SCHIZOPHRENIA

Schizophrenia is often looked at as the crazy mental disease. People with schizophrenia are seen as having split personalities. People with schizophrenia are often violent and dangerous. People with schizophrenia will never get better. These are just some of the myths that are placed on people who have the mental disorder known as schizophrenia. Today, more than two million Americans deal with the mental illness of schizophrenia. With the media portraying schizophrenics as reckless, crazy, untreatable animals there is no wonder why people who suffer from schizophrenia are looked down upon and judged. In this paper, I will discuss the history, development, treatment, and dispel some myths about schizophrenia. What is schizophrenia? Schizophrenia is a complex mental disorder that makes it difficult to tell the difference between real and unreal experiences, think logically, have normal emotional responses, and behave normally in social situations. While the latter three can be associated with bi-polar disorder as well, people often associate the real and unreal experiences with schizophrenia. There are three different onsets of schizophrenia: childhood onset schizophrenia (before the age of 13) and adolescent onset schizophrenia (between 13 and 18 years of age) and adult onset schizophrenia (over the age of 18). There are also different types of schizophrenia. The most common types of schizophrenia are paranoia schizophrenia, disorganized schizophrenia, catatonic schizophrenia, residual schizophrenia, and undifferentiated schizophrenia. Each type comes with its own characteristics and treatment may vary. Paranoia Schizophrenia, according to the National Library of Medicine, may have the delusion that one or more people are plotting against them or their loved ones. It is difficult or

SCHIZOPHRENIA

impossible for others to convince them that they are not the target of a plot. People with this condition may spend a lot of time thinking about how to protect themselves from the person or people they believe are trying to harm them. Other symptoms may include becoming socially isolated, feeling tense or suspicious, and auditory hallucinations. This type of schizophrenia does not include disorganized speech or thoughts that come along with other types of schizophrenia. Disorganized schizophrenia is the type of schizophrenia where behavior is disturbed and has no meaning. The onset of disorganized schizophrenia usually happens before the age of 25. According to Weiss (2008), the symptoms of disorganized schizophrenia include active behavior but in an aimless and non constructive way, bizarre and inappropriate emotional response, difficulty feeling pleasure, delusions, lack of motivation, hallucinations, strange or silly behavior, and speech that doesnt make any sense. Most of these symptoms are seen in other types of schizophrenia. However, the main difference is there are a lot of strange and aimless behavior and speech that often doesnt make sense. The next type is catatonic schizophrenia. This type of schizophrenia, according to CNN Health, includes episodes of behavior at extreme opposite ends of the spectrum. You may seem like you're in coma-like daze unable to speak, move or respond or you may talk and behave in a bizarre, hyperactive way. Catatonic episodes may last for a month or longer without treatment. Symptoms of catatonic schizophrenia include physical immobility or excessive mobility, extreme resistance, peculiar movement, and mimicking movement or speech. Catatonic schizophrenia is much rarer today because of the advance treatments made for schizophrenia.

SCHIZOPHRENIA

Having catatonic schizophrenia is more likely to occur with other health issues such as certain dementias and Parkinsons diseases. Next is residual schizophrenia. Residual schizophrenia is defined as someone who has a serious psychotic episode. However, after the psychotic episode has passed, the person doesnt have schizophrenia. All of the symptoms from disorganized and paranoia schizophrenia apply. These psychotic episodes come in waves. Without treatment the psychotic episodes can happen more frequently. Finally, there is undifferentiated schizophrenia. This type of schizophrenia is when a person meets many of the symptoms, but does not fully or clearly fit one of the other types of schizophrenia. However, the symptoms may be as extreme as catatonic schizophrenia or slight hallucinations. The person diagnosed with undifferentiated schizophrenia must display two or more symptoms of schizophrenia. Treatment for Schizophrenia Treatment for schizophrenia has come a long way since the 1800s. Today, for treatment of schizophrenia, we have more humane ways of treating this mental illness. Before these more humane treatments were initiated, there were a few that were not so great. 1. Trepanation: According to the International Trepanation Advocacy Group the earliest surgeries man ever performed were called trepanations or boring holes in the skull with saws, picks, manual drills, or axes to cure headaches, treat mental illnesses, and bring about enlightenment. People living in prehistoric periods believed that evil spirits inside

SCHIZOPHRENIA

the body caused illness and that drilling a hole into the person's skull would release the evil spirits, thereby curing them. ITAG goes on to explain that 70% of trepanations were successful in the early 1800s. Some skulls even had more than one hole in them which shows that multiple trepanations were performed and successful. Today, scientists have seen no scientific or medical use for trepanation and therefore dont see it as a necessity. People can choose to have the procedure done if they want but finding a medical center is tricky and the cost is simply outrageous. 2. Asylums: Before 1844, the mentally ill were stashed away in prisons and the basements of public buildings. It wasnt until the middle of the 19th century that a woman named Dorothea Dix pushed to improve the quality of housing for the mental illness. Before then, mental asylums were places where the mentally ill were tortured and experimented on. Some of the methods of torture included forced induced vomiting. Terror, electroshock therapy at high voltages, and bloodletting (draining a persons blood by 4/5ths). The father of asylum torture programs in the United States was Dr. Benjamin Rush (who also signed the Declaration of Independence). Dr. Rush advocated and practiced terror by designing and using the straitjacket and the tranquilizer chair. The tranquilizer chair was introduced by Dr. Rush in 1811. The chair confined the patient from their every move. The chair was to control the flow of blood toward the brain and, by reducing muscular action or reducing motor activity, reduced the strength and rate of the pulse. The chair did no harm or good. Famous insane asylums include the former State Lunatic Hospital at Danvers (Danvers State Hospital). Danvers is believed to be the place where lobotomies were started. It housed 2,300 patients during its peak in the

SCHIZOPHRENIA

1940s. Next is the Long Island Pilgrim Psychiatric Center. The PPC was the biggest insane asylum housing 14,000 patients during its peak in the 1950s. In addition to lobotomies and electroshock therapy, doctors at Pilgrim violently induced patients into comas using large doses of insulin. Finally, the worst asylum of them all was located in London and was called the Bethlehem Royal Hospital. This place not only did lobotomies, electro shock therapy, and trepanations but they also performed castrations. In 1961, when the inhumane procedure was banned, there were over 4,000 people who were deemed sterile. In the early 1800s, the asylum allowed patrons to pay a penny to see the horrible acts that were happening to the patients and were even allowed to poke long sticks at them while the patients were tied up in cages. The Bethlehem Royal hospital was so bad that the word bedlam is derived from its name. 3. Electroshock Therapy: According the National Mental Health Association (2012), ECT is a procedure in which a brief application of electric stimulus is used to produce a generalized seizure. In the U.S. during the 1940s and 1950s, the treatment was administered mostly to people with severe mental illnesses. Even though ECT is now regulated, during the misunderstanding of mental illness, it was used excessively. 4. Oral medications: Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications. Antipsychotic medications have been available since the mid-1950's. The older types are called conventional or "typical" antipsychotics. Some of the more commonly used typical medications include: A) Chlorpromazine (Thorazine) B) Haloperidol (Haldol) C)Perphenazine (Etrafon, Trilafon) and D) Fluphenazine (Prolixin).

SCHIZOPHRENIA

In the 1990's, new antipsychotic medications were developed. These new medications are called second generation, or "atypical" antipsychotics. These medications include: A)Risperidone (Risperdal) B)Olanzapine (Zyprexa) C)Quetiapine (Seroquel) D)Ziprasidone (Geodon) E)Aripiprazole (Abilify) and F)Paliperidone (Invega).

The healthcare system and schizophrenia

Patients with schizophrenia represent an exposed population with high medical needs that are frequently missed or undertreated. Primary care providers have the potential to reduce health discrepancies experienced by this population and make a significant difference in the overall health of these patients.

Schizophrenia of all types is considered a pre existing condition for health insurance. With President Barack Obamas health care reform, schizophrenics (along with other mental health disorders), would be able to obtain and afford private health insurance. It is also terribly difficult to acquire a reasonable life insurance policy with a mental disorder such as schizophrenia. While the insurance companies are getting it together, there are hundreds of free mental health clinics popping up all over the country. In Philadelphia, there are currently 35 free medical clinics that have mental health departments. The name of the mental health departments in the free mental health clinics are called the Beck Initiative (Department of Behavioral Health and Intellectual dis-ABILIY Services 2012). According to the DBHIDS (2012) Aaron T. Beck is the founder of cognitive studies at the University of Pennsylvania.

SCHIZOPHRENIA

The Veterans Administration (VA) Hospital has also taken extra steps to address the issues of mental health including schizophrenia. There has been more awareness about mental health since the failure of taking care of the Vietnam War veterans. The VA now has a behavioral health department in each hospital. There are also 24/7 online chat and phone chat for those who have episodes or problems and cant get a VA hospital. These services are available to family, friends, current active and reserve members, as well as veterans. When the Iraq and Afghanistan troops started to come home, there was a serious outbreak of mental illnesses including schizophrenic activity and post traumatic stress disorder. Now more than ever, the VA has been more prepared and understanding of the mental health issues that are returning home.

Famous People with Schizophrenia

There are a lot of famous names that suffer from schizophrenia. Here are just a few names: 1. Megan Fox -Model/Actress from the film Transformers 2. Peter Green- Fleetwood Mac founder and guitarist 3. Vincent van Gogh- Infamous painter 4. Nathaniel Ayer Cello player depicted in (The soloist) a film about a man who dropped out of Julliard. 5. John Nash- Professor of mathematics, and Nobel Prize winner, also depicted in the film, Beautiful Mind.

The Media and Schizophrenia

SCHIZOPHRENIA

While researching how the media portrays mental illnesses, I only thought about movies and television shows. The news media never crossed my mind until I read an article from the Canadian Journal of Psychiatry. The article speaks about a study that was publish that stated 6 out of 23 schizophrenic patients carry a weapon during an episode at this particular clinic. The very next day after this study was released, the local newspaper called the Sunday Express (2006) ran an article titled Armed and Dangerous: Public at Risk as Mental Patients Escape the Care Net. The journalist extrapolated that in this particular community, all 1250 schizophrenic patients were running around trying to hurt or kill everyone in their paths. The article goes on to state that Although the printed news is not the most significant source of violent stereotypes (television and movies are), it belongs to a larger media communication process that reflects and reinforces social stereotypes painting people with mental illness as violent and unpredictable. There is no question that the mentally ill has caught a bad rap in the news media in the last couple of decades. In the wake of the Columbine shootings, there were three theories that circulated the media as to why this shooting happened. The first was bullying which today, has come more to the forefront of issues in our schools. The second was the music. The media attacked musician Marilyn Manson reporting that his music was the cause of the deadly massacre. And finally, the news media reported that the shooters (Eric Harris and Dylan Klebod) had severe depression and undifferentiated schizophrenia. The mental illnesses of these two boys were played up the most (next to gun control). Another event that schizophrenia was blamed for was the 2007 shooting at Virginia Polytechnic Institute and State University. The shooter, 23 year old Seung Hui Cho, was diagnosed with schizophrenia. He was allegedly on schizophrenia medication at the time of the shooting. Even with all the other issues that these three young men

SCHIZOPHRENIA

10

had, the first thing that comes to the medias attention is the mental illnesses that these boys had. This type of attention can lead the public to believe that those with mental illnesses are ticking time bombs waiting to explode. When a gunman ran into an Arizona mall and shot and killed six people and injured 14 others including U.S. Representative Gabby Giffords, the name calling of the gunman began. As described by the National Alliance on Mental Illness Unfortunately, words used by news media and otherspsycho and lunatic to name only two--reinforced the stigma too often associated with mental illness. Lets abandon the stereotypes and the stigmas that distort the nature of mental illness. The news media isnt the only outlet that stigmatizes people with schizophrenia. A man who suffers from schizophrenia goes on a shooting spree in Times Square and later stabs a pregnant physician in the stomach. These are the opening scenes from Wonderland, a drama set in the psychiatric and emergency room units of a New York City hospital. Premiering in 2000, Wonderland was immediately canceled because of low ratings and heavy criticism from mental health groups. The series depicted a bleak life for people with mental illness and groups like the National Alliance on Mental Illness (NAMI) criticized its theme of hopelessness. The show reappeared on television in 2009 only to be canceled again. Movies also depict schizophrenia as a sad but true illness. For example, the movie A Beautiful Mind, depicts John Nash (Nobel Prize winner) as a brilliant, troubled mind with delusional thoughts and severe hallucinations. His delusions and hallucinations began after the United States government asks him to help break Soviet codes. Another movie is Girl, Interrupted which shows the treatment of mental hospitals in the 1950s for a young

SCHIZOPHRENIA

11

schizophrenic girl. Though both of these films were based on true stories about real people, Hollywood still glamorized schizophrenia. Hollywood made it seem as if (for Girl, Interrupted) when you are diagnosed with schizophrenia, you are shipped off to a mental hospital, drugged, and given candy every 10 minutes until you are cured. A Beautiful Mind was glamorized by making its viewers think that everyone with schizophrenia is either extraordinarily intelligent or a gunman that shoots up schools. Both movies were great. However, they both demonstrate the extreme opposites of what a schizophrenic may encounter in their lifetime. There is no movie outside of a documentary that depicts an average day in the life of person living with schizophrenia.

Common Myths about Schizophrenia

These myths about schizophrenia are provided by www.PeopleSayImCrazy.org

1. Myth: People with schizophrenia have "split personalities." This is the perhaps the most pervasive myth about the disease, and it is perpetuated in the news, movies, and television shows. Reality: This is a symptom of a different illness entirely. "Split personalities" or "multiple personalities" are not a symptom of schizophrenia; in fact, these symptoms indicate a different mental illness called Dissociative Identity Disorder. 2. Myth: People with schizophrenia are dangerous. This is also perpetuated in the media and in movies and television shows.

SCHIZOPHRENIA

12

Reality: Some people with schizophrenia may be dangerous, but most are not. Some people with schizophrenia may be prone to violent outbursts, but the vast majority

of people with this disorder tend to withdraw from society when they become symptomatic. 3. Myth: Schizophrenia is caused by child abuse, terrible parenting, or an otherwise horrible childhood.

Reality: Neglect or abuse has not been shown to be an important factor in the development of schizophrenia. As has been stated, there are both genetic (inherited) and environmental factors associated with schizophrenia, and childhood experiences have not been cited as a strong environmental factor.

In conclusion, Schizophrenia is a mental illness that over two million Americans live with everyday. Most people diagnosed with schizophrenia live a normal life with the help of various forms of treatment such as oral medications, psychotherapy, and ECT. The medical community still doesnt know what causes schizophrenia however; it is closely linked to heredity. Insurance companies consider schizophrenia a pre-existing condition and it is terribly difficult to get life insurance with this mental illness. With ObamaCare going to the Supreme Court, having a pre-existing condition such as schizophrenia wont prohibit getting the proper insurance and treatment. Until then, there are free programs that help individuals and families dealing with mental

SCHIZOPHRENIA

13

illnesses. The media still portrays mental illnesses such as schizophrenia in a negative way. With the news media, television shows, and movies, putting negative stigmas on mental disorders, its hard for the mass population to understand mental illnesses. And finally, there were a few myths that were dispelled about schizophrenia. In the end, education about mental illnesses is the only way that people will understand what it really means.