A mental disorder characterized by various symptoms such as hallucinations, delusions, among many other symptoms, schizophrenia is often misunderstood or misrepresented. Schizophrenia is commonly mistaken for split personality disorder. This case of mistaken identity is likely because schizophrenia literally means “to split the mind” in Greek. This “split” in the mind simply implies that the mind is disjointed as opposed to multiple personalities.
So just what is schizophrenia? How does it look to observers? Well, like any medical condition schizophrenia is classified by its symptoms. The symptoms of this disorder are most commonly divided into positive and negative symptoms, though depending who you ask there are other categories. Personally, I use three categories for my own explanations, positive, negative, and cognitive. This may seem confusing at first; after all, how can symptoms of something like schizophrenia be positive? Positive symptoms are basically the symptoms that are “added”, while negative symptoms are an absence of certain factors. Cognitive symptoms are simply the ones that revolve around things like thought processes and memory. Confusing, right? Do not worry, this will all get explained in more detail throughout the article.
The presence of positive symptoms often comes in the form of various hallucinations (hearing, seeing, smelling, feeling, and even tasting things that are not real), and delusions which are essentially false beliefs. Hallucinations are one of the hallmarks of the illness, though they are not exclusive to one another. Typically, auditory hallucinations and visual ones are the most common, taking the form of voices and a whole menagerie of figures respectively. The voices many hear due to the illness are often cruel and verbally abusive. It is not uncommon to also have your life narrated or to even be commanded to perform actions by auditory hallucinations.
Visually, hallucinations can range from pleasant to bizarre and even downright terrifying in appearance. For instance, there was a period of time in my life where my wife would consistently see a young woman that strongly resembled something out of a horror movie. As a result, for the longest time she avoided the basement and any dark rooms. The point to keep at the front of your mind is that from the perspective of those who experience these symptoms, they appear real. For many people with schizophrenia, there is no telltale difference between what is real and what is not. If your worst fears seemed as real as everything else around you, would you not be terrified? I sure as hell would be. On that note, onto the next point, delusions.
These beliefs can be just as varied, numerous, and terrifying as the hallucinations. Typically, delusions are referred to as delusions of paranoia, grandeur, control, or reference. Paranoid delusions are pretty straight forward, they are the belief that people are out to harm or persecute you. Examples could include feeling like somebody has poisoned your food, or that the government is after you. Delusions of grandeur are characterized by believing that you are famous, rich, or powerful. For instance, some people with the illness believe they are religious figureheads such as the Pope or Jesus. When somebody believes that somebody or something else can control their thoughts and behavior that is referred to as delusions of control. Delusions of reference are when somebody feels that somebody is trying to communicate or send a message directly to the individual. For example, believing that people are sending you messages through the radio. While there are other types of delusions, these four should cover a large swathe.
While there are other types of positive symptoms, hallucinations and delusions are two of the more predominant ones. Now that we have that covered, lets move on, shall we?
As stated earlier this category is determined by the absence or lack of certain characteristics. These can include a lack of emotional expression of the face (also known as having a flat or blunt affect), a noticeable decrease in the ability to feel pleasure or joy (known as anhedonia), apathy, and alogia or poverty of speech.
Flat affect is likely one of the most obvious negative symptoms. Simply put, there is a distinct lack of emotion in facial expression, almost a blank or empty expression. To be clear, this does not necessarily mean that somebody with the illness does not feel the emotions, it simply means that it is not expressed through body language.
Anhedonia is undoubtedly one of the most distressing negative symptoms. Activities that once brought happiness or satisfaction, now give nothing or very little in terms of emotional reward. This can be particularly frustrating when attempting to find relief in once loved past times. While there may be a lack of satisfaction, many people with the illness are acutely and painfully aware of this absence in their lives.
Apathy typically presents itself through being unmotivated or easily fatigued. Daily tasks such as personal hygiene often suffer as a result.
Poverty of speech can occasionally be frustrating for those around the person with schizophrenia as it may seem like they are not interested, or that the conversation is one sided. It is important to note that just because somebody with the illness is not vocal, does not mean that they do not enjoy the company.
The signs typically classified as negative symptoms are typically more constant and steady as opposed to their positive counterparts. While they may not be as acutely stressful, it is important to understand that for many people, the negative symptoms are more stressful on a day to day basis than some positive symptoms.
Thought processes are the name of the game when it comes to this category. Difficulty concentrating, memory issues, and slowed psychomotor speed make up the bulk of cognitive symptoms. As with negative symptoms, cognitive difficulties are commonly rather constant and steady. Having a challenging time paying attention and concentrating is usually caused due to easily being distracted by one’s thoughts and environment. Memory issues typically present in being forgetful; for instance, forgetting to perform certain actions like brushing your teeth. A slowed psychomotor speed simply put is when it takes longer for somebody to absorb and process information and formulate a response. It should also be noted that many people who have schizophrenia struggle with abstract thinking such as metaphors or certain sayings.
Cognitive symptoms can be considered a part of negative symptoms, though for the sake of ease of use I choose to keep it as a separate group. Although not as acute as positive symptoms, cognitive difficulties can be equally as detrimental and aggravating for the person with the illness.
Hopefully after reading this article you have even a little more information to use in your journey to understand schizophrenia. The symptoms and much of the medical jargon can be extremely confusing to those who are not experienced with it. I hope that this article has helped you, even if only a little. Do not forget, knowledge is power. This is especially true when dealing with any medical condition – do not hesitate to go searching and hunting for more information. There is so much information available that whole books could be devoted to symptoms alone. Be sure to check out the resources section of my blog for other websites that may be of benefit.