According to the National Institute of Mental Health – Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.
According to available public records, the term Schizophrenia was first used to describe an illness in 1887, more than 100 years ago by a pioneer psychiatrist called Eugen Bleuler. And since then we have come to accept two things – that schizophrenia means a loss of touch with reality in a patient and secondly, that it is rare.
But newer studies conducted by scientists have begun to question both these points. They are trying to redefine schizophrenia, and are also coming to the conclusion that it is more common than once thought of among the general population.
Which means that now schizophrenia isn’t looked at as a specific and rare single illness, but more of an amalgamation of different type of symptoms and conditions which can also be seen in people not suffering from any mental illness.
The main problem with diagnosing someone as a schizophrenic is because of how limiting the diagnosis method is. Even a well-qualified practitioner of mental health usually looks for the following factors in a person to diagnose them as suffering from schizophrenia. Conditions like – hallucinations (hearing voices, seeing sounds that aren’t there), thought disorder (being unable to think straight), paranoia, grandiosity (delusional beliefs that one possesses special powers or is famous), and anhedonia (inability to experience pleasure).
The problem arises when the symptoms mentioned above doesn’t affect all the people and not with the same intensity also. And having one symptom doesn’t mean that you will develop any of the other either.
So what happens in the offices of a mental health professional? Most of the diagnosticians tend to look at the main problems faced by the person. And the patients too will choose to focus on problems that give them the most difficulty. And when the doctors see these problems in isolation, they quickly club the problems as the symptom of a single illness. And when you start defining illness based on the symptoms of people in hospitals, then you end up with a definition that doesn’t take into account the problems and symptoms of majority of people who do not enter the hospital system.
And it isn’t even that difficult to trigger the common symptoms associated with schizophrenia. Prisoners in our jails who spend vast amounts of time in solitary often ‘lose’ their mind and their thought processes. People who go without sleep for more than two nights consecutively see hallucinations and have delusions. Overdosing on alcohol and drugs can also bring about symptoms usually associated with schizophrenia.
What this suggests is that schizophrenia isn’t one specific, rare, and rigorously defined illness. Not at all, in fact, it consists of a wide range of unrelated conditions which are also seen in people not mentally ill. The severity of the conditions themselves can range from the minor to the severe. It is just that the people diagnosed as a schizophrenic often have conditions that fall on the extreme end of that spectrum.
What all could be the causes behind such conditions? What causes hallucinations and delusions and paranoia in people? According to research, the modern man living in big cities often face unprecedented stress that former generations of people before him have not faced. Lack of space, pollution, stressful jobs all contribute towards it. As does childhood experiences like poverty, early drug and alcohol abuse, migration, etc. People who have been victims of violent assaults also tend to be on top of the list of people likely to suffer from these conditions. Conditions like paranoia are also seen in people with anxiety and depressive episodes.
Family and genetic factors also play a part, but so far research hasn’t been able to single out a single specific gene responsible for causing schizophrenia. There’s likely to be different genes that are responsible for contributing to it. And like with all genetic factors, it is ultimately our environment that decides which way these genes end up shaping our lives.
At the end of the day, the idea isn’t to retell or redefine schizophrenia for the current generation. But it is simply an impetus for an idea or a thought that there’s more to mental health than what meets the eye. And that we must spend more time and resources to better understand our psychotic problems. Like with all illnesses, the diagnostic criterions change over time and I’m sure this will happen with schizophrenia as well.
If we start focussing on specific problems, then we will be able to get help to a person while targeting their specific problem. This is the only way forward, and not by planning treatment for a loosely defined illness that affects different people differently.