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Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. People with schizophrenia -- the most chronic and disabling of the major mental illnesses -- often have problems functioning in society, at work, at school, and in relationshipsSchizophrenia can leave its sufferer frightened and withdrawn. It is a life-long disease that cannot be cured but can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split or multiple 
personality. Schizophrenia is a psychosis, a type of mental illness in which a person cannot tell what is real from what is imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. The behavior of people with schizophrenia may be very strange and even shocking. A sudden change in personality and behavior, which occurs when schizophrenia sufferers lose touch with reality, is called a psychotic episode.

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Who Gets Schizophrenia?

Anyone can get schizophrenia. It is diagnosed all over the world and in all races and cultures. While it can occur at any age, schizophrenia typically first appears in the teenage years or early 20s. The disorder affects men and women equally, although symptoms generally appear earlier in men (in their teens or 20s) than in women (in their 20s or early 30s). Earlier onset of symptoms has been linked to a more severe course of illness. Children over the age of 5 can develop schizophrenia, but it is very rare before adolescence.

At one time, doctors classified schizophrenia based on distinct subtypes:
  • Paranoid: Where someone feels he is being persecuted or spied on.
  • Disorganized: Where people appear confused and incoherent.
  • Catatonic: Where people can be physically immobile or unable to speak.
  • Undifferentiated schizophrenia: Asubtype in which no paranoid, disorganized or catatonic features are prominent
  • Residual Schizophrenia: In which psychotic symptoms are markedly diminished or no longer present
Scientists think the above distinctions are no longer as accurate or useful as once thought and therefore instead just focus on describing symptoms and their severity.
The most common symptoms of schizophrenia can be grouped into several categories including positive symptoms, cognitive symptoms, and negative symptoms.
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Positive Symptoms of Schizophrenia

In this case, the word positive does not mean "good." Rather, it refers to obvious symptoms that are exaggerated forms of thinking or behavior that become irrational. These symptoms, which are sometimes referred to as psychotic symptoms, include:
  • Delusions: Delusions are strange beliefs that are not based in reality and that the person refuses to give up, even when presented with factual information. For example, the person suffering from delusions may believe that people can hear his or her thoughts, that he or she is God or the devil, or that people are putting thoughts into his or her head or plotting against them.
  • Hallucinations: These involve perceiving sensations that aren't real, such as seeing things that aren't there, hearing voices, smelling strange odors, having a "funny" taste in your mouth, and feeling sensations on your skin even though nothing is touching your body. Hearing voices is the most common hallucinationin people with schizophrenia. The voices may comment on the person's behavior, insult the person, or give commands.
  • Catatonia (a condition in which the person becomes physically fixed in a single position for a very long time).
Disorganized symptoms of schizophrenia are a type of positive symptom that reflects the person's inability to think clearly and respond appropriately. Examples of disorganized symptoms include:
  • Talking in sentences that do not make sense or using nonsense words, making it difficult for the person to communicate or engage in conversation
  • Shifting quickly from one thought to the next
  • Moving slowly
  • Being unable to make decisions
  • Writing excessively but without meaning
  • Forgetting or losing things
  • Repeating movements or gestures, such as pacing or walking in circles
  • Having problems making sense of everyday sights, sounds, and feelings

Cognitive Symptoms of Schizophrenia

Cognitive symptoms include:
  • Poor executive functioning (the ability to understand information and to use it to make decisions)
  • Trouble focusing or paying attention
  • Difficulty with working memory (the ability to use information immediately after learning it)

Negative Symptoms of Schizophrenia

In this case, the word negative does not mean "bad," but reflects the absence of certain normal behaviors in people with schizophrenia. Negative symptoms of schizophrenia include:
  • Lack of emotion or a very limited range of emotions
  • Withdrawal from family, friends, and social activities
  • Reduced energy
  • Reduced speech
  • Lack of motivation
  • Loss of pleasure or interest in life
  • Poor hygiene and grooming habits

What Causes Schizophrenia?

The exact cause of schizophreniais not yet known. It is known, however, that schizophrenia -- like cancer and diabetes -- is a real illness with a biological basis. It is not the result of bad parenting or personal weakness. Researchers have uncovered a number of factors that appear to play a role in the development of schizophrenia, including:
  • Genetics (heredity): Schizophrenia can run in families, which means a greater likelihood to develop schizophrenia may be passed on from parents to their children.
  • Brain chemistry and circuits: People with schizophrenia may have abnormal regulation of certain chemicals (neurotransmitters) in the brain, related to specific pathways or "circuits" of nerve cells that affect thinking and behavior. Different brain circuits form networks for communication throughout the brain. Scientists think that problems with how these circuits operate may result from trouble with certain receptors on nerve cells for key neurotransmitters (like glutamate, GABA, or dopamine), or with other cells in the nervous system (called "glia") that provide support to nerve cells within brain circuits. The illness is not believed to be simply a deficiency or "imbalance" of brain chemicals, as was once thought.
  • Brain abnormality: Research has found abnormal brain structure and function in people with schizophrenia. However, this type of abnormality doesn't happen in all schizophrenics and can occur in people without the disease.
  • Environmental factors: Evidence suggests that certain environmental factors, such as a viral infection, extensive exposure to toxins like marijuana, or highly stressful situations, may trigger schizophrenia in people who have inherited a tendency to develop the disorder. Schizophrenia more often surfaces when the body is undergoing hormonal and physical changes, such as those that occur during the teen and young adult years.

How Do Doctors Diagnose Schizophrenia?

There’s no simple test to find out if someone you love has schizophrenia. It’s a severe mental illness that is very hard to diagnose. It affects the way a person thinks, processes emotions, maintains relationships, and makes decisions.
It’s especially hard to diagnose in teenagers because many of the first signs of schizophrenia in young people, such as bad grades, sleeping too much, or withdrawal from friends, can at first seem like typical problems. But schizophrenia is much more than that.

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Is It Schizophrenia?

If you think someone you know may have schizophrenia, reach out to your doctor or psychiatrist. Tell them what you have noticed and ask them what steps you should take, especially if the person isn’t interested in getting help.
The first thing they will want to do is a psychological evaluation and a complete medical exam. This will allow the doctor or specialist to track your loved one’s symptoms over about six months to rule out other possible conditions, such as bipolar disorder, and other possible causes.
The doctor may also want to do a blood test to make sure that alcohol or drug abuse isn’t causing the symptoms. And a test that scans the body and brain, such as an MRI or CT scan, might also help eliminate other problems like a brain tumor.

Making the Diagnosis

To get an official diagnosis of schizophrenia, your loved one has to show at least two of the following symptoms most of the time for a month, and some mental disturbance over six months:
  • Delusions (false beliefs that the person won’t give up, even when they get proof that they’re not true)
  • Hallucinations (hearing or seeing things that aren’t there)
  • Disorganized speech and behavior
  • Catatonic or coma-like daze
  • Bizarre or hyperactive behavior
Getting the diagnosis as early as possible will improve your loved one’s chances of managing the illness. If he gets the proper care, which will probably include medication and psychotherapy, a kind of talk therapy, he is likely to do better.


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