Approximately one percent of people in the United States live with schizophrenia. That’s around 3 million people. Of any mental health disorder, schizophrenia is likely the least understood, those with the disorder are often painted by mainstream society as violent individuals who have little to no ability to live in the real world. They are therefore some of the worst feared people in the country. Having schizophrenia does not mean you have a “split personality” or have “multiple personalities.” I am writing this blog to educate readers on this disorder so that we can stamp out stigma against people with schizophrenia.
There are a lot of different symptoms that people with schizophrenia can have. The symptoms are divided into what are called “positive,” “negative” and “cognitive” symptoms. Positive symptoms have to do with episodes of psychosis and include hallucinations, delusions, catatonia, and distorted thinking. In order to be diagnosed, people need to have experienced at least one type of positive symptom.
Negative symptoms are when emotions, actions and thoughts are negatively affected and include not being able to experience or express emotions, feeling unable to enjoy life, being less talkative, and having a hard time starting or continuing endeavors.
Cognitive issues include an inability to comprehend information and integrate it into decision making, having problems paying attention, and not being able to remember things.
Some people with schizophrenia are only slightly affected by their symptoms in their everyday lives, some moderately and some severely.
Like all other mental health disorders, it’s known that there are certain factors that make it more likely for someone to develop schizophrenia, but there is no known direct cause. Those with other people in their family (both immediate and extended) who have schizophrenia are more likely to be diagnosed with the disorder.
People who didn’t have enough nutrients in the womb, whose mothers had birthing issues and those who developed certain viruses just before or after birth are at higher risk. Brain chemistry and development issues can be risk factors. Certain stresses and behaviors can be risk factors, such as substance use, where a person lives, and trauma. There’s research that shows that if someone has schizophrenia in their family, they have an elevated risk of developing the disorder if they use marijuana as a teenager.
There are a number of different treatment options. The first step in treatment tends to be a psychiatrist prescribing one of a class of drugs called antipsychotics. Once the person is more stable, they usually start some type of one-on-one talk therapy. Group and family therapy can be added and are shown to be beneficial.
The most popular type of talk therapy for those with schizophrenia (and for pretty much all mental health issues) is cognitive behavioral therapy (CBT). It focuses on changing negative thought patterns and behaviors, which in turn positively affect emotions and creates a road to recovery. Recovery typically involves a lot of work by the individual, but usually pays off by improving symptoms, allowing them to take control over their life, and push themselves to achieve their goals.
There are several other types of therapies that can be useful, such as Acceptance and Commitment Therapy (ACT) which emphasizes acceptance of the self, mindfulness techniques, and commitment to small and big goals.
One of the most promising newer therapies is called “coordinated specialty care” and involves using antipsychotics, talk therapy and “case management, family involvement, and supported education and employment services, all aimed at reducing symptoms and improving quality of life.” So far, this treatment has stayed mainly in the research stages, but it’s starting to roll out and hopefully, it will be available to more people soon. The studies have shown that this type of care leads to better quality of life.
According to research done by the National Alliance on Mental Illness (NAMI) on the general public’s view of schizophrenia, when asked what kind of symptoms they thought were part of the disorder “violent behavior…was selected by 60% of the public.” Why are so many people afraid of those who have symptoms of psychosis that goes along with schizophrenia?
Perhaps because they have watched movies that depict people struggling with these issues as violent, sometimes murderous people. Movies like The Shining, Halloween, Donnie Darko, Me, Myself and Irene, and Shutter Island have violent characters who are either diagnosed with schizophrenia or have symptoms of psychosis.
Another thing that adds to the stigma: there is a lot of news coverage when someone with schizophrenia is accused or convicted of committing a violent act, and little to no coverage of the vast majority of the people with the condition who are not hurting anyone. According to numerous studies, those with the disorder are anywhere from “1.2 times more likely” to “twice as likely” as the general public to engage in illegal violent behavior. That risk can go up when people are dealing with issues such as substance abuse, homelessness or lack of mental health care.
What might convince people that those with schizophrenia are only very rarely violent individuals? The most likely way to do this would be to hear their individual stories. That’s how you win both hearts and minds. Facts can be important, but they are a jumping off place.
I’m not saying that any of you reading this (or really anyone at all) is a bad person if they are scared of folks with the disorder. It was only in the last five years that I let go of this fear.
Here are some great stories I found online about those with the diagnosis.
Check out Cecilia McGough’s Ted Talk “I Am Not a Monster” about her experiences with symptoms, and the stigma she has had to deal with as a college student when it became known what she was dealing with. There’s a wonderful website out of the UK called Time to Change, with 40 blog posts from people who live with the disorder. My favorite is from “Ash” and it’s titled “It should be ‘normal’ to talk about schizophrenia.”
Feeling particularly brave? There is a very intense video called “Schizophrenia Simulation” that shows what it can be like to experience symptoms of psychosis.
I hope I’ve cleared up some myths, fears, and misperceptions here. When more people understand what it’s like to live with schizophrenia, we can start to stamp out social stigma attached to the disorder. The less stigma, the more comfortable people with the condition will be to share their stories, both personally and publicly, and seek treatment without judgment.