Association on Schizophrenia

National Alliance on Mental Illness on Schizophrenia

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