Schizophrenia: The Truth

Most people hear the word "schizophrenia" and think certain key words:

• Multiple personality
• Crazy
• Violent
• Killer

I want to eradicate each of these thoughts. Of course, it's no one person's fault that these thoughts are ingrained in society to do with the disorder of Schizophrenia. The media portrays the myths, the stigma, as fact. There's endless films showing killers turning out to have Schizophrenia, going on a crazy rage as they switch personalities. This blog post aims to dissipate all myths and incorrect "facts" surrounding this complex disorder, because that's all it is- a mental health disorder.

The biggest myth surrounding Schizophrenia is that it is multiple personality. This really isn't true. In fact, that is a different disorder entirely- Dissociative Identity Disorder (DID). Even then, nowadays it is really viewed as "multiple personality", but rather different "alters". However, I'll get into DID another time.

In order to truly reduce the stigma of Schizophrenia, I will first outline what the disorder entails, followed by my own personal story of receiving a diagnosis of Paranoid Schizophrenia.

What is schizophrenia then?

First of all, there are eight subtypes of Schizophrenia, although many specialists view subtypes as outdated and use the broad term Schizophrenia when diagnosing- particularly in the USA. The most common subtype is Paranoid Schizophrenia.

Schizophrenia symptoms are drawn into two categories- Positive and Negative. The positive symptoms aka "psychotic" symptoms, usually result in a change of thought or behaviour. They are as follows:

• Hallucinations. This can be when someone sees, hears, feels, tastes or smells things that are very real to them, but they do not exist outside of their mind. Examples include seeing bizarre images, hearing voices (which is most common), or smelling something disgusting. Hallucinations alone can sometimes have serious consequences, as the sufferer is not thinking or behaving within reality. I've met people who have seen the devil, heard demons, and I've met people who have had really positive experiences, such as hearing their mother's voice guiding them through life, etc. It's not always devastating.
• Delusions. A delusion is a fixed false belief based on an unrealistic view or thought. Common delusions are that of grandeur (someone believing they're an important, powerful persos, a celebrity, world leader, or even God) and persecutory (someone believing they are being watched, monitored, harassed, spied on and conspired against.) Delusions can also cause extremely disordered thoughts in every day occurrences, such as a sufferer believing they are being sent hidden messages through the TV or radio. This adds to the delusion. Hallucinations and delusions can cross over, fuelling each other, which can make the psychosis worse.
• Confusion. Dealing with psychosis causes a great deal of confusion for the person experiencing it. They might find they cannot concentrate on every day tasks, due to their mind being "full" or "noisy" and because of this, their speech may become jumbled. Sometimes, people speak in riddles or rhymes (known as word salad), and this can make conversation difficult.
• Changes in behaviour and thoughts. It is extremely common for people with Schizophrenia to become agitated by their psychotic symptoms. Some people experience what is known as "thought broadcasting". This is where there is a fixed belief that either their thoughts are disappearing/being removed or being planted in their head.

The positive symptoms of Schizophrenia usually happen in episodes, though if left untreated, a person can become severely unwell. Positive symptoms can be controlled by Antipsychotic medication, which can alter the receptors that produce dopamine, which in turn lessens the hallucinations and delusions.

The negative symptoms of Schizophrenia are usually longer lasting than psychotic symptoms and are much harder to treat. They have more of a long term impact on a person's quality of life and the way they live day to day. Symptoms include:

• Loss of interest in things the person used to enjoy, including life in general.
• Social withdrawal
• Poor self care
• Feeling less likely to initiate conversation
• Deficit in emotional responsiveness

There are a few different treatment actions for negative symptoms, including some antipsychotics, antidepressants (though results vary) and therapy.

Of course, not everyone with Schizophrenia will experience all of these positive or negative symptoms. In fact, those with Paranoid Schizophrenia are less likely to struggle with blunted emotional responsiveness and/or cognitive functions. However, those with Schizophrenia have a 5-10% chance of taking their own life within ten years of diagnosis. They are also more likely to harm themselves than harm others. There goes the "crazy killer" stigma right out of the window.

What causes Schizophrenia?

The truth? No one truly knows. There are some risks to developing the illness, though, including genetics (the illness can run in families), birth complications such as lack of oxygen or premature labour, and drug abuse (in particular Cannabis and Cocaine). Researchers say the drug abuse can cause an acute "drug-induced" psychosis, which can develop into Schizophrenia in some patients, usually within a few years of the original psychotic episode.

While there is no known cure for Schizophrenia, the prognosis of the illness is improving, especially compared to a few decades ago. 50% of people diagnosed are either recovered or managing symptoms within ten years of diagnosis. This means they are in work and living independently. 15% of those diagnosed are not better and are in hospital. Basically, the sooner the treatment, the better the outcome.

My story

I'm 11. My mother is opening the windows downstairs to let some air into the house. I'm walking around after her shutting them, saying I'm afraid of the shotguns. I'm not being playful. I'm not imagining things. I am having a paranoid delusion.

I'm 16 (or thereabouts). I keep hearing a man's voice saying nasty things about me, but when I turn around, there's no one there. I'm not mishearing. I am having an auditory hallucination.

I'm 21. I'm finding it difficult to go outside, and shut myself off from my friends and family. I'm at university and I stay in my room out of fear. I'm not depressed. I'm experiencing intense paranoia.

I'm 24 and have been admitted to hospital for the first time. I am in the garden having a cigarette when I see a camera on the roof turn towards me, and I hear the man's voice telling me the secret service are monitoring me. I'm not daydreaming. I am having a visual and auditory hallucination accompanied by a paranoid delusion.

This is a brief time scale of how my psychotic illness manifested, and believe me, it got worse.

I started hearing voices at some point in my teens. I never thought anything of it, really. They weren't happening all the time and I thought it happened to everyone. I carried on with life- school then college. In college, I flourished and was having the time of my life. I had many friends and loved my course(s). Then I applied for university, in which I was accepted onto the music course. A year of complete excitement, living miles away from home and drinking most nights was fun, I won't lie. Second year came and I started feeling different. I was experiencing paranoia again, this time about my friends and even strangers. I had a feeling that I was constantly being watched or followed, but I put it to the back of my mind and tried to carry on. My last year of university came and I was a shell of my former self, completely avoiding lectures and my flatmates. I was like a hermit in my en-suite room. I was also struggling with an eating disorder at this time and that took the focus of my life for a while, though the paranoia and voices persisted throughout this time period.

I ended up withdrawing from university completely. I just couldn't cope with speaking to lecturers or socialising with friends.

Fast forward two years and I am on a downward spiral. I'm hearing voices all day every day (two voices most of the time), visually hallucinating and completely convinced that I'm not human and the secret service are conspiring against me. I was struggling with conversation, and my emotions. I couldn't concentrate (I didn't read or watch much TV for over two years). I would sit, and drift off- lost in my delusion and hallucinations. That was my life for a while. I pretty much stopped writing music apart from the odd song I could muster up and I lost a lot of friends. I stopped feeling pleasure in things I used to enjoy and I totally neglected my self care. I experienced "thought broadcasting" (as mentioned above in the Positive Symptoms list) and believed the Secret Service were stealing my thoughts and placing new ones in my head. 

I've hallucinated giant spiders, snakes, children, animals, angels, demons. Most of them were terrifying. My voices made me harm myself, via hitting myself, cutting my skin and trying to walk into traffic. My delusions have been bizarre at times (I once thought I was a cockney and one time thought I was really important).  

I was diagnosed with Paranoid Schizophrenia by four consultant psychiatrists. I remember the day I found out. Dread slapped me across the cheek. I experienced the fear that many people experience when they hear the word Schizophrenia. "I'm crazy". "Do I have multiple personalities?". Luckily, I had an amazing consultant psychiatrist who explained it all to me in great detail that it's just a psychotic illness. So that was my diagnosis. What do I do now? This is where treatment comes in...

I was given a care co-ordinator, a support worker and a psychologist. These were the staple in my recovery plan. I tried a few antipsychotics that didn't work. One of them made me a zombie. Another gave me serious side effects including muscle jerks and eyeball shakes. One made me gain four stone in weight. It took three whole years to find the right one, and boy is it good. I haven't had a full psychotic episode in 16 months. I still sometimes hear voices and visually hallucinate but it usually only lasts a few hours and is nowhere as bizarre as it once was. Delusions don't really happen anymore for me- very few and far between.

I do still really struggle with lack of pleasure and concentration- my negative symptoms I guess, but it's not all bad. I have some really positive things in my life that keep me going. I live independently without professional support and I am hoping to work within the next year or so. Here's hoping.

So there's the truth about Schizophrenia. Is it surprising? Let me know in the comments. Also, if you want to see more posts about mental health, go to my new website here and subscribe. That way you'll be notified whenever I post.

Thank you,

Leigh