Schizophrenia is Complex and Heterogeneous

woman-mirrors 22Jan2019

Schizophrenia is caused by a mixture of genetic and environmental influences (such as in utero; see below).  As these several factors come into play, schizophrenia in one person might well be somewhat different from the same condition in another.  Thus, the biology would indicate that the term “schizophrenia” refers to a number of disorders, appearing similar to each other in ways, but not the same.  Hence, the term “heterogenous”.

In Utero

May assaults on the developing fetus can occur during pregnancy.  In utero damage is one possible contributing factor to the emergence of schizophrenia in early adulthood.  The insults to fetal integrity include gestational diabetes, bleeding during pregnancy, and obstetric complications (asphyxia, emergency cesarean section, low birth weight).  Infections and high maternal stress experiences during the particularly important 2nd trimester might lead to fetal disturbances.  These 2nd trimester influences on the fetus could double the risk of developing schizophrenia in adulthood.

Articles related to Schizophrenia:

It Does At Times Run in Families

Schizophrenia can and sometimes does run in families.  Families with one person with schizophrenia are more likely to have other family members with it.  Adopted children born to biological parents with a genetic loading for schizophrenia seem to have the same risk for developing schizophrenia in their new, adoptive home.  It also runs in families that have family members with bipolar disorder (manic depression).  Thus, these 2 conditions are biologically linked in some way.

A Brain-based Condition

Schizophrenia is a condition that affects the brain.  As is discussed on our page Your Mind & Your Brain (, all our body areas are interconnected.  Thus, schizophrenia affects many other organ systems, too, like the immune system and the endocrine system (e.g., diabetic tendencies).  But the brain is likely at the center of the condition.

A Common Problem

Schizophrenia is really common.  Worldwide, about 77 million people have schizophrenia.  It crosses all the artificial social distinctions that we 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

It’s 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 medications, when someone was sent to an asylum they usually stayed for life.   With today’s medications and other treatments it can wane to almost no symptoms.  Often people stop their medications at times and deteriorate, only to improve when they start taking them again.

Diagnose and Treat It Immediately and It Might Go Away

Starting and stopping medications is an exceptionally bad idea.  It is likely that schizophrenia makes itself worse, that is, psychosis is toxic and causes more psychosis.  Allowing any psychosis to persist for very long can condemn the person to a lifetime of worse illness.  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 their life.

Persistent Psychosis Makes It Worse

The pathophysiology that underlies psychosis seems 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 remit completely.

It’s a Medical Condition

Though hopefully clear from the above discussion, but to make it crystal clear for emphasis, schizophrenia is physical.  It is physical as a missing limb 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 a “mental” illness by this meaning.  It’s not some ethereal 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 behavioral changes for a time before the first real schizophrenic signs of the illness appear.  There is debate among schizophrenia experts about how soon before full schizophrenia the early signs can be seen.  Maybe years before.  Maybe in toddlers or infancy.  Schizophrenia researchers are working actively in in this area.  If we could tell early enough who is going to develop schizophrenia we might be able to prevent it all together.

We Need Better Medications

Anyone with schizophrenia, and anyone who knows anyone with schizophrenia, will agree that we need better medications.  Today’s best medications are huge advances over the medications 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.  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 (unusual) or very, very bad (more typical).  People with schizophrenia may hear voices that others don’t hear.  (That is, that are not really there.)  They may not understand what’s going on around them.  And because of this 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 then 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.

Helpful links:

National Institutes of Health, National Institute of Mental Health

U. S. National Library of Medicine, Medline Plus

The Mayo Clinic

American Psychiatric Association

National Alliance on Mental Illness