Do you also feel like this world is not real? Let's talk about schizophrenia

Have you, or someone you know, ever felt confused about whether the things you think and hear are real or not? Sometimes you may feel as if you are in a different world, experiencing and feeling things that others cannot understand. That is the kind of mental disorder we are going to talk about today , schizophrenia . Although this may seem a bit complicated, let's keep it simple.

What is this schizophrenic -emotional disorder?

Simply put, schizophrenia is a serious mental illness that affects both your mind and body. It disrupts the way your brain works. This means that your thoughts, memory, sensations (feelings), and behavior can become distorted. This can make it difficult for you to function in many areas of your daily life. If left untreated, the condition can affect everything from your job to your social relationships and romantic relationships. You may also be unable to organize your thoughts and may behave in ways that could lead to harm or other health problems.

Are there types of schizophrenia ?

In the past, psychiatrists talked about different types of schizophrenia . For example, ``Paranoid Schizophrenia`` (the type where you are suspicious of everything and feel like someone is against you) and ``Catatonic Schizophrenia`` (the type where you keep your body in one position or move around excessively). However, these classifications were not really useful for accurately diagnosing the disease or choosing the right treatment for it.

Therefore, experts now view it as a condition with different aspects and levels of the same illness. Just as a rainbow has many colors that are related to each other, it is considered a ``spectrum``. Here are some conditions that fall into this ``Schizophrenia spectrum``:

• `(Schizotypal personality disorder)` (This also falls under the category of personality disorders)
• `(Delusional disorder)` (the presence of many delusions)
• `(Brief psychotic disorder)` (Short-term mental confusion)
• `(Schizophreniform disorder)` (Symptoms similar to schizophrenia , but of shorter duration)
• `(Schizoaffective disorder)` (a condition characterized by mood swings along with schizoaffective symptoms)
• Other specified or unspecified schizoaffective spectrum disorders. These allow doctors to identify unusual types of schizoaffective disorder that are not usually seen.

Who is most affected by this situation?

Schizophrenia usually begins between the ages of 15 and 25 in men and between the ages of 25 and 35 in women. About 20% of newly diagnosed cases are over the age of 45. When it occurs at this age, it affects men more than women.

It is very rare for children to develop schizophrenia , but it is not impossible. If the condition begins in childhood, it can usually be more severe and more difficult to treat.

How common is schizophrenia ?

This is a fairly common condition. Worldwide, it affects about 221 people per 100,000.

What are the five main symptoms of schizophrenia ?

Often, people with schizophrenia don't realize they have these symptoms. But those around you, your family, and friends, can notice these changes. Here are the five main symptoms of schizophrenia :

1. Delusions: These are false beliefs that you have in your mind that cannot be proven wrong, no matter how much evidence you have. For example, you might think that someone is controlling what you think, say, or do. Or, you might think that someone is conspiring against you or trying to harm you. Maybe you think that you have special powers or that you are very famous.

2. Hallucinations: A condition where you see, hear, feel, smell, or taste things that are not there. The most common is hearing voices that are not there. These voices may speak to you, criticize you for what you are doing, or even give you orders.

3. Disorganized or incoherent speaking: You may have difficulty keeping your thoughts organized when speaking. This may mean that you have difficulty staying on topic, or your thoughts may be so jumbled that others may not understand what you are saying. You may sometimes be unable to put your words together and may speak in a way that makes no sense.

4. Disorganized or unusual movements: Your movements and behaviors may be different from what others expect. For example, you may spin around in one place for no apparent reason, or suddenly become frozen in place without moving at all. You may also hold strange postures.

5. Negative symptoms: This refers to a decrease or loss of your ability to perform as expected. For example, you may show no emotion on your face, or you may speak in a monotone tone that is devoid of emotion.This includes a loss of interest in anything, especially being social, and generally losing interest in doing things you enjoy. You may also lose interest in keeping clean and taking care of your appearance.

Due to these symptoms, you may also experience things like:

• Being suspicious and afraid of everything.
• Not caring about one's cleanliness and appearance.
• Depression, anxiety, and suicidal thoughts may occur.
• You may be tempted to abuse alcohol, nicotine, prescription medications, or other drugs in an attempt to relieve these symptoms.

What are the causes of schizophrenia ?

Schizophrenia has no single cause. Experts believe that it is caused by a combination of factors. Three main causes have been identified:

• Imbalances in the chemical signals used to communicate between your brain cells.
• Problems with brain development before birth.
• The loss of connections between different parts of the brain.

What are the risk factors for schizophrenia ?

Although the exact causes of this have not yet been confirmed, there are several factors that increase the risk of developing this condition:

• Environment: Many factors in your environment can increase your risk of developing schizophrenia . Being born in the winter increases your risk slightly. Some diseases that affect the brain, such as infections and autoimmune diseases (conditions where your own immune system attacks parts of your body), can also increase your risk. Being under a lot of stress for a long time can also contribute to this.
• Developmental and birth factors: The way you develop in the womb can also affect your risk of schizophrenia . If your mother had gestational diabetes, preeclampsia, malnutrition, or vitamin D deficiency during pregnancy, you may be at higher risk of developing schizophrenia . You may also be at higher risk if you were born with a low birth weight or had complications during birth (such as an emergency cesarean section).
• Drug use: Some drug use, especially in high doses and at a young age, has been linked to schizophrenia . The link between heavy cannabis use in young people, especially teenagers, and the condition has been well-studied. But experts are still not sure whether cannabis use is linked to schizophrenia.Is it a direct cause, or is it just a contributing factor?

Is schizophrenia genetic?

Experts have yet to find a single, definitive cause for schizophrenia , so it's not clear whether it's caused by genetics. However, if someone in your family, especially a parent or sibling, has schizophrenia , you're at a much higher risk of developing the condition.

How is schizophrenia diagnosed?

Your (or your loved one's) doctor can diagnose schizophrenia or a related disorder by asking questions, describing your symptoms, and observing your behavior. He or she will also ask questions to look for other possible causes of your symptoms. Then, they will compare those findings with the criteria for a diagnosis of schizophrenia .

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of schizoaffective disorder requires:

• At least two of the five main symptoms we talked about must be present.
• You must have had these symptoms for at least a month .
• Your symptoms must have affected your work or your relationships (friends, romantic, professional, or other) .

What tests are done to diagnose this condition?

There are no specific diagnostic tests for schizophrenia . However, before diagnosing schizophrenia , doctors may do some tests to rule out other conditions. The most common types of tests are:

• Imaging tests: Doctors usually use imaging tests, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan, to rule out problems such as stroke, brain injury, brain tumors, or other changes in brain structure.
• Blood, urine, and spinal fluid (spinal tap) tests: These tests look for chemical changes in your body fluids to look for things that could be causing your behavior changes. These can rule out things like heavy metal poisoning, other causes of poisoning, and infections.
• Brain function testing: An electroencephalogram (EEG) test detects and records the electrical activity of your brain. This test can help rule out conditions such as epilepsy.

Can schizophrenia be cured?

Schizophrenia cannot be completely cured.But this is often a treatable condition. A very small percentage of people can recover completely from schizophrenia . But it's not a cure, because there's no way to tell who will relapse and who won't. That's why experts consider people who recover from this condition to be "in remission."

How is schizophrenia treated?

Treatment for schizophrenia usually involves a combination of medications, psychotherapy, and self-management techniques. These include:

• First- and second-generation antipsychotics: Drugs like Haloperidol - Haldol®, Aripiprazole - Abilify®, Aristada®, Olanzapine - Zyprexa®, Lyablvi®, Symbyax®, and Quetiapine - Seroquel® work by blocking the action of certain chemicals (neurotransmitters) that your brain uses to send messages between cells. However, these can cause side effects such as drowsiness, weight gain, and tremors.
• Next-generation antipsychotics: The FDA recently approved a new class of antipsychotic drugs called Xanomeline and trospium chloride (Cobenfy™). This class of antipsychotic drugs works on cholinergic receptors instead of dopamine receptors. In clinical trials, this new treatment has been shown to reduce symptoms of schizophrenia and has different side effects. Side effects include nausea, stomach upset, urinary retention, increased heart rate, and constipation.
• Psychotherapy: Talking therapies such as Cognitive Behavioral Therapy (CBT) can help you cope with and manage the condition. Long -term treatment can also help with secondary problems such as anxiety, depression, or substance abuse that may accompany schizophrenia .
• Electroconvulsive Therapy (ECT): If other treatments have not worked, your doctor may recommend ECT. This treatment sends an electric current to your scalp, which stimulates parts of your brain. This stimulation causes a brief seizure-like state, which can help improve brain function in people with severe depression or anxiety. If you have ECT, you will be given anesthesia. So you will be asleep during the procedure and will not feel any pain.

How soon will I feel better after treatment?

Your doctor is the best person to tell you how long it will take for you to feel better with medications and treatments. Different medications take different amounts of time to work. Your doctor can also talk to you about other treatment options that may help if your first treatment doesn't work.

What can I expect if I have this condition?

Schizophrenia is a condition that varies greatly from person to person. You may have difficulty with things like work, relationships, and taking care of yourself. But with treatment, you can work, take care of yourself, and have happy relationships.

This condition often has a cyclical effect. This means that there may be periods when the disease flares up and your symptoms become very bad. Then there may be periods when your symptoms improve a little, but not completely.

No matter how serious this condition is, don't forget that with treatment you can live with it and minimize its impact on your life.

What is the outlook for this situation?

Schizophrenia is not a fatal illness. But its effects can lead to dangerous or harmful behaviors. About a third of people with schizophrenia experience worsening symptoms over time. This may be because your symptoms do not respond to treatment, or because you find it difficult to follow a treatment plan well enough to manage your condition. About 10% of people with schizophrenia die by suicide.

Others respond well to treatment, but they may have periods when symptoms return and get worse. They may also have ongoing problems, such as difficulty concentrating and thinking, due to the effects of the pre-existing condition.

How can I reduce my risk, or prevent this?

Because experts still don't know exactly why schizophrenia develops, it is impossible to prevent it or reduce the risk of developing it.

How do I take care of myself?

If you have schizophrenia , you should do these things to take care of yourself and manage your condition:

• Take your medications as prescribed: The most important thing you can do is take your medications correctly. If you have schizophrenia , don't stop taking your medications without talking to your doctor. Talk to your doctor about any problems or side effects you're having, and choose a medication that works for you and has the fewest or no side effects.
• See your doctor as recommended: Your doctor will set up a schedule for you to see them. These appointments are very important for managing your condition.
• Don't ignore symptoms:If you are diagnosed and seek medical treatment early, you are more likely to respond well to treatment and have good outcomes.
• Avoid alcohol and drug use: Alcohol and drug use can worsen the symptoms of schizophrenia and cause other problems. This includes using prescription medications in ways other than recommended.
• Consider getting support: You can get helpful resources and information from organizations like the National Alliance on Mental Illness. There are places in Sri Lanka that provide similar services, so check them out.

When should I see my doctor?

You should see your doctor as prescribed. Also, if you notice a change in your symptoms, for example, if your symptoms get worse even when you take your medication, you should see your doctor. If the side effects of your medication are interfering with your life, you can also tell your doctor about it. Your doctor can sometimes treat your condition better, and can recommend alternative medications or treatments that do not have side effects.

When should I go to the Emergency Department (ETU) ?

If you have thoughts of harming yourself or others, call the National Mental Health Helpline at 1926 immediately. If you feel that you are about to harm yourself, go to the nearest hospital emergency department immediately, or call the Suwaseriya Ambulance Service at 1990.

What can I do if my loved one is showing symptoms of schizophrenia ?

If you think your loved one is showing signs of schizophrenia or a related condition, you can try to help in these ways:

• Ask how you can help: Listening to them, offering your help, keeping the lines of communication open with them, and helping them feel connected to others.
• Encourage them to find someone who can help: Schizophrenia-related mood disorders, especially medication, can improve a person's symptoms and help them understand what is real and what is not.
• Don't judge or argue: Even if there is evidence, don't judge them or argue with them about what is true or not. People who experience hallucinations or superstitions usually don't respond to evidence because they can't figure out what is true or not.
• Stay calm:If they are upset or angry, don't raise your voice. Try to make your surroundings as calm and quiet as possible. Also, make sure they don't feel trapped or threatened in any way.
• Get help in an emergency: People with schizophrenia are at high risk of suicide. If they talk about thinking about harming themselves or others, seek help immediately (e.g. call 911, take them to a hospital).

Finally, what to remember

Schizophrenia can be a frightening condition for both you and your loved ones. But despite the misconceptions that society has, it is not a condition that is impossible to recover from, to live a happy, fulfilling life. If you think you have symptoms of schizophrenia , it is important to talk to a doctor as soon as possible. Their job is to help you. Doctors, especially those who have specialized training in mental illnesses like schizophrenia , are trained to help you feel less judged, embarrassed, or embarrassed.

If you think your loved one may be suffering from psychosis or schizoaffective disorder, encourage them to seek treatment in a gentle, supportive manner. Early diagnosis and treatment can make a big difference in their recovery and management of this condition.

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