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What is Schizophrenia ?

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schizo means split and Freni a– in this,case refers to the mind even though,schizophrenia can be interpreted to mean,splitting of the mind it does not refer,to a split personality,like some media sources might portray,but rather schizophrenia describes a,scattered or a fragmented pattern of,thinking schizophrenia is actually a,syndrome meaning there are all sorts of,symptoms that might be associated with,it and different patients might,experience different symptoms although,the symptoms can be broadly categorized,into three major areas positive symptoms,negative symptoms and cognitive symptoms,all right taking a step back most human,symptoms from any illness are extreme,versions of a normal physiologic process,for example everyone has a heartbeat,right and tachycardia is a fast,heartbeat in the same way everyone has a,normal body temperature but during a,fever that temperature is higher in,schizophrenia patients have positive,symptoms which aren’t positive in the,sense that they’re helpful but positive,in the sense that there’s some new,feature that doesn’t have any normal or,physiologic counterpart these are the,psychotic symptoms so delusions,hallucinations disorganized speech and,disorganized or catatonic behavior,none of which occur physiologically,delusions are false beliefs that the,person might feel very strongly about so,much so that they won’t change their,mind even if you give them evidence,against it there are all sorts of,different delusions like for example a,delusion of control where somebody,thinks that some outside force or person,or a thing is controlling their actions,they could also be delusions of,reference where someone might think that,insignificant remarks are directed at,them like a newscaster is speaking,directly to them through the TV,hallucinations are a second type of,positive symptom and can be any kind of,sensation that’s not actually there,including visual but also including,auditory sensations like hearing voices,or commands a third type is disorganized,speech an example being something like a,word salad which seems like just a,random jumbling of words or phrases like,pencil dog,hat coffee blue disorganized behavior on,the other hand could be like if they,exhibit some bizarre or silly behavior,that’s out of context and doesn’t seem,to have much of a purpose like for,example wearing multiple layers of,jackets on a hot summer day,also sometimes their behavior is,described as catatonic which has to do,with their movements posture and,responsiveness so like they might be,super resistant to moving or being an,unresponsive stupor negative symptoms,are like when there’s this reduction or,removal of normal processes and this is,like a decrease in emotions that they,can express or a loss in interest in,things that they once found interesting,one type of negative symptom is called,flat effect where they don’t respond,with an emotion or reaction that would,seem appropriate like if they saw,something very unexpected like a small,monkey playing in the living room they,might simply sit and watch idly as if,nothing was happening another type is a,loggia or poverty of speech which is a,lack of content in their speech so like,if somebody asks them do you have any,children they might respond with yes,instead of yeah one boy and two girls a,third type of negative symptom is a,volition which is this decrease in,motivation to complete certain goals so,someone might stay home for long periods,of time without trying to reach out to,friends or find work cognitive symptoms,are like not being able to remember,things learn new things or understand,others easily these symptoms are more,subtle though and are more difficult to,notice and might only be detected if,they have really specific tests,performed an example might be somebody,not being able to keep track of several,things at once like a phone number and,an address people with schizophrenia,seem to cycle through three phases,typically in order during the prodromal,phase patients might become withdrawn,and spend most of their time alone and a,lot of times this seems similar to other,mental disorders like depression or,anxiety disorders during the active,phase patients experience more severe,symptoms like delusions hallucinations,disorganized speech disorganized,behavior or or cat,atonic behavior following an active,phase patients often enter into a,residual phase where they might exhibit,cognitive symptoms like not being able,to concentrate or becoming withdrawn,again as with the prodromal phase for an,official diagnosis of schizophrenia,patients need to be diagnosed with two,of the following symptoms delusions,hallucinations disorganized speech,disorganized behavior or catatonic,behavior or negative symptoms and at,least one of them has to be either,delusions hallucinations or disorganized,speech so basically they couldn’t have,just disorganized behavior and negative,symptoms even though some patients have,cognitive symptoms as well,they aren’t specifically needed for a,diagnosis also though for a diagnosis,signs of these disturbances must be,ongoing for at least six months meaning,that they’re likely in one phase or,another for a period of six months but,there must be at least one month of,active phase symptoms and finally those,symptoms can’t be attributable to,another condition like substance abuse,now that we’ve diagnosed it why does it,even happen in the first place,what causes schizophrenia well we don’t,really know since it seems like the,signs and symptoms of schizophrenia are,pretty unique to humans or at least,they’re hard to imagine or notice in,animal models like mice or rats one clue,is that the majority of antipsychotic,medication that improves schizophrenia,symptoms block the dopamine receptor d2,which reduces dopamine levels in neurons,this suggests that maybe schizophrenia,has something to do with increased,levels of dopamine these medications,though are neither universally nor,completely effective and don’t work for,everyone with schizophrenia which adds,to the confusion and means there’s,probably more to it than just the d2,receptors interestingly one of the most,effective antipsychotic drugs,clozapine is a weak d2 antagonist,suggesting that other neurotransmitter,systems like norepinephrine serotonin,and gaba are involved twin studies have,shown support for a genetic basis as,well even though there haven’t been any,specific genes conclusively linked to,schizophrenia,also environmental factors like earlier,prenatal exposure to infection and,certain autoimmune disorders like celiac,disease have been linked with,schizophrenia finally another important,set of clues involves the epidemiology,schizophrenia seems to happen slightly,more in men than in women with onset in,the mid 20s for men but late 20s for,women and the clinical signs for,schizophrenia are often less severe some,studies suggest this difference might be,due to estrogen regulation of dopamine,systems there doesn’t however seem to be,any difference among race now treating,schizophrenia can be really tricky and,antipsychotic medications are often used,but it’s super important to combine the,efforts of several clinicians and health,professionals including professionals in,therapy or counseling medicine in,psychopharmacology antipsychotics can be,very effective at reducing symptoms but,they often come with a lot of additional,considerations to keep in mind like cost,and the potential for unwanted side,effects like tolerance dependence and,withdrawal,you

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