For the sake of explanation, think of the brain as a graphic user interface (GUI), such as a web browser, translating a series of 0s and 1s into projections of sight and sound. It is a matter of assembling information into usable patterns. Likewise, the brain, through its sense organs of sight, smell, taste, hearing, and touch, as well as other senses, puts the electromagnetic waves, and slices of time of the real universe into an order that makes sense. Presented on our “screens” are trees, people, music, noise, hot and cold, pain, intuition, cause and effect, and life in general.
Humans are creatures inundated with pareidolia. This refers to the tendency to see patterns and assign meaning to them. It is seeing an elephant in a cloud, white snakes along lines in a paragraph that separates the words, face profiles in the veins of marble, or the man in the Moon. It has been said that pareidolia is a sort of flaw, but on a grander scale, a similar process is probably what creates for us our universe—it is why wavelengths of 650nm are, to us, red; why a sound with a frequency of its peaks at 1 kHz is unpleasant; and why the many different inputs coming at us are seamlessly incorporated into our navigating the world around us. The anatomy of the brain is such that we all pretty much see the universe the same way.
What is schizophrenia?
However, the same cannot be said of schizophrenics, who, in many respects, see a different reality, a different universe even. Their faulty perspective of the world can originate from inside them without any outside influences. (See “Positive symptoms,” below.) If the universe is a biological “construction” of the world interpreted as real, schizophrenics’’ constructions are faulty, making normal functioning impossible. Just as the universe is our own concoction in our own consciousness, the universe of the schizophrenic is just as real and tangible to them. This is why a well-known symptom of schizophrenia is the afflicted hearing voices that are as real as what is heard in actual conversations.
Schizophrenia afflicts 1% of the world’s population and is highly debilitating, and it is ranked by the World Health Organization as one of the top 10 illnesses contributing to the world’s burden of disease.
What are the symptoms of schizophrenia?
- Positive symptoms: This refers to symptoms originating from the schizophrenic mind, not good symptoms. Some of these symptoms include the following:
- Hallucinations: Seeing, hearing, smelling, etc., things that aren’t there.
- Delusions: Believing things that aren’t true.
- Disorganized thinking, speech, and neologisms, which are made-up words.
- Negative symptoms: Some of these include flat affect, immobility, and disinterest. At its worst, a catatonic for the afflicted can be involved. 20% of schizophrenics are primarily affected by negative symptoms.
- Cognitive symptoms: This includes trouble learning, remembering, understanding, and/or problem-solving.
- Emotional symptoms: Depression or anxiety can be seen in schizophrenics.
How is schizophrenia diagnosed?
The diagnosis of schizophrenia is a matter of categorizing symptoms according to the DSM-5, which what book psychiatric diagnosticians use. The criteria are laid out, but generally speaking, they include positive and negative symptoms, disordered thinking, and dysfunctional interaction within personal or occupational relationships lasting longer than six months. The diagnosis excludes disorders arising from substance abuse.
How is schizophrenia treated?
For the most part, the mechanisms of treating schizophrenia by antipsychotics aren’t completely known. However, the brain’s neurotransitters, which orchestrate and modulate the propagation of signals along organized nerve tissue, are key. This makes sense since no thought, much less a thought disorder, can occur without the role of the neurotransmitters. The following neurotransmitters are manipulated with antipsychotic drugs:
- Dopamine: This is possibly the most major one involved with schizophrenia, although it appears that other neurotransmitters are at work in tandem with dopamine. Excess of dopamine in some parts of the brain and a decrease in it in others has been seen in cases of schizophrenia. The prefrontal cortex of the brain, which is involved with both personality and in executive decision-making, is dependent on dopamine (as well as GABA).
- Glutamate: This is the excitatory neurotransmitter. Low glutamate activity has been implicated in cases of schizophrenia.
- GABA: This refers to gamma-amino-butyric acid, the major inhibitory neurotransmitter.
- Acetylcholine: The relationship between this and its associated stimulation via nicotine is unclear in respect to schizophrenia.
Do we know what causes schizophrenia? Does it make one more prone to other psychiatric disorders?
No, we do not what causes schizophrenia, and yes, it does make one more prone to other psychiatric disorders.
It is possible that it is an interaction or co-morbidity of several mental health diseases that have similar symptoms. It is generally accepted that it is a genetic disorder, can be inherited, and can have a strong presence in family history.
Schizophrenics have higher rates of depression, anxiety, suicide, and substance abuse, but so do people from families with histories of these aberrations in behavior, a fact that adds support for the genetic cause.
Schizophrenics are often inadequately treated due to social avoidance, stigmata, and their own compliance, or lack thereof, with their medications due to delusions. They are abused by omission of common social interaction and courtesies. They suffer immensely. An untreated schizophrenia is an emergency and a tragedy.
Thankfully, although not cures, many medications have been able to lessen symptoms to allow schizophrenics a level of function that can give them a quality of life impossible before. As the explorations of neurotransmitters and their receptor sites continue, better treatment and a better understanding of the disease continue to come closer to the grasps of modern medicine.