Schizophrenia

Working for a social service organization years ago, former Housing Options case manager and counselor Carol McCardell, MSW, LCSW, reacted to an individual with schizophrenia much as would anyone unfamiliar with mental illnesses. “She would come in talking to herself and sometimes she would sign in under a different name. I thought she was weird.” After learning about the illness, McCardell understood that this individual was most likely talking back to the voices she was hearing and that she was probably signing in under a different name due to paranoia.

Director of program services Claire Purkis, agrees that this is a common reaction. “People are often uneducated about schizophrenia. It’s a real chronic medical problem.” People’s ignorance about the disease perpetuates the stigma attached to mental illness, and the effect that has on individuals with mental illnesses is serious.

Forty percent of Housing Options residents cope on a daily basis with the chronic, severe, and disabling disease of the brain known as schizophrenia, or schizoaffective disorder. “I live an interesting life,” one resident comments. “No one really understands psychosis and how debilitating it can be unless they know someone who has had a psychotic episode.”

Schizophrenia affects approximately 2.2 million American adults, or 1.1 percent of the population age 18 and older. The first signs of the disease typically emerge in the teenage years or early twenties. It interferes with a person’s ability to think clearly, to distinguish reality from fantasy, to manage emotions, make decisions, and relate to others. Most people with schizophrenia suffer chronically or episodically throughout their lives.

Science has confirmed that schizophrenia is not caused by bad parenting or personal weakness. A person with schizophrenia does not have a “split personality,” and statistics show that people with schizophrenia are far more likely to be victims of violent crimes than to be violent themselves.

Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different, as a group, from the brains of people without the illness. Like many other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors. Recent research has identified the first genes that appear to increase the risk for schizophrenia. As with cancer and diabetes, the genes only increase the chances of becoming ill and do not cause the illness by themselves.

Current treatment methods include medication, rehabilitation, and individual psychotherapy.

  • Antipsychotic medications do not cure schizophrenia, nor do they ensure that further episodes will not occur, but they do reduce hallucinations and delusions and allow for more effective and appropriate functions. Side effects may occur but can be reduced by changes in dosage.
  • Rehabilitation emphasizes social and vocational counseling, job training, problem-solving and management skills, use of public transportation, and social skills.
  • Individual psychotherapy is a sharing of experiences with a trained professional. It is not a substitute for medication and is most helpful after drug treatments have relived symptoms.

Hospitalization may be required when an individual is experiencing extreme hallucinations and delusions or struggling with suicidal thoughts.Although there is not a cure for schizophrenia, there most certainly is a future for individuals with the illness. Besides treatment, spirit and drive have much to do with an individual’s outcome, says McCardell. “The essence of recovery is to understand that you have this illness but not give up hope to have a satisfying life.” Purkis notes that there has been marked improvement in the outlook for schizophrenic patients, where only a few years ago, the diagnosis was that the disease would get perpetually worse over the years and that long-term care was essential. Now, the mental health system has begun “expecting people to move up and move on,” Purkis says. “It’s not that patients are cured, but they can be fulfilled and contribute.”