Schizophrenia has been with us since time began, but it has only recently been considered a mental illness. Prior to the 19th century schizophrenia has been misunderstood. It was considered witchcraft during the Middle Ages and criminality in other time periods. People suffering with various disorders such as epilepsy and schizophrenia have been burned at the stake, had holes drilled into their skulls, shot, hanged or been imprisoned, all because the population at the time did not understand mental illness. Today there are currently one to two percent of the population who is afflicted with the disease.

People suffering from schizophrenia may hear voices in their head, they don.t realize the voices are being generated by their brains. They believe other people hear the voices and they are very real. They may see things that are not there, they may believe aliens are sending them telepathic messages, they may feel the CIA is out to get them or they may have delusions of grandeur believing they are the Queen of England or Calvin Klein. These are all classic symptoms of the disorder. They may also feel that people are able to read their minds. They often feel that people are out to harm them. The symptoms are so severe that they become terrified of the outside world, or they are extremely agitated and super vigilant watching everything around them.

There are times that they are very lucid and will appear normal, but often times they are in their own reality and when they talk they do not make any sense. Or they may sit for hours without speaking or moving. They may show inappropriate affect, meaning they will laugh at nothing or cry for no reason, or they may have flat affect whereby they don.t show any emotion at all.

Everyone is affected one way or they other by the horrors of schizophrenia. Families and friends bare the burden of caring for people with schizophrenia. Employees and employers watch as the disease takes it toll. Many schizophrenics can live in the outside world with proper medication and maintain a somewhat normal life while others are so debilitated that they lose their jobs and eventually become so incapacitated that they must be hospitalized. Sometimes a schizophrenic individual will assault someone and then the law is involved until it is determined that the person is suffering from schizophrenia is mentally ill and needs hospitalization.

Fortunately there is treatment available and most people diagnosed with schizophrenia can live normal lives within the community. They can remain with family, live in group homes or in independent living. They can maintain jobs and raise families. Scientists are constantly working to find new medications and new therapies to relieve the symptoms of schizophrenia. They are continuing the research on the causes and therapies for schizophrenia. New medication is being studied and hopefully one day there will be a cure for schizophrenia. There may even be ways to prevent the illness from occurring in the first place. One day the terrible consequences of living with this disease may be a thing of the past.

Positive Symptoms

What constitutes positive symptoms are symptoms that are psychotic; they are not seen in the regular population. These symptoms render a person suffering from schizophrenia out of touch with reality. The symptoms will come and go, and their severity will depend upon if they are getting treatment or not. Treatment will prevent or at least control the symptoms so that they are milder. The positive symptoms of schizophrenia include:

Hallucinations

Hallucinations are things that a person with schizophrenia, sees, hears, smells, or feels when nobody else experiences these things. These symptoms are called psychotic symptoms because they are not part of reality or what is really happening. The most common of these symptoms is hearing voices. These voices might tell the patient to do different things, they might reprimand the patient, or they may warn the patient that there is imminent danger when in reality there is not. These voices might tell the person to kill somebody or they might tell the person that certain people are out to murder him or her. Sometimes there many voices all talking at once.

Hallucinations can also include seeing things that do not exist, and smelling odors that do not exist either. Patients can also feel things crawling on them or feel fingers touching them and yet nobody else can see it. Sometimes when these patients are having these hallucinatory symptoms others can tell and sometimes they cannot.

Delusions

Delusions are false beliefs that are not shared by anyone else, they are not part of the person.s culture, or upbringing, or education. These beliefs can be very bizarre such as seeing cigarettes sailing through the air, or people walking around the park with three heads. These beliefs are so strong that no one can convince them otherwise. They may believe that people such as their neighbors are controlling their thoughts. Sometimes people with schizophrenia hear the voices in their heads and sometimes they hear the TV talking to them telling them different things. They even think that the radio stations are broadcasting their thoughts all over the country.

Delusions of grandeur are when they feel that they can do something which is totally impossible such as not having any formal education and telling everyone that they applied for a job and the interviewer was so impressed they were given the position of CEO. They might also believe that they are some famous person, such as Napoleon or Queen Victoria.

Delusions of persecution are when they feel they are being harmed in some way, someone is out to kill them or poison them, cheating on them, plot against them or hate them and want to do them some harm even though they have not figured out how or what that might be.

Thought Disorder

These symptoms have to do with organizing and communicating thoughts. The patient may have trouble organizing thoughts in a cohesive fashion and they and when spoken they do not make sense. For example they might say, .I walked across the moon, shoelace fell off the dog barked up the man.s nose.. Besides disorganized that they may have garbled words you cannot understand. They might have blocked thoughts where they start to say something and then stop. It occurs when the patient feels that his or her thought has completely been lifted from his or her mind. Finally the person can utter completely nonsense words.

Movement disorders

These movements can be agitated body movements like making the same movement over and over again such as pacing back and forth. They may be completely motionless such as not moving, and with eyes focused on the same spot. This is condition is called catatonia and rarely happens when medication is available.

Negative symptoms

Negative symptoms are not specific to schizophrenia and can be mistaken for symptoms of depression and other mental illness: These symptoms include loss of pleasure in life, flat affect meaning the individual does not show any emotion at all, lack of ability to participate and sustain in activities, and speaking very little. The patients may neglect the most basic things such as hygiene. They do need help to cope with daily activities.

Cognitive dysfunctions

Cognitive dysfunctions are sometimes hard to distinguish as well. They could be very subtle such as not being able to make decisions or comprehend certain things. They may have trouble maintaining focus and paying attention, and they may have problems with short term memory.

Antipsychotic medication has been used for over 60 years. The older medications are called typical antipsychotic medication and they include:

Chlorpromazine, (Thorazine), Haloperidol (Haldol), Perphenazine (Etrafon, Trilafon) Fluphenazine (Prolixin).

Researchers are constantly finding new treatments and new ways to relieve the symptoms of schziophrenia and as a result there is new medication referred to as second generation medications or atypical antipsychotic medications now use since the 1990.s. One of the new medications, clozapine (Clozaril), is effective in controlling hallucinations and the breaks with realilty. As good as this drug is for effectively controlling psychotic symptoms, it has a serious side affective. Clozapine causes a condition called agranulocytosis, where white blood cells are lost. This is serious because it is white blood which are responsible for warding off infection in our bodies. Therefore people using clozipine must constantly (about every two weeks) have blood tests to make sure their white blood cell count is not too low. It can be very costly to have these blood tests done. However, Clozapine is still an important antipsychotic medication that is often used when other drugs do not prove to be effective.

There are other atypical antipsychotic drugs which do not cause the agranuloctoisis side affect. These antipscychotic drugs include: Risperidone (Risperdal), Olazapine (Zyprexa).Quetiapine (Seroquel), Ziprasidoen (Geodon), Aripoprazole (abilify), and Palliperidone (Invega).

Side Affects

Patients are always concerned about side affects and so they should be. If you are a patient do not go off your medication even if you are experiencing side affects. Always talk to your doctor and follow his or her advise. Going off your medication on your own will risk the terrible symptoms coming back and may even cause more side effects by going off the too quickly. Your doctor will decide if you need to go off those medications, or change dosages. or even change medications. Also, sometimes it just takes awhile before the medication takes affect and during the adjustment period there will be side affects. These side affects often wear off in a matter of weeks. Finally, since many medications causes drowsiness, it is important not to drive while adjusting to a new medication. The medication may specifically warns against driving.

The possible side effects from these antipsychotic drugs include: drowsiness, a sudden onset of dizziness when shifting positions, skin rashes, blurred vision, sensitivity to the sun, menstrual problems, and rapid heartbeat.

There are other factors associated with atypical antipsychotic drugs such as weigth gain. Weight gain can also lead to such things as diabetes or it could led to high cholesterol or other metabolic changes in the body. Doctors will routinely check the blood glucose levels, lipids, and their patients. weigth when they are are on atypical antipsychotic medication.

It is not uncommon for atypical antipsychotic medication to affect movement.This could translate to rigidity, restlesness, tremors. and muscles spasms. One of the side affects of taking long term atypical antipsychotics is a condition called tardive dyskinesia. This condition causes uncontrolled muscles movements. The muscle moviements is typically found around the mouth area. Sometimes this condition will cease once the medication is stopped. However, in other patients the condition can be mild or severe and is not curable. The condition is rare, but of course if you feel you may have tardive dyskinesia you must alert your doctor right away.

Antipsychotic drugs can be taken in liquid or pill form and sometimes they are administered by injection. After about six months of taken the drugs patients should feel a lot better and the hallucinations and the delusions should go away.

Sometimes it takes a while to find just the right medication as everyone.s biological makeup is different. Also, it is important to let your doctor know what other medication you may be taking such as minerals, or herbal remedies. There could be some serious reactions to mixing certain substances together with antipsychotic drugs.

There are various therapies such as psychothery, cognitive behavior therapy, family education groups, illness management groups and self help groups that can help patients and their families, learn about, manage, and cope with schizophrenia.

If you feel you have schizophrenia or you have a family member who you believe does and you would like to know where to get help for that person. You can begin by being their advocate to help them get the help they cannot do on their own. You can talk to a doctor, a social worker, a nurse, or call a hospital directly to ask for social services to inquire about where to begin the process of getting help. Hospitals and social service centers may have the sources available to direct you onto the right path to getting help for yourself or for your family member or friend who needs it.

You can try your local yellow pages to see if there are psychiatric services available in your area. You can even speak to your family doctor, or religious leader. Networking is a very useful way of getting information for just about anything, use it to your advantage whenever you have the chance.

Besides local hospitals you can try university psychiatry and psychology departments, some of these university have mental health services that can help you or point you in the right direction for getting help. Try all your mental health clinics in your area, they too might have the services or they can point you in the right direction.

Various communities have hotlines for people who are in need of help. The people running the hotlines may not be professionals but they are trained to deal with people who are having problems and need someone to talk to, a place to stay, or resources to lead them to the care that they require. Don.t assume that a hotline is only to talk someone out of suicide; they are a very important resource in the community for all kinds of mental health and physical conditions. Sometimes they are the only lifeline for a person who is alone and isolated from society.

Depending upon the type of resources you require for yourself or you family member or friend here is a few places where you can begin your search:

Services for mental health and substance abuse in your area:

http://mentalhealth.samhsa.gov/databases/

Medicare and Medicaid programs to help pay for health care

http://www.cms.hhs.gov/MHS/

Affordable Health Care in Your Area

http://www.hrsa.gov/

Clinical Trials . There are currently clinical trials available for schizophrenia and other mental illness, by participating you will help to determine the effectiveness of new drugs and treatments and advance medical research.

More medical resources:

http://www.nlm.nih.gov/medlineplus/mentalhealth.html

Immediate help for crisis intervention

http://www.nimh.nih.gov/health/topics/suicide-prevention/if-you-are-in-crisis-and-need-immediate-help.shtml

The reduction of dosage level actually starts in the acute stage as the symptoms disappear. The goal is to get the patient on the lowest drug level that will maintain and control the schizophrenia. If symptoms reappear during this period the dosages will again be increased until a level dosage can be found that will sustain the individual and control the symptoms. The system is not foolproof, even with controlled supervision over medication the person may experience a relapse and need increased dosages once again. However, relapses are more common when total medication has been discontinued.

Most patients suffering from schizophrenia will benefit from drug medication, others may not respond to medication therapy and some patients who have schizophrenia do not need medication at all. It is difficult to know which patients are going to fall in which category and so it is very important that a person suffering from symptoms of schizophrenia be followed by a psychiatrist to manage the symptoms in a systematic and meaningful way and therefore any issues can be dealt with right away.

Antipsychotic medication has been a proven treatment for over 50 years and will continue to remain in use as new and more effective medications are being developed. Antipsychotic drugs cannot cure the disease, but they help manage the illness and allow the patient to live a normal productive life. The physical make up of each individual is unique and therefore not every medication will work on every patient. Doctors must often try different medication just to find the one that works the best for their patients.

Neuroleptics

The very first drug that was discovered by accident actually, was Thorazine. Afterward different medications such as Navane, Prolxin, Stalazine Trilafon Haldol, and Mellaril were included. These drugs are called neuroleptics because they have known side affects, which affect the nervous system. These drugs do manage the positive symptoms of schizophrenia, which are hallucinations, delusions, thought disorders, loose associations, ambivalence, or emotional lability. These older antipsychotic drugs are not as effective for negative symptoms of schizophrenia such as flat affect or deceased motivation.

The older antipsychotic drugs were called typical antipsychotic drugs and now since 1989, there are new antipsychotic drugs called atypical antipsychotic drugs. These drugs are effective in controlling muscles spasms and tremors, restlessness, or muscle rigidity.

Clorzaril was the first of the brands to be used. It is used when other antipsychotic drugs fail. This drug does have a known side affect where it reduces the white blood cells affecting the immune system. Patients who are currently on Clozaril must have blood tests every two weeks to make sure the white blood cell count does not go down too low.

There are other atypical antipsychotic drugs which include: Seroquel, Risperdal, Geodon and Zyprexa. Most people can live at home and in the community when they are taking these medications.

Many of these medications will have side affects and therefore it is important to report all side affects to your doctor. Sometimes it just takes a change in dose or a change of medication to give you the relief you need. Never stop medication on your own as it can cause a serious relapse and you will be very ill once again.

Normally there are a whole team of mental health specialists to help you in every way. There are psychiatrists, psychologists, counselors, therapists, social workers, maybe even drama therapists or art therapists and music therapists to help you. You may have on the job training specialists and workshops, that teach you occupational and home skills. There may even be a case manager who coordinates the various functions of the team to see you have the proper care you need. Of course the type of treatment you have depends largely on the resources available in your area.

Medications

Medications are the mainstay of treatment for schizophrenia. They do have some side affects which may make you reluctant to take them, but don.t give up. They offer the most effective way to relieve your symptoms at this time. Work with your doctor to find just the right medication for you. You may go through a period of trial and error and then there is an adjustment period for the medication to take affect. It will however, be worth it in the end.

Antipsychotic Drugs

Antipsychotic Drugs work on the seratonin and dopamine, which are neurotransmitters in the brain to bring them back in balance. The first generation of antipsychotic drugs is called conventional, or typical antipsychotic medication. These drugs are very effective to control positive symptoms of schizophrenia such as hallucinations, delusions, and thought disorder. However, they can also cause tardive dyskinesia, which is uncontrolled motor movements, such as spasms, or twitting around the mouth. These medications include: Haloperidol (Haldol), Thioridazine and Fluphenazine. These older medications are also less expensive than the newer drugs. They can often be purchased in generic form.

Atypical antipsychotic medication

These atypical antipsychotic medications are what are called second generation. They are effective in treating both positive symptoms of schizophrenia and negative symptoms such as flat affect or lack of motivation. These atypical antipsychotic medications include: Clozapine (Clozaril), Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Ziprasidone (Geodon), Aripiprazole (Abilify) and Paliperidone (Invega).

Clozapine needs to be monitored, it can cause the reduction of white blood cells and so bloods must be taken every two weeks to make sure that the white blood cells are fine.

Risperidone (Risperdal) is the only drug that is approved as a medication for children with schizophrenia at this time.

The known side affects of atypical antipsychotic drugs are weight gain, high cholesterol, and diabetes.

Sometimes antidepressants and anti anxiety medications are used to treat the symptoms. Everyone is different and will respond differently to treatment. Therefore make sure you work with your doctor to find the right medication for you. You will also want to combine your medication with therapy, which can help you cope with life stressors. You can be part of individual or group counseling. You may be included in a cognitive behavior program or psychotherapy. And you may have family therapy to include everyone who are close to you and interested in your good health. Take advantage of all these services to help you live a normal healthy, happy life.

Doctors will rely upon a personal evaluation, family history, emotional history, and medical history including other diagnosed conditions and presenting symptoms to make their final diagnosis.

Though Schizophrenia can appear very similar to Bipolar I Disorder; the changes in the moods from mania to depression do not follow the Bipolar Disorder pattern. There is also Schizoaffective Disorder, which also looks similar to schizophrenia. In schizophrenia the mania stage (such as hallucinations and delusions) can occur in the early, in the active and in the late stages of the disease whereas in Schizoaffective Disorder they occur during the active stage only. These moods must be present for a good period of time during the episode and they must last for at least two weeks. Schizoaffective Disorder has a better prognosis than schizophrenia but still not as good as for a mood disorder such as Bipolar Disorder.

Brief Psychotic Disorder only requires as little as one symptom of hallucination, delusion, thought disorder or flat affect, but it lasts about one month and then it is over. Therefore the doctor will not diagnosis full blown schizophrenia.

Organic Disorders

Organic disorders are brain disorders. They can resemble the symptoms of schizophrenia. For example, the doctor will rule out encephalitis, which can mimic the hallucinations found in schizophrenia. Encephalitis is caused by a virus, which causes swelling in the brain. Delirium can cause mental confusion, hallucinations, incoherent speech, and disorientation. Delirium can be due to many things such as substance abuse, illness, anxiety, and shock. This condition too must be ruled out.

Drug abuse

Certain illicit drugs can bring on the symptoms of schizophrenia such as hallucinations, delusions, bizarre behavior and babbling. Phencyclidine (PCP) or angel dust can cause negative symptoms of schizophrenia, such as an emotionless stupor. The doctor can take blood tests to determine if the symptoms of schizophrenia are really caused by the ingestion of these drugs. The doctors would also observe the patient at times when he or she has abstained from illegal drug use (most likely in a hospital setting) to see if there is a difference.

Also other mental disorders such as Obsessive Compulsive Disorder, Schizoid Personality and Post Traumatic Stress Disorder can resemble schizophrenia when the patient is exhibiting hallucinations, disorganized behavior, paranoia, and delusional thinking.

The diagnosis for schizophrenia is given according to the criteria set out by the American Psychiatric Association and published in The Diagnostic Statistical Manuel (DSM IV).

In order to meet the criteria:

The person must exhibit at least two of the following conditions: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, or presence of negative symptoms.

There is significant impairment to carry on daily living, school, or work.

The symptoms persist for at least six months

Only one symptom is required if the person is suffering from a persistent voice or voices in their head directing their behavior.

There are also five subsets of schizophrenia: Paranoid: Catatonic, Disorganized, Undifferentiated, and Residual.