Paranoid Schizophrenia: Modes of Recovery

Definitions of Schizophrenia
 

Schizophrenia is just a label and no individual has exactly the same experience of the illness as anyone else therefore no definition is necessarily the "right" one. One person's illness does not define the condition. People don't often fit exactly into boxes. For example whilst my diagnosis has always been said to be paranoid schizophrenia a psychiatrist once asked me if I would like to try some lithium, a drug normally given to persons with manic depression (another label). There is a continuum of mental health conditions all overlapping at some point. There is even one mental health condition which is actually called autistic spectrum disorder condition. Having said this I thought I'd collect a few definitions for you, below, even where they are quite out of date in this case commenting at the bottom. But one definition is that it is a mental health condition whose symptoms are delusions and hallucinations. A delusion is when you believe something to be the case that isn't. With hallucinations most people know about visual and auditory hallucinations, that is seeing and hearing things that aren't really there, at least in your location, but what is less well known is that you can taste, smell and feel things that aren't really there. I have had all those types of hallucination.  But you see  a large part of the condition is simply the  way you get treated  once you have the diagnosis.  The condition is created by abuse and conflict with power structures, one might surmise, and then the diagnosis makes this many times worse (many times and then times 3 again for young black males).  This is an easy matter to prove, and I know it has been over the decades eg in America with undercover so called paranoid schizophrenics with fake medical records who find they receive automated abuse from the so called health apparatus having to be rescued in the end I think I read. The  weakness of all the following definitions is they were written by doctors for doctors the doctors themselves being part of the condition as well as what led to the patient coming into contact with them.

Schizophrenia: A mental disease marked by a breakdown in the relation between thoughts, feelings and actions, frequently accompanied by delusions and retreat from social life - Concise Oxford Dictionary. 

Schizophrenia: Mental disease marked by disconnection between thoughts, feelings and actions - The Readers Digest Great Encyclopaedic Dictionary. 

Schizophrenia: Psychosis. A severe illness, usually starting in early adult life; relapses are common, and the disease may be progressive. Hallucinations are also common. It is sometimes inaccurately called split personality - The Readers Digest Great Encyclopaedic Dictionary. 

Schizophrenia: A serious mental disorder marked by irrational thinking, disturbed emotions and a breakdown in communications with others. Schizophrenia is the most common type of psychosis, accounting for about half the serious mental illness in Britain. The cause is not known, but it may be related to a hereditary disorder in metabolism - The Readers Digest Illustrated Family Medical Encyclopaedia. 

Schizophrenia: Schizophrenia is an emotive word. Thanks to old films like The Three Faces of Eve, many mistakenly take it to mean having a multiple personality. The condition was originally called dementia praecox (early madness), but in 1911 a Swiss psychiatrist, Eugene Bleuler, renamed it schizophrenia, which comes from the Greek, meaning 'splitting of mind'. Because the symptoms of schizophrenia are still not clearly recognised, families may simply not understand the increasingly strange behaviour of a member. These symptoms fall into four main categories. There is "simple schizophrenia", which includes a general deterioration in personality, illogical thoughts, the wrong kind of emotion for a certain situation, or no emotion at all. These symptoms usually start during or after adolescence. The "hebephrenic type" will hear hallucinatory voices and have delusions - like believing that announcements on TV or radio have a personal message. The "catatonic type" is characterised by alternate cycles of unpredictable excitement and stupor. Movement is affected: sufferers may become almost immobile or take up rigid positions. The main feature of the "paranoid type" is delusions of persecution. Sufferers are convinced they are being watched, followed, plotted against and persecuted. They think people are whispering about them, laughing at them, or out to get them. Stress may help to bring on symptoms of schizophrenia but there are serious arguments between psychiatrists as to the possible causes of the condition, its various diagnoses - and even as to its actual existence. The psychiatrist RD Laing, for example, provoked great controversy with his belief that people developed schizophrenia as a way of coping with intolerable family circumstances. "Insight" is a term routinely applied to signify good mental health or the recovery of patients, when they are able to see they have been suffering delusions. Up to this point they maintain they are normal and in good health. Psychotherapy is rarely used to treat schizophrenics, as they have no insight*. But over the last 25 years drugs have proved a very effective treatment - controlling hallucinatory voices, calming excitement and reducing delusions. With their help, schizophrenics can become less anti-social and they can re-enter the ordinary world - The Sunday Times A-Z of Preventative Medicine.

Schizophrenia: This is the commonest major psychiatric disorder and affects about 1% of the population of the Western World. It usually shows itself between the ages of sixteen and twenty-five and lasts for life. About half the patients in psychiatric hospitals are schizophrenics, as are many of the homeless who inhabit city streets. Schizophrenia is not a disease in the normal sense of the word and has no fixed characteristics. Definitions vary wildly and the condition is being officially re-defined. At one time it was called "premature dementia" (dementia praecox), but it is in no sense a dementia and the intellectual powers are not affected. There is no laboratory test for schizophrenia and no observable change in the nervous system**. The diagnosis is based entirely on the behaviour of the person under consideration - Royal Society of Medicine Encyclopaedia of Family Health. 

Schizophrenia: Schizophrenia is the commonest psychiatric illness, accounting for some 80% of patients under the age of 65 who have been in hospital for 2 years or more. The term schizophrenia was introduced by Bleuler in 1908 replacing an older name dementia praecox in order to describe the apparent splitting of mind which is characteristic of the condition, part remaining in touch with reality and part not. The manifestations are protean, the commonest being withdrawal, regression, infantilism, asocial or antisocial behaviour, aberrant ideas, delusions, and hallucinations. Several clinical types are recognised: simple, paranoid, hebephrenic and mixed. The onset is usually in adolescence or early adult life and the course is chronic, sometimes with remissions. Despite intensive research over many years, the aetiology and pathogenesis of schizophrenia are still not understood. It is certain however, that there is a strong genetic component - Oxford Companion to Medicine.

Schizophrenia: a mental disorder, a psychosis of unknown origin, which can lead to profound changes in personality and behaviour including paranoia and hallucinations. Contrary to popular beilef, it does not involve a split personality. Modern treatment approaches include drugs, family therapy, stress reduction and rehabilitation. Schizophrenia implies a severe divorce from reality in the patient's thinking. Although the causes are poorly understood, it is now recognised as an organic disease, associated with structural anomalies in the brain. In 1995 Canadian researchers identified a protein in the brain, PSA-NCAM, that plays a part in filtering sensory information. The protein is significantly reduced in the brains of schizophrenics, supporting the idea that schizophrenia occurs when the brain is overwhelmed by sensory information. There is some evidence that early trauma, either in the womb or during delivery, may play a part in causation. There is also a genetic contribution - Hutchinson Encyclopaedia 

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Further Comments on the Above

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*The Sunday Times A-Z of Preventative Medicine says above "Psychotherapy is rarely used to treat schizophrenics, as they have no insight". These days I think psychotherapy is recommended at all stages

 

**The Royal Society of Medicine Encyclopaedia of Family Health says above the condition last for life. This is an unfortunate statement as Open Dialogue proves. In addition Brent Nokes who painted my book cover and had a number of years with schizophrenia recovered completely and not only that has stayed well without medication since the 1970s. They also say it produces no observable change in the nervous system so this must have been written before PET scans (see Useful Links section). I haven't got a PET scan of my brain to hand so here's a picture of my cat Miss Pingu Tobaski.

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