In this age of widely available, easily accessible information, learning about brain related disorders, such as schizophrenia, are just a couple of mouse clicks and Google search away. Unfortunately, these terms also often get colloquially re-clothed into different definitions. And many of these definitions are flat-out wrong. The term “psycho”, for example, has become so grossly misused to define any relatively strange character trait, that it is now a cringe worthy cliche. Just ask your any of your single friends if they have ever dated a “psycho” — the overuse of the word is astounding, in my opinion.
The same goes with the term schizophrenia. In everyday speak, it is often conflated with being confused, out of sorts, having diametrically opposed thoughts, or the feeling of having multiple competing “personalities”.
So, let’s get the definition down: Schizophrenia is a disorder that affects how a person sees reality. Thoughts turn into delusions or hallucinations; behaviors include becoming socially isolated, less emotionally expressive (or almost completely devoid of emotion), and much less willing to talk/communicate.
To explore further the characteristics of schizophrenia, symptoms are separated into three categories: positive, negative, and cognitive. Hallucinations and delusions are positive symptoms; social isolation and lack of emotional expressiveness are negative; lack of attention span and severely disjointed thinking are cognitive.
What causes schizophrenia is linked to several different hypotheses. Here are a few of the more common hypotheses:
Dopamine hypothesis: Hyper-stimulating dopamine production, particularly at the D2 receptor, may cause schizophrenia symptoms.
Gene / hereditary hypothesis; Although a child may inherit genes that could predispose schizophrenia, it can still be a biological “coin toss” of whether the child will actually develop schizophrenia. Some studies have revealed a link to paternal age and the likelihood that a child will become schizophrenic. In addition, cell mutations and epigenetic triggers have also been linked to schizophrenia.
Neurological hypothesis: Damage or abnormal function within the prefrontal cortex appears to have a strong link to schizophrenia. For instance, studies show that a larger than normal lateral ventricle, decrease in gray matter within the temporal cortex, and dramatic decrease in brain tissue can significantly increase the chances of developing schizophrenia.
That said, considering that there is not just one, smoking gun cause for schizophrenia, then how exactly is it treated?
From early generation dopamine blockers such as chlorpromazine, to later developed medications such as aripiprazole and risperidone, drug therapies for treating schizophrenia are split into two main categories: typical antipsychotics (First Generation) and atypical antipsychotics (Second Generation).
Chlorpromazine is considered First Generation (or FGA); aprirpazole and risperadone are second generation (SGA). Other drug options are available in each of the categories and come with their own risk-to-benefit ratio of side-effects, as well as to what degree they treat positive, negative, and cognitive symptoms.
Environmental and sociological factors also play a part in individuals who suffer from schizophrenia. One remarkable angle to these factors involves how various cultures are structured. For instance, studies have shown that in cultures with a strong sense of community, symptoms of schizophrenia tend to be more manageable than in cultures that are more industrially developed and heavily individualistic. In other words, despite the biological factors that can trigger schizophrenia, a strong support system can be highly valuable,
Benson, K., Zarcone, V. (2005). Etiology of Schizophrenia. Retrieved from https://www.sciencedirect.com/topics/neuroscience/etiology-of-schizophrenia
Patel, K., Cherlan, J., Gohil, K., Atikinson, D. (2014). Schizophrenia: Overview and Treatment Options. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/
PsychVisit. (2020). Psychological and Social Factors Associated with Schizophrenia. Retrieved from http://www.psychvisit.com/conditions/schizophrenia/4-causes-schizophrenia/4-06-psychological-social-schizophrenia.html