Do you know someone who seems like he or she has “lost touch” with reality? Does this person talk about “hearing voices” no one else can? Does he or she see or feel things that others can’t? Does this person believe things that aren’t true?
Sometimes people with these symptoms have schizophrenia, a serious illness.
What is schizophrenia?
Schizophrenia is a serious brain illness. Many people with schizophrenia are disabled by their symptoms.
People with schizophrenia may hear voices other people don’t hear. They may think other people are trying to hurt them–we call this paranoia. Sometimes they don’t make any sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.
Who gets schizophrenia?
Anyone can develop schizophrenia. It affects men and women equally in all ethnic groups. Teens can also develop schizophrenia. In rare cases, children have the illness too.
When does it start?
Symptoms of schizophrenia usually start between ages 16 and 30. Men often develop symptoms at a younger age than women. People usually do not get schizophrenia after age 45.
What causes schizophrenia?
Several factors may contribute to schizophrenia, including:
Genes, because the illness runs in families
The environment, such as viruses and nutrition problems before birth
Different brain structure and brain chemistry.
Scientists have learned a lot about schizophrenia. They are identifying genes and parts of the brain that may play a role in the illness. Some experts think the illness begins before birth but doesn’t show up until years later. With more study, researchers may be able to predict who will develop schizophrenia.
What are the symptoms of schizophrenia?
Schizophrenia symptoms range from mild to severe. There are three main types of symptoms.
Positive symptoms refer to a distortion of a person’s normal thinking and functioning.
They are “psychotic” behaviors. People with these symptoms are sometimes unable to tell what’s real from what is imagined. Positive symptoms include:
Hallucinations: when a person sees, hears, smells, or feels things that no one else can. “Hearing voices” is common for people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem.
Delusions: when a person believes things that are not true. For example, a person may believe that people on the radio and television are talking directly to him or her. Sometimes people believe that they are in danger-that other people are trying to hurt them.
Thought disorders: ways of thinking that are not usual or helpful. People with thought disorders may have trouble organizing their thoughts. Sometimes a person will stop talking in the middle of a thought. And some people make up words that have no meaning.
Movement disorders: may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may stop moving or talking for a while, a rare condition called “catatonia.”
Negative symptoms refer to difficulty showing emotions or functioning normally.
When a person with schizophrenia has negative symptoms, it may look like depression. People with negative symptoms may:
Talk in a dull voice
Show no facial expression, like a smile or frown
Have trouble having fun
Have trouble planning and sticking with an activity, like grocery shopping
Talk very little to other people, even when they need to.
Cognitive symptoms are not easy to see, but they can make it hard for people to have a job or take care of themselves.
Cognitive symptoms include:
Trouble using information to make decisions
Problems using information immediately after learning it
“Cross Jesus one too many times, fail too often, sin too much, and God will decide to take his love back. It is so bizarre, because I know Christ loves me, but I’m not sure he likes me, and I continually worry that God’s love will simply wear out.
Periodically, I have to be slapped in the face with Paul’s words in Romans 8:38-39, ‘For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.’“
I admit I live with a continuous fear that God’s love has limits. That someday, I will sin myself beyond a Savior’s reach. It nags on me and betrays me. The fear that I will end up on some spiritual “junk heap” is real, and it is pervasive. I guess it has to do with the unbelievable richness of God’s fantastic grace.
This doubt accentuates my depression, aggravating it and poisons my whole being. I feel worthless and so alone. Since my particular struggle is with paranoia, I end up bringing that with me into the throne room. Kids who have been beaten by their fathers often visibly flinch when Dad raises his arm to scratch his head. They cower and duck out of habit, waiting for the blows.
Our heavenly Father has gone out of his way to make the gospel truly good news. We often have to be convinced of a love that cannot be diluted by the stuff of life. And we who are the wounded and paranoid need that assurance. We are loved with a love of such quality and quantity, and such magnificence that all we can scream is “GRACE!”
As broken people we must come and allow ourselves to be loved with this outrageous love. Our depression, bipolar disorder, addictions, BPD, OCD, and schizophrenia are not insurmountable issues. We are sick, we admit it. We are different than other people (“the norms”). But the Father delights in us.
He especially loves his lambs who are weak and frightened.
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
Neglect of personal hygiene
Lack of emotions
Emotions inappropriate to the situation
A persistent feeling of being watched
Trouble functioning at school and work
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
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
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 911or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
This should supply direction and dialogue on the issues faced by every church member. It is a great opportunity we have been given— to minister to every person in the Body of Christ. —Bryan
by Ken Camp, Associated Baptist Press —
Living with depression — or any other form of mental illness — is like viewing life “through a glass darkly,” according to Jessy Grondin, a student in Vanderbilt University’s Divinity School. “It distorts how you see things.”
Like one in four Americans, Grondin wrestles with mental illness, having struggled with severe bouts of depression since her elementary-school days. Depression is one of the most common types of mental illness, along with bipolar disorder, another mood-altering malady. Other forms of mental illness include schizophrenia and disorders related to anxiety, eating, substance abuse and attention deficit/hyperactivity.
Like many Americans with mental illness, Grondin and her family looked to the church for help. And she found the response generally less-than-helpful. “When I was in the ninth grade and hospitalized for depression, only a couple of people even visited me, and that was kind of awkward. I guess they didn’t know what to say,” said Grondin, who grew up in a Southern Baptist church in Alabama.
Generally, most Christians she knew dealt with her mood disorder by ignoring it, she said. “It was just nonexistent, like it never happened,” she said. “They never acknowledged it.” When she was an adolescent, many church members just thought of her as a troublemaker, not a person dealing with an illness, she recalled.
A few who acknowledged her diagnosed mood disorder responded with comments Grondin still finds hurtful. “When dealing with people in the church … some see mental illness as a weakness — a sign you don’t have enough faith,” she said. “They said: ‘It’s a problem of the heart. You need to straighten things out with God.’ They make depression out to be a sin, because you don’t have the joy in your life a Christian is supposed to have.”
A Baylor University study revealed that among Christians who approached their local church for help in response to a personal or family member’s diagnosed mental illness, more than 30 percent were told by a minister that they or their loved one did not really have a mental illness. And 57 percent of the Christians who were told by a minister that they were not mentally ill quit taking their medication.
That troubles neuroscientist Matthew Stanford. “It’s not a sin to be sick,” he insists. Stanford, professor of psychology and neuroscience and director of the doctoral program in psychology at Baylor, acknowledges religion’s longstanding tense relationship with behavioral science. And he believes that conflict destroys lives. “Men and women with diagnosed mental illness are told they need to pray more and turn from their sin. Mental illness is equated with demon possession, weak faith and generational sin,”
Stanford writes in his recently released book, Grace for the Afflicted. “The underlying cause of this stain on the church is a lack of knowledge, both of basic brain function and of scriptural truth.” As an evangelical Christian who attends Antioch Community Church in Waco, Texas, Stanford understands underlying reasons why many Christians view psychology and psychiatry with suspicion. “When it comes to the behavioral sciences, many of the early fathers were no friends of religion. That’s certainly true of Freud and Jung,” he noted in an interview.
Many conservative Christians also believe the behavioral sciences tend to justify sin, he added, pointing particularly to homosexual behavior. In 1973, the American Psychiatric Association famously removed homosexuality from its revised edition of its Diagnostic and Statistical Manual of Mental Disorders. As a theologically conservative Christian, Stanford stressed that scripture, not the Diagnostic and Statistical Manual, constitutes the highest authority.
But that doesn’t mean the Bible is an encyclopedia of knowledge in all areas, and all people benefit from scientific insights into brain chemistry and the interplay of biological and environmental factors that shape personality. Furthermore, while he does not presume to diagnose with certainty cases of mental illness millennia after the fact, Stanford believes biblical figures — Job, King Saul of Israel and King Nebuchadnezzar of Babylon, among others — demonstrated symptoms of some types of mental illness. “Mental disorders do not discriminate according to faith,” he said.
Regardless of their feelings about some psychological or psychiatric approaches, Christians need to recognize mental illnesses are genuine disorders that originate in faulty biological processes, Stanford insisted. “It’s appropriate for Christians to be careful about approaches to treatment, but they need to understand these are real people dealing with real suffering,” he said. Richard Brake, director of counseling and psychological services for Texas Baptist Child & Family Services, agrees. “The personal connection is important. Church leaders need to be open to the idea that there are some real mental-health issues in their congregation,” Brake said.
Ministers often have training in pastoral counseling to help people successfully work through normal grief after a loss, but may lack the expertise to recognize persistent mental-health problems stemming from deeper life issues or biochemical imbalances, he noted. Internet resources are available through national mental-health organizations and associations of Christian mental-health providers. But the best way to learn about available mental health treatment — and to determine whether ministers would be comfortable referring people to them — is through personal contact, Brake and Stanford agreed. “Get to know counselors in the community,” Brake suggested. “Find out how they work, what their belief systems are and how they integrate them into their practices.”
Mental-health providers include school counselors and case managers with state agencies, as well as psychiatrists and psychologists in private practice or associated with secular or faith-related treatment facilities, he noted. Stanford and Brake emphasized the vital importance of making referrals to qualified mental-health professionals, but they also stressed the role of churches in creating a supportive and spiritually nurturing environment for people with mental-health disorders. Mental illness does not illustrate lack of faith, but it does have spiritual effects, they agreed. “Research indicates people with an active faith life who are involved in congregational life get through these problems more smoothly,” Brake said.
Churches cannot “fix” people with mental illness, but they can offer support to help them cope. “The church has a tremendous role to play. Research shows the benefits of a religious social support system,” Stanford said. They stressed the importance of creating a climate of unconditional love and acceptance for mentally ill people in church — a need Grondin echoed. “There needs to be an unconditional sense of community and relationships,” she said. She emphasized the importance of establishing relationships that may not be reciprocally satisfying all the time.
People with mental-health issues may not be as responsive or appreciative as some Christians would like them to be, she noted. “Others need to take the initiative and keep the relationship established. People don’t realize how hard it can be (for a person with a mood disorder) to summon the courage just to get out of bed,” Grondin said. Christians who seek to reach out to people with mental illness need to recognize “they are not able to see things clearly, and it’s not their fault,” Grondin added.
Mostly, Christians need to offer acceptance to people with mental illness — even if they don’t fully understand, she insisted. “Just be present. Offer support and love,” Grondin concluded. “You won’t always know what to say. Just speak words of support into a life of serious struggles. That means more than anything.”
(EDITOR’S NOTE — Camp is managing editor of the Texas Baptist Standard.)
A great book:
“Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness” [Paperback] can be found at www.Amazon.com, by Matthew S. Stanford Ph.D
For more information: National Alliance on Mental Illness (800) 950-6264 Anxiety Disorders Association of America (240) 485-1001 Depression & Bipolar Support Alliance (800) 826-3632 American Association of Christian Counselors (800) 526-8673 Stephen Ministries (314) 428-2600