Guest Post: Understanding Schizophrenia

This week I would like to introduce a guest blogger, The Beast. The Beast is a college student majoring in Biology, who also happens to suffer from schizophrenia, making everyday tasks that are autonomous to us, such as showering, eating, talking, etc. potentially quite difficult to nearly impossible. Portrayal of schizophrenia is often quite extreme in the media, showing either criminals who are mentally ill, or homeless individuals suffering from mental illness. In addition to, and perhaps because of this portrayal, there are many misconceptions about the illness, which hinders social awareness. This article by The Beast gives great insight into further understanding schizophrenia, as well as potentially dispel misconceptions individuals may have associated with the mental illness.


Understanding Schizophrenia

by The Beast at Mouth of the Beast

My sophomore year in college was a difficult one. I went from having excellent grades to failing  all but one class, I couldn’t concentrate, couldn’t study, at night voices rung inside my head, and at  my worst, I became immobile, frozen for over half an hour. After a few weeks of this, I got help, and was eventually diagnosed with prodromal schizophrenia. The early, less severe, stage of the disease. Statistically, I have about a fifty fifty chance of developing the full disorder…

What is Schizophrenia?

According to NAMI, the National Alliance on Mental Illness, schizophrenia is a thought disorder that effects about one in a hundred people. That may not sound like a lot, but think about sitting down in a large lecture hall or busy theater, chances are one or more people in those rooms have schizophrenia. One out of every hundred adds up to millions of sufferers in the US alone.  But what exactly IS schizophrenia? Well, there’s no easy answer, because the disease effects everyone so differently. Most psychiatrists break the symptoms of schizophrenia into negative, positive, and cognitive symptoms. People who have the disease may have few to all of these symptoms.

Positive Symptoms

Positive symptoms are symptoms that are added when the disease develops. Positive does not mean good, it simply means something additional is happening to the person. They may include the following…

Delusions, adamant belief in things that are untrue or not real. For example, a person may believe they are the reincarnation of Jesus, or that the FBI is stealing their thoughts. They will believe these things despite evidence against it.

“Word Salad” is another word for disorganized speech. Sometimes people with schizophrenia may be unable to coherently form sentences and thoughts that make sense to other people. This is often called “word salad” because it presents as a bundled hodgepodge of words.

Hallucinations, hearing, seeing, feeling, or even tasting things that are not real, such as the voices and noises I hear at night. Often, and unfortunately, the voices are negative in nature. They may also command the sufferer, for example, to kill or hurt themselves. For this and other reasons suicide and self harm rates in schizophrenia are extremely elevated, with about forty percent attempting suicide at some point.

Catatonia, this is what I was experiencing when I was “frozen”, it is the inability to react to the outside environment. It can present as complete lack of motion or repetitive movements with no reaction to the outside world. It can go on for hours, day, or longer…

Negative Symptoms

Many schizophrenia sufferers also suffer from negative symptoms. Negative symptoms are when a person loses a capacity that they had before the onset of the disease. They include…

Flatness, inability or lack of propensity to display emotion, they may also speak in a flat, monotone voice.

Lack of Enjoyment, people with the disease may find themselves unable to enjoy life.

Lack of Motivation, inability to complete or start objectives. This makes school, work, and life in general difficult for many people with the illness.

Alogia, or lack of speech, is when a person speaks less, speaks less fluently, and/or takes longer to speak.

Cognitive Symptoms

Schizophrenia often affects the way people think in a negative way, these are cognitive symptoms. Schizophrenia is a disease that slowly eats away at the grey matter of the brain. Because of this, it should be no surprise that cognitive symptoms occur.

Disorganized Thinking, inability to think in a logical manner.

Difficulty Understanding, this was my biggest problem before I got treatment. I could literally not read a word on a page due to not understanding the letters. It is truly a horrendous feeling.

Trouble Concentrating

Trouble with Memory

Lack of Awareness, many people with schizophrenia are unable to understand that they have the disorder. Oftentimes this makes treatment difficult.

Types of Schizophrenia

Although removed from the DSM V, the “Bible” of psychiatry, I will include the old subtypes of schizophrenia here, so that you may see just how different the disease can be from person to person.

Paranoid Schizophrenia, this subtype mostly presents with positive symptoms, including paranoid delusions that someone, or something, is out to get them. Although this may sound bad, those with this subtype actually have a comparably high recovery rate. This is also the most common form of schizophrenia.

Disorganized Schizophrenia presents mostly with negative symptoms, and is also grossly disorganized in everyday life. This makes mundane tasks such as showering and remembering to eat difficult. Many homeless people have disorganized schizophrenia.

Catatonic Schizophrenia, is a diagnosis given when catatonia is present in the person. Relative to the other forms of the disease, the recovery rate is fairly low for catatonic schizophrenia.

Treatment

In the modern day, schizophrenia is treatable, but not curable. The first anti-psychotics, called typical anti-psychotics, were laden with problems and horrible side effects which made them most unpleasant to take. Modern medications are called atypical anti-psychotics, and are often more tolerable than their predecessors. Although these medications manage symptoms, they will never cure the illness.

Many people stop taking their medication, whether it be due inability to pay for it, lack of awareness of their illness, or severe side effects, this puts them at a higher risk of relapse. Anti-psychotics also do not fully protect a person from relapsing into a psychotic episode (a period where symptoms are at their worst), and medications may not work for everyone.

A lot of choosing the right medication comes down to trial and error, and that is something that must be done with the help of an experienced psychiatrist. Cognitive Behavioral therapy (CBT) in which the person learns to manage their symptoms, is also very helpful in schizophrenia.


In addition to blogging about mental health and mental illness, The Beast also blogs about biology and photography! Check out his blog at http://www.mouthofthebeast.com/


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Exploring my confrontation with mental illness

For today’s post, I would like to share with everyone insight into my own personal  and very humbling experience with mental illness – specifically what I felt during my engagement with mental illness and what I was able to take away from the ordeal.

Up until 3 years ago, I can safely say I had no idea what mental illness was. Whether it was my lack of education or personal ignorance towards the subject, I paraded around with the notion that “I have a strong mind, only those who are weak experience mental illness”. What I believed to be correct at the was not only incorrect, but shortsighted.

I can remember the event so vividly. I was sitting in a chair at a friend’s place and I remember starting to feel odd. It was a feeling I’d never felt before, which was quite alarming at the time. It started with a sense of dread, as though something catastrophic were about to happen, followed by a variety of unpleasant symptoms: severe chest pain, hyperventilation, I felt like I was choking on an invisible object, started shaking and sweating uncontrollably and, to top it off, was unable to concentrate on anything. When I looked at words on a page, I had difficulty understanding them. Sounds started to echo inside my head. When I heard a noise, I would hear it 4 or 5 times. This would happen for every noise. After what I believe was 5-10 minutes of this, I started to experience something else – the most terrifying event of the whole ordeal for me – derealisation.

Derealisation is an altered perception of subjective reality which may be brought upon by a traumatic event, such as the loss of a loved one, or, in my case, an anxiety attack. When derealisation set in, I had no idea what I believed in anymore. The only thought that I had at the time was “all that I perceive is a figment of my imagination”, which led me to start thinking that every person and object that I interacted with externally was an internal recreation that my brain perceived as reality. I couldn’t cope with all of this at the time. Life felt like it was spiraling out of control. I felt as though I was losing my mind. I called my girlfriend and had her take me home, thinking that rest would help the situation, but it did not. I continued to experience these symptoms for about a week until I consulted a doctor. At the time, I did not have a family doctor. If I was ill, I saw a doctor at a walk-in clinic.

When I first went to a doctor, I went while I was experiencing a full-blown panic attack. Again, I didn’t know it at the time, but reflecting upon it now, I am able to understand that. The doctor I saw asked about my symptoms, saw me for a few minutes and sent me off with a prescription for an antidepressant. Because the doctor’s diagnosis was so brief and I perceived my symptoms as being life-threatening, I went to another doctor for more answers. Thankfully, the second doctor I spoke with was more willing to explore my symptoms. I had various tests done – blood work, ECGs, x-rays, even a CT scan. All came back showing normal results, except for the ECG, which showed something that the doctor couldn’t quite put his finger on, so he consulted a colleague to figure it out, which turned out to be heart condition.

A year and one cardiac ablation later, the condition was no longer present, yet I was still plagued by anxiety. This forced me to start reflecting upon everything in my life. I couldn’t live like that anymore – I felt like I was going insane daily, having maybe 2-3 hours out of any given day where I wasn’t struggling with my thoughts. I wanted relief from my thoughts – an out, of any sort. At around this point, I had been having intense intrusive thoughts which weren’t comprehensible to me. The thoughts were relating to suicidal ideation, self-harm and harm to others. Having these constant thoughts made me a recluse. I wouldn’t leave the house in fear of harming myself, others, or because I didn’t want the possibility of something I perceived as “bad” to happen.

About 2-3 months after the ablation, the anxiety worsened until I eventually broke. For the first time in years, I cried like a baby. This didn’t just happen randomly. At the time, I was reflecting on my moral compass after reading something awful that just happened in the news about a large-scale manipulation of people. This resonated particularly well within me, and I started to realize that I had been manipulating people – taking them for granted. I had a purely subjective view of things, only seeing how things could benefit me, not the impact my actions would have in relation to the world and those around me. Having that thought opened up a whole new avenue of understanding for me, which allowed me to see my actions from an objective point of view. With this understanding, I started to see the error of my ways; certain things about myself that I disliked. The manner in which I was acting directly clashed with my morals and beliefs. This was the root cause of my anxiety.

After a year of reflection upon my actions, I was able to see the so-called error of my ways, which helped shape me into the person that I, in the long run, wanted to become. My anxiety stemmed from many factors, but largely, it came down to how I was interacting with the world around me. I wasn’t acting in a harmonious manner with the world. I was acting with selfishness as my motivator.

When we go about day-to-day life, our minds try to communicate with us in various ways. In my case, anxiety was my mind’s form of communicating. While the entire ordeal was very taxing, both mentally and physically, I learned a lot about myself and the world around me, which is something that I won’t ever forget. Although the experience was truly and utterly terrifying, I found that now, it was very humbling and helped shape who I wanted to become in life.

Mental illness may present itself in a variety of ways. My story above shows how important it is to see a medical professional when symptoms start to interfere with your day-to-day life. You may find an underlying condition that could be detrimental to your health. While it may not be a cure for your mental illness, cooperating with a medical health professional can help improve your quality of life, both physically and mentally.

Exploring objective and subjective perspectives

With the awareness that we now possess pertaining to active and passive thoughts and how emotions and thoughts may be manipulated by external stimuli, we are ready to explore the subject of objective and subjective perspectives, but, before we do, we must be able to define what a perspective is.

A perspective can be defined as a view point that an individual forms in regard/relation to an external stimulus. Similar to all things, perspectives may be manipulated by external stimuli if one does not possess the appropriate awareness. By utilizing objective and subjective perspectives correctly, an individual is able to respond to an external stimulus in a requisite manner.

From an objective perspective, an individual removes their personal bias from the perspective. By doing so, the individual is then able to see the facts for what they are, not concerning themselves with whether or not a fact is just or unjust in relation to their moral compass. Viewing an external stimulus in this regard allows one to view the factual truth in relation to the external stimulus, but doesn’t necessarily allow for a relative empathetic response. Inversely, from a subjective perspective, an individual embraces their personal bias in relation to an external stimulus, which allows them to respond in a more relative and empathetic manner, but doesn’t necessarily allow an individual to see the factual truth of the external stimulus.

Both of these perspectives may be beneficial if used correctly by an individual – for example; a professor grading an essay. The professor may want to grade from an objective perspective to be fair towards all of his/her students. While this may be beneficial in some applications, it could be detrimental in others for example: A professor may want to use the more empathetic subjective perspective combined with an objective perspective to interact with a bereaving student. The professor has to be aware that students may use lies such as the loss of a loved one to manipulate the professor into giving them an extension on an assignment, but the professor also has to be aware that the student may be telling the truth, requiring a more empathetic response.

While these perspectives are beneficial if used appropriately, they may be detrimental if one is used with strict adherence. An individual who views external stimuli from strictly an objective perspective may over time begin to lose the ability to relate empathetically towards external stimuli. The same can be said about strict adherence to a subjective perspective. If an individual views external stimuli solely from a subjective perspective, they become more unbeknownst to the factual truth in relation to external stimuli. They may be able to empathize well with other individuals, but, because of the inability to see the factual truth external stimuli, they also may develop ideologies that may be considered radical.

By using and combining these perspectives accordingly, individuals are able to act in a requisite manner in relation to external stimuli while protecting their ideologies.

Exploring emotional manipulation stemming from external stimuli

Having explored active and passive thoughts, intrusive thoughts, stress and a handful of mental maladies, we are ready to being to understand how external stimuli may manipulate an individual if they do not possess preexisting awareness.

As we know, external stimuli are enabled by emotional vulnerabilities – that is not to say emotional weakness at all. Certain external stimuli may affect one individual more than another depending on a number of factors, but largely comes down to how an individual feels toward a certain stimulus, or their connection to it. This could be something emotional, such as the death of a loved one, to something such as a political outcome that makes one party happy, another miserable, and the rest apathetic to the matter.

In the case of an emotional stimulus, such as a loved one passing, a person who has a strong emotional connection with the deceased individual will undoubtedly be affectedly more than a person who had little to no emotional connection to the individual at all. The same is the case with a political outcome – one party may express content in the situation if they have invested their time in it, where as a person who did not invest the time in the situation will be affected very little if at all by it. Everyday external stimuli are exploiting our emotional vulnerabilities in some way, shape or form, for some period of time. The duration may be instant, such as a reaction to a funny picture from one’s betrothed, perhaps of a cat, or it may be prolonged, such as if someone destroys another individual’s car, leaving the individual to feel furious. When an external stimulus exploits vulnerability in an individual, the individual becomes focused on the thought at hand, which can either be negative or positive. Anger, however, is quite different.

When an individual is angry, their heart rate rises, increasing their adrenaline, inducing a fight-or-flight type of response. When this type of intense emotion is triggered, all thoughts on the individual’s mind (not pertaining to the anger) are no longer important, which can lead to potentially detrimental behavior if prolonged. When angry, it is very easy to lose sight of why one was angry in the first place, which may induce even more anger. Being in this state of mind for extended periods of time can be very taxing to an individual’s mental well-being, which may lead to further mental health issues arising in the future.

Knowing how emotions and thoughts may be manipulated in this way provides awareness to help alleviate unwanted manipulation from external stimuli from occurring. Nobody has to be a slave to this form of manipulation. Being fully aware of how certain stimuli affect an individual is a key factor in maintaining and developing good mental health.

If anyone feels they are plagued by issues with anger, please see here for more information, or contact your local mental health association.