Schizophrenia: How to Identify and Treat It

The term "schizophrenia" is well-known to many, even those not working in the mental health field. Schizophrenia is a severe mental disorder, yet for some reason, it is often confused by the general public with another mental disorder—split personality. This confusion likely stems from its Hebrew name, 'shasat.' However, the intention is not that the psyche splits into different identities (split personality is professionally known as 'dissociative identity disorder'), but rather there is a split or lack of coordination between different functions of the psyche. Schizophrenia is not split personality but a mental disorder that impairs a person's ability to understand and interpret reality accurately. It is often accompanied by hallucinations and delusions, causing cognitive and behavioral disturbances.

Schizophrenia is a chronic illness, meaning those who suffer from it will deal with it throughout their lives. It affects about one percent of the world’s population. In Israel, 50% of mental health hospitalizations occur due to schizophrenia. It typically develops from the age of 20, but can appear from adolescence onward. It affects men and women similarly.

It is unclear what causes schizophrenia to erupt. The theory is that it involves a combination of genetic and environmental factors.

There are several main types of schizophrenia recognized in psychiatric medicine. The most common (and also well-known) type is paranoid schizophrenia, characterized by paranoia, suspicion, and hostility towards the environment. The second type is catatonic schizophrenia, characterized by non-responsiveness to external stimuli, as well as lack of movement and activity. The third type is disorganized schizophrenia, primarily characterized by speech disorders, such as disorganized speech.

Some sufferers are aware of their condition, but others are disconnected from reality, living in a sort of parallel reality of their own—hence they do not understand why the environment regards them as different.

How to Identify Schizophrenia?

Schizophrenia has many symptoms. These are typically divided into "positive" symptoms (i.e., abnormal behaviors) and "negative" symptoms (i.e., a decline or decrease in normal behaviors). Additionally, some symptoms are behavioral, some sensory, and others cognitive.

Here are some significant symptoms that can help identify schizophrenia:

• Hallucinations are a very common symptom, with the most known and common hallucination being "hearing voices."
• Delusions—for example, the person thinks they are being persecuted (a common symptom of paranoid schizophrenia), or false beliefs—such as someone suddenly thinking they are the Messiah, for instance.
• Disorganized or incomprehensible behavior (usually resulting from hallucinations or cognitive stimuli unrelated to reality). This may include behaviors such as wearing clothes inappropriate for the weather, unexpected aggression, lack of response to the environment, etc.
• Neglect of personal care.
• Emotional flatness and lack of interest in surroundings.
• Avoidance of social relationships.
• Speech disorders, such as speech that lacks content or form, or speech blockages.
• Lack of motivation.
• Concentration difficulties.
• Memory disturbances.
• Difficulty understanding and interpreting information.

People with schizophrenia often do not recognize the symptoms themselves when they appear. Therefore, it is typically the environment that notices the symptoms and refers the patient for diagnosis and treatment. If multiple symptoms are identified in an individual, they should be referred for diagnosis by a clinical psychiatrist, who can diagnose the disorder and recommend appropriate treatment.

Does each of us suffer from split personality? Really? Rabbi Yitzchak Fanger offers a fascinating lecture. Watch

How to Treat Schizophrenia?

Treatment for schizophrenia is usually carried out through a combined effort of a psychiatrist, family doctor, nurse, social worker, and, if necessary, also a psychologist.

The main part of treatment for schizophrenia involves administering appropriate medications. Treatment involves antipsychotic drugs that balance the secretion of dopamine and serotonin in the brain. These medications are mostly given in pills, but if necessary, they can be given by injection. Several weeks usually pass from the start of treatment until the medications effectively impact the patient. In some cases, alongside antipsychotic medications, there is also a need for treatment with anti-anxiety and antidepressant drugs.

Today, it is possible to tailor the medication precisely to the patient by analyzing their genetic load. Medications are also tailored based on the type of schizophrenia and the specific symptoms the patient exhibits.

Besides medication, there is a need for the psychological support of a social worker, nurse, or psychologist. Such support is usually provided at mental health centers.

Can Schizophrenia Be Cured?

Schizophrenia is a chronic illness, and as of today, there is no real cure for it. However, current medications allow most patients to live as normal a life as possible, sparing them much suffering that plagued them in the past and often eliminating the need for extended and complex hospitalizations.

May we all be blessed with complete health of body and soul.

Rabbi Eyal Unger provides an in-depth explanation of schizophrenia. Watch