schizophrenia

Clearing up misconceptions

Jamie VanGeest

During Erin Williams’ sophomore year living in Centennial Hall, her life became frightening.

She saw shadows of people hiding in dark corners. Williams said the shadows would whisper to her, but she could never make out their words.

“I was literally terrified all of the time,” she said.

Afraid to leave her residence hall room, Williams avoided meeting people. Her door always was locked. She would go to the hall’s cafeteria for food only late at night when no one was around.

While attending class, Williams always sat in the back so she wouldn’t be too close to the other students.

There are many misconceptions about the face of schizophrenia. Some might think it’s the face of someone in an institution, or the face of a stranger on a street corner having a one-person conversation.

The real face of schizophrenia includes people who won Nobel Prizes, people who struggle with homelessness, parents, children and one former University student.

Williams knew she was depressed, but something more was causing her paranoia, she said. She participated in a research study for depression, but left with a diagnosis of schizoaffective disorder.

Schizoaffective disorder is characterized by a combination of symptoms of schizophrenia and a mood disorder, which explained the depression Williams felt with her paranoia.

Today most clinicians and researchers agree schizoaffective disorder is a form of schizophrenia, according to the National Alliance on Mental Illness.

Williams’ story isn’t uncommon; the onset for schizophrenia typically occurs when people are of college age.

“The late adolescents and early adult years are when (schizophrenia) comes on and when it hits, it can be devastating,” said Kelvin Lim, a professor in the psychiatry department.

Often schizophrenia emerges in men in their late teens and early 20s and in women in their mid-20s to early 30s, according to the National Institute of Mental Health.

Schizophrenia affects 1 percent of the population. Approximately 2.4 million Americans have the disease, the institute reports.

There are three categories of symptoms for schizophrenia: positive, negative and cognitive.

Symptoms

Positive symptoms include unusual thoughts or perceptions.

People with positive symptoms can experience hallucinations. Also, when a person sees, hears, smells or feels things no one else can, they are experiencing positive schizophrenia symptoms, according to the institute.

The most common hallucinations people with schizophrenia experience include hearing voices that might comment on their behavior, order them to do things or warn them of impending danger.

Some people might have some of the symptoms of schizophrenia such as hallucinations, but do not have the disease.

“Eight to 15 percent of the (entire) population may have auditory hallucinations sometime during development,” Tonya White, a professor in the psychiatry department, said.

People with positive symptoms of the illness also could experience delusions.

Delusions are false personal beliefs that are not part of the person’s culture and do not change, even when others present proof that the beliefs are not true or logical, the institute reported.

People with paranoid schizophrenia believe others are deliberately cheating, harassing, poisoning or spying on them. They also think people are plotting against them or people they care about.

Negative symptoms of schizophrenia include a loss or decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life.

“It’s harder to treat people with negative symptoms then it is for people with positive symptoms,” said John Vuchetich, an assistant professor in the psychiatry department.

Cognitive symptoms include problems with attention, memory, and the ability to plan and organize, according to the institute.

Causes and outcomes

There is no known cause for schizophrenia, but it is thought that the illness is caused by a mixture of genes and the environment.

In the general population, schizophrenia occurs in 1 percent of the population, but it occurs 10 percent of the time in families in which a first-degree relative, such as a parent or a sibling, has schizophrenia.

Another struggle people with the illness deal with is addiction. The most common drug addiction of people with schizophrenia is nicotine. Seventy-five to 90 percent of people with schizophrenia smoke compared with 25 percent to 30 percent in the general population, the institute reported.

Also, people with schizophrenia are more likely to abuse alcohol than the general population.

Ten percent of people with schizophrenia commit suicide and 40 percent will attempt it, according to the World Fellowship for Schizophrenia and Allied Disorders. This rate is much higher than the rate in the general population.

Treatment

The most common treatments for schizophrenia include taking antipsychotic medications. These have been in existence since the 1950s, but the medications today have fewer side effects.

Antipsychotic medications don’t cure schizophrenia, but they manage symptoms, the institute reported. Schizophrenia is like diabetes in that people with the illness will need to take medication for the rest of their lives. Taking the medication requires constant management.

But antipsychotic medication has a high relapse rate and people often quit taking it.

The relapse rate is 80 percent within two years. With continued drug treatment, only about 40 percent of recovered patients will suffer relapses, the institute reports.

Williams stopped taking her first medication after six months.

“I wouldn’t take because it made me tired,” she said.

Another issue with antipsychotic medications is people sometimes quit taking them when they start to feel better. They might also stop if side effects such as daytime drowsiness or weight gain are too much to handle.

Williams would stay out late at night, and then have to take her medication, which would make her tired during her job the next day.

When she stopped, her hallucinations came back, so she began to take her medication again.

“The biggest issues are the side effects and the side effects are the leading cause of why people do not want to take them,” Williams said.

Some ways to prevent relapse are getting an antipsychotic in the form of a shot, according to the institute. Also, timers are available to remind people to take their medications.

People who take antipsychotic medications also can benefit from psychosocial therapy, the institute reports.

This type of therapy can help people cope with difficulties with communication, motivation, self-care, work and establishing and maintaining relationships with others, according to the institute.

Misconceptions

Schizophrenia often is viewed in a negative light in society from media to language.

“There’s (negative) words in the vernacular, (such as), ‘Oh that’s really schizoid,’ ” psychiatry professor Tonya White said. “It’s usually in a negative light.”

One of the many misconceptions about schizophrenia is that most people with the illness commit violent crimes.

“(People) will think people with schizophrenia are more aggressive,” White said.

A search of schizophrenia on CNN’s Web site listed stories only about people with schizophrenia who have committed crimes.

Most people with schizophrenia do not commit violent crimes, the institute reports. In fact, people with schizophrenia often prefer to keep to themselves.

“There are people with schizophrenia who are aggressive, but there are people without schizophrenia who are aggressive,” White said.

One reason people might view schizophrenia in a bad light is because they don’t understand it, she said.

“The more people don’t understand things, they can become scared,” White said.

“There are many people with mental illness who have contributed greatly,” White said.

Erin Williams said, “People think (people with schizophrenia) can’t function in normal society.”

Williams graduated from the University in 2005 with a bachelor’s degree in global studies.

Williams is working as a freelance photographer who focuses on landscapes, but is learning to master portraits.

She plans to marry her fiancé in a few months.

Williams said he has supported her since the onset of her illness.