Schizophrenia
By Ed Wilcock, LMSW-ACP, LCDC
Is schizophrenia really split personalities? When a friend with very little exposure to mental health issues asked me this sort of technical question last week, I was taken a little off-guard. It caused me to remember how complex it can be to understand mental illnesses.
There are several categories of mental illnesses, the most common being mood disorders, like depression and anxiety. Other categories include developmental disorders, mental retardation, personality disorders, such as antisocial personality disorder and borderline personality disorder; and thought disorders. Schizophrenia is a disorder of thought that is diagnosed in 4-5 million Americans.
The onset of schizophrenia typically occurs between the late teens and mid-thirties. Onset prior to adolescence is rare, though some cases as early as five or six years of age have been reported. No laboratory findings have been identified that are diagnostic of schizophrenia. However, with new neuroimaging technology, it has become clear that there are both physical and chemical differences in the brains of people with schizophrenia. It has also been discovered that first degree biological relatives of people who have schizophrenia are at ten times the risk of having the disease than the general population, which suggests that heredity is involved.
Schizophrenia tends to be chronic, lasting at least six months, and in many cases, a lifetime. Such issues as poor parenting or drug and alcohol abuse have been ruled out as causes of the disease. In my opinion the misperception that schizophrenia is split personality comes from the often sudden and dramatic onset that changes the person’s behavior. Changes in the brain can cause a person to have hallucinations, delusions and paranoia. A person with schizophrenia often hears voices and may feel like the world is “out to get” them. Delusions about the government and/or religion are common and can cause a total misperception of reality. Bizarre behaviors and social isolation are common symptoms of the disease, and suicide may become a major concern. Approximately 10% of people with schizophrenia commit suicide and 20-40% make at least one attempt over the course of the illness.
In the last ten years, great breakthroughs in the treatment of schizophrenia have occurred, because of what are called new generation antipsychotic medications. These medications have allowed many people to avoid highly expensive and confining hospitalizations. The new medications are not only effective, they cause significantly fewer and lighter side effects than did the older medications, such as Thorazine.
However, new generation antipsychotic medications are expensive, often costing as much as $600-800 per month. The Betty Hardwick Center (BHC), whose annual budget falls just short of $12 million, currently purchases about $1 million dollars of patient medications in a year. In addition, the major drug manufacturers donate about $800,000 in medications through the Patient Assistance Program, but more funding is needed to shorten waiting lists and assure services to people who desperately need them. In fiscal year 2005, the Betty Hardwick Center served 3,014 people, of which 435 had schizophrenia and related disorders.
With proper treatment and good support, individuals with schizophrenia can lead normal lives. People who would have been considered disabled 10-15 years ago, are now capable of living and working in the community.
Peer support is very helpful in combating the isolation that schizophrenia can cause. Two local support groups that help provide peer support are Advocates of Abilene and Schizophrenics Anonymous. Anyone interested in learning about meeting times for these groups may call 673-2300.
Ed Wilcox is the director of Child and Adolescent Mental Health Services at the Betty Hardwick Center. Mental Health Matters is sponsored by the Mental Health Association, phone (325) 673-2300, e-mail mhaa@bitstreet.com. Need help? Call the Hope Line (325) 677-7773.