Schizophrenia – beyond the boundaries of reality

Volume 13 Issues 5 May, 2023

Buildings were getting twisted, the cat was getting bigger, and the door didn’t stop shrinking. The chairs and tables floated for no reason, and the talking coffee cup made no sense at all.

The girl across the room who seemed sweet a minute ago was about to devour me with her abnormally sharp car keys and not to mention she had a distorted face. It was too late to run and too early to decide if this was a nightmare. Though this scenario may seem to be part of the next Doctor Strange movie, what if I tell you that such experiences are only a tiny fraction of the number of psychotic attacks that schizophrenic patients have over their lifetime?

Seems scary right?

It should be because schizophrenia is no ordinary disorder, and people suffering from it often require lifelong treatment. It is a serious psychological condition that makes a person perceive reality abnormally (hallucination delusions, loss of adaptive behaviour etc. ).

Sensations of the dimensions of objects, distances, and faces of people often get disoriented, that have debilitating effects on the person. Schizophrenia may present with varied symptoms, and these symptoms can be grouped into positive, negative and cognitive symptoms. Positive symptoms include Hallucinations, Delusions (of grandeur or persecution), derailment, grossly disorganised behaviour, inappropriate affect, and movement disorders.

The positive symptoms of schizophrenia have been remarkably portrayed in the movie “The Beautiful Mind “, and John Nash has left no stone unturned in making his character of a brilliant yet troubled mathematician truly memorable.

Social withdrawal, a distorted sense of time and a lack of motivation are some common negative symptoms. Cognitive symptoms encompass features like poor executive control and trouble focusing.  Schizophrenic patients often complain about listening to imaginary voices that compel them to do certain tasks, comment on their behaviour and sometimes even warn them of danger. People with delusions of grandeur believe that they are important, famous, or powerful. Such people claim to possess special abilities and this absurd delusion can make them turn violent with time.

Some claim to have been assigned to a special covert mission, while others may also think that people around them are able to read their minds and control their thoughts. Schizophrenic patients are not known to have apt social behaviour, which is not quite surprising considering the paranoid state of mind that they are sometimes in. A patient may laugh uncontrollably when hearing some sad news. Movement disorders typically appear as agitated movements, such as repeating a certain motion or uttering the same words over and over again, but can in some cases, include catatonia, a state in which a person does not move and is unresponsive to others.

Although schizophrenia has been around for centuries, no scientific data has been able to pinpoint the exact cause of this disorder. Rather, a variety of biological and environmental risk factors interact in a complex way to increase the likelihood that someone might develop schizophrenia.

Like many complicated diseases, even schizophrenia has been found to have a genetic basis suggesting the likelihood of molecular phenomena to be the main culprit. The likelihood of developing schizophrenia increases dramatically if a close relative also has the disease. Abnormal embryologic development of the brain can also increase the chances of developing schizophrenia. Some studies also attribute excess dopamine to be one of the reasons; thus, drugs that reduce dopamine release in the brain have been helpful in treating schizophrenia.

Neurologic studies have shown the cerebral ventricles ( spaces in the brain filled with CSF ) to be enlarged in patients with schizophrenia as compared to normal individuals. The activity of temporal and frontal lobes was also found to be diminished in such patients, which can provide us with a possible explanation for the deterioration of functioning in language and thought processing that is commonly observed.

A person with an identical twin with schizophrenia has less than a 50% chance of developing it, and over 60% of all schizophrenic people have no first- or second-degree relatives with schizophrenia supporting the fact that environmental causes are also involved.

A person’s emotional status in his/her life, his/her upbringing and stress are also major predisposing factors for developing schizophrenia. Antipsychotic drugs are the cornerstone for the treatment of schizophrenia, along with therapies, vocational rehabilitation, social skills training etc. Newer research programs are also being undertaken that promise us advanced treatments soon. Schizophrenia is no less than a curse; living with it has dreadful consequences. It’s like being trapped in a cage designed by our own mind where the boundaries of reality are nothing but a meagre joke.

Those people with schizophrenia suffer a lot, battling through the worst nightmares that seem so real and longing for a steady state of mind that’s way out of reach.  Their thoughts, delusions and hallucinations may not adhere to reality, but their pain and suffering is only as worse as we can imagine.

However, with love, care, therapy and proper medical treatment, I am sure we can bring about a magical difference in the lives of those with schizophrenia. 

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