Understanding Schizophrenia

Symptoms

By Mayo Clinic staff,

There are several types of schizophrenia, so signs and symptoms vary. In general, schizophrenia symptoms include:

  • Beliefs not based on reality (delusions), such as the belief that there’s a conspiracy against you
  • Seeing or hearing things that don’t exist (hallucinations), especially voices
  • Incoherent speech
  • Neglect of personal hygiene
  • Lack of emotions
  • Emotions inappropriate to the situation
  • Angry outbursts
  • Catatonic behavior
  • A persistent feeling of being watched
  • Trouble functioning at school and work
  • Social isolation
  • Clumsy, uncoordinated movements
Schizophrenia ranges from mild to severe.

Some people may be able to function well in daily life, while others need specialized, intensive care. In some cases, schizophrenia symptoms seem to appear suddenly. Other times, schizophrenia symptoms seem to develop gradually over months, and they may not be noticeable at first.

Over time, it becomes difficult to function in daily life. You may not be able to go to work or school. You may have troubled relationships, partly because of difficulty reading social cues or others’ emotions. You may lose interest in activities you once enjoyed. You may be distressed or agitated or fall into a trance-like state, becoming unresponsive to others.

In addition to the general schizophrenia symptoms, symptoms are often categorized in three ways to help with diagnosis and treatment:

Negative signs and symptoms
Negative signs and symptoms represent a loss or decrease in emotions or behavioral abilities. They may include:

  • Loss of interest in everyday activities
  • Appearing to lack emotion
  • Reduced ability to plan or carry out activities
  • Neglecting hygiene
  • Social withdrawal
  • Loss of motivation

Positive signs and symptoms
Positive signs and symptoms are unusual thoughts and perceptions that often involve a loss of contact with reality. These symptoms may come and go. They may include:

  • Hallucinations, or sensing things that aren’t real. In schizophrenia, hearing voices is a common hallucination. These voices may seem to give you instructions on how to act, and they sometimes may include harming others.
  • Delusions, or beliefs that have no basis in reality. For example, you may believe that the television is directing your behavior or that outside forces are controlling your thoughts.
  • Thought disorders, or difficulty speaking and organizing thoughts, such as stopping in midsentence or jumbling together meaningless words, sometimes known as “word salad.”
  • Movement disorders, such as repeating movements, clumsiness or involuntary movements.

Cognitive signs and symptoms
Cognitive symptoms involve problems with memory and attention. These symptoms may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. They include:

  • Problems making sense of information
  • Difficulty paying attention
  • Memory problems
When to see a doctor:\ People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it often falls to family or friends to get them help.
Suicidal thoughts and behavior

Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

For more info, Mayo Clinic has much more on its website: http://www.mayoclinic.com/health/schizophrenia/DS00196/DSECTION=symptoms

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Handling a Diagnosis of Tardive Dyskinesia

Tardive Dyskinesia (TD) is a condition of involuntary, repetitive movements of the jaw, tongue or other body movements. It frequently is a side effect of the long-term use of antipsychotic drugs used to treat schizophrenia or bipolar disorder. It is almost always permanent. I’ve been told Vitamin E might help a bit.  Benzodiazepines have also been used with mixed results on a short-term basis.

Some examples of these types of involuntary movements include:

  • Grimacing
  • Tongue movements
  • Lip smacking
  • Lip puckering
  • Pursing of the lips
  • Excessive eye blinking

(Wikipedia)

I recently was diagnosed as having TD after the use of Zyprexa. My version is my lower jaw moves from side-to-side, unless I concentrate on not doing it. I quickly revert to this involuntary movement when I’m not aware of it. I recently saw a video of myself (with my family) and sure enough there I was, doing the ‘jaw thing.’ It was very obvious. It was also very embarrassing. (I have the ‘lithium jitters’— where my hands always shake, but TD is different.)

There are a couple of things I might mention:
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1) I’ve discovered that there is a real social isolation with this TD stuff. To be doing this in public is “not acceptable.” I have had people come up to me wanting to know what’s my problem. Since I can’t control the movement I just say, “It’s my meds— they affect me this way.” In a way it’s like wearing a neon sign saying, “I’m a fruit cake.” Having a mental illness is stigma enough, but the TD just puts a new edge on it.

2) As a natural introvert the isolation has only deepened. (I avoid crowds and most social engagements.) I guess if the truth be told, I’m uncomfortable when others look at me strangely or whisper to each other. My standard ‘paranoia level’ has taken a new twist. I feel I’m compelled to explain. I guess I’m embarrassed when others are embarrassed.

3) I settle myself down in my faith to cope. I know I’m not alone in this– the Lord Jesus is always with me. He holds me tight through all these twists and turns. Since I isolate myself so much, I savor the connection I have with a few friends who have become inured to my condition. Social media helps out— Facebook is a big help, as well as my two blogs.

4) One of the things I try to remember are the issues of selfishness and pride. I keep reminding myself it’s not about me all the time. One of the significant areas mentally ill people deal with is self-absorbed thinking. It seems it comes with the illness.

5) I try to keep a sense of humor everyday. It breaks down the mental pain to tolerable levels. We can take ourselves too seriously sometimes. Be more patient with yourself. I know I have to.

I ask that you remember me in prayer from time-to-time. I’m in ‘uncharted waters’ (it seems) and I sometimes feel all alone with my mental illness and all its tangents. I want good to come out of this. (An instantaneous healing would be o.k. But, I’m not too finicky.) Sorry for so much.

If you can’t pray, don’t feel at all impinged upon.

Hiding Our Wounds

Brennan Manning Quote
“You are the light of the world. A city set on a hill cannot be hidden. 15 Nor do people light a lamp and put it under a basket, but on a stand, and it gives light to all in the house.”

Matthew 5:14-15, ESV

Overall, I think this Manning quote is a great observation. We, the torn and wounded, often try to hide, secluding ourselves in the “Island of Misfit Toys.” (Got to love those 60s Christmas cartoons.) We pretty much accept our lot as damaged merchandise.

Maybe we choose to isolate ourselves more than we want to admit. Could that be what we do? Are we still embarrassed and ashamed by all that we’ve done? That’s quite possible.

This may come as a shock, but the Church doesn’t need any more gifted people.

But it does need broken people who understand ‘the giftedness of the flawed.” When we conceal, we diminish the Church by our absence. We can ostracize ourselves, through a self imposed shame— but the Church will suffer. We need to show them that everyone can be healed, even screwy ‘fruit-cakes’ like us.

I recently had the privilege of speaking to a class of young Bible college students.

My subject was decidedly not on being successful, but on being a failure. Whole courses are geared toward ministerial success– but where are the ones for failure? I think that it just might be even more important, in the long run.

No human effort is going to erase your past.

I have tried and it can’t be done. I have blitzed my brains on drugs and booze, but I still remember the people I’ve hurt. (And I pray for them.) There really isn’t a cure for the evil we have done. I believe in forgiveness. And I hold to the idea that are sins are never to be a subject of  guilty accusation–

“He will again have compassion on us;
    he will tread our iniquities underfoot.
You will cast all our sins
    into the depths of the sea.”

Micah 7:19

Our dark iniquity is put in a very deep place. But there are the memories of an unkind word, or a sad and dark foolishness that we must learn to live with. There will be many regrets, and we face the terrible consequences of our sins, but it’s enough to know that all is under the blood of Jesus.

We are indeed forgiven. Completely.

We are now to live as forgiven sinners, yet precious in God’s eyes. We discover that although the Father has no favorites among His children, but He does have intimates. We are to live the rest of our lives for His glory, exploring that intimacy.

“Leave the broken, irreversible past in God’s hands, and step out into the invincible future with Him.”

  Oswald Chambers

Being Paranoid

A person who is paranoid has fears, such as being watched, harmed or poisoned. He or she does not trust others and is suspicious that others are “out to get” him or her. These seem very real.

It’s normal to wonder if people are talking about you when you hear them whispering as you walk into a room. These thoughts are usually passed off and not dwelled upon for most people. We give them little credence. Not a problem.

A person who is paranoid, however, does dwells upon suspicious thoughts. He or she goes out of their way to prove their suspicions even though no evidence exists to confirm their thoughts. It’s very hard to reason or speak what is real.

Paranoia is usually found in small degrees in almost every mental illness.

Symptoms

  • Use and/or withdrawal of certain drugs, such as marijuana, crack cocaine and angel dust (PCP)
  • Alcohol withdrawal
  • Deafness or problems with hearing
  • Illnesses that affect the central nervous system, such as Alzheimer’s disease or other dementias, a stroke, a brain tumor
  • Mental illnesses, such as bipolar disorder or schizophrenia
  • Paranoid personality disorder, (PPD)

How to Recognize Paranoia

A person with paranoia may also:

  • Appear cold and aloof
  • Be withdrawn and anxious in social situations
  • Act stubborn and combative
  • Appear “on guard” at all times, out of fear of being controlled or harmed

A paranoid person also:

  • Complains about his or her health and often feels vulnerable and inferior to others
  • Holds grudges easily
  • Displays bitterness and resentment toward others
  • May be easily drawn into religious cults or other groups with strict beliefs
  • Is quite susceptible to conspiracy theories, religious or political
  • Can have delusions of being persecuted

Treatment

Treatment for paranoia depends on its cause. If it is a symptom of another condition, treatment for the condition will often take care of or lessen the paranoia. Paranoid personality disorder is treated with counseling, support therapy and often with medication. Treatment for this disorder is not easy, though, due to the nature of paranoia. Persons who are paranoid often do not trust others including doctors, therapists or family members trying to help them get treatment. It is likely that you will need to intervene, patiently and gently. 

Ministering to the paranoid treatment requires a huge commitment. Typically you’ll see lots of anger as they confront others of mistreating them.

What You Can Do for a Friend or Relative

The most important thing you can do is to encourage your friend or relative to get professional help. Be aware that you may need to make the initial appointment with a professional. You may also need to take them to the appointment and stay with them. Be supportive. Paranoia requires patience, understanding, love and encouragement of the person’s loved ones and friends.

Those close relationships are typically what frees a person who struggles.

Be aware of the types of medication your friend or relative takes and when they should take it. You should also alert their physician or psychiatrist to any side effects that you notice when they do or do not take their medication. 

If I may, I would suggest a movie for you, “A Beautiful Mind.”  This may give you a little insight.

Cleveland Clinic PPD Introduction Site http://my.clevelandclinic.org/disorders/personality_disorders/hic_paranoid_personality_disorder.aspx

Suite 101 PPD Site http://personalitydisorders.suite101.com/article.cfm/paranoid_personality_disorder

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