Schizophrenia: Fighting A Losing Battle

 Dhihan Ahmed

Schizophrenia

“Every thought is a battle. Every breath is a war, and I don’t think I’m winning anymore.” 

- Unknown

Picture this. Everyday you wake up, you forget who you are, where you are, and how you got here. It’s as if every day is a new nightmare that you’re forced to live through. But you are the only one living through these nightmares, none of it is based in reality. Because of this, no one understands your struggles and they label you as crazy. No one cares about your daily struggles because they aren’t the ones facing them. You go seek help from someone, ANYONE, only for the door to be closed in your face every time. A life like this sounds like pure hell on Earth doesn’t it? Well, this truly is a reality for those suffering from schizophrenia. Now, what comes to mind when you hear the word “schizophrenia”? Whatever it is, I can almost guarantee that what it is you’re thinking is heavily skewed and unfactual. If that’s the case, what is it then?

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Those suffering from it have an impaired view of the real world and struggle to distinguish reality from their own imagination. Mayoclinic states that although it can affect any age, the chances of it occurring greatly increases with age. A lot of the symptoms for it can be broken down into 2 categories, positive and negative. A positive symptom is an active experience/behavior and a negative symptom is a diminished action/behavior. Some positive symptoms of schizophrenia include unordered speech and disorganized behaviors such as doing things out of the ordinary, while some negative symptoms include the loss of feeling pleasure and overall muted emotions. Besides the symptoms for it, some of the most common and well known effects of schizophrenia include hallucinations and delusions, both of which involve experiencing/believing in something that is not real or based in any truth. Again, this probably lines up with the general public’s thoughts on schizophrenia. However, another prominent effect of schizophrenia is extreme paranoia, which is the constant belief that someone is out to get you and that you’re never safe. An illness as serious as this can’t be that common in people, can it? Well, according to the World Health Organization, schizophrenia affects ~24 million people in the United States, or about 1 in 300 people (1% of the general population). One of those 24 million people is my own mother. Everything I’ve said and will say directly applies to my mother as well. Now that I’ve given some of the physical effects of schizophrenia, you might be asking “what would the consequences of these effects be?”

Living everyday with hallucinations and paranoia inadvertently has an effect on your relationship with others too. When you’re constantly in fear of other people, you begin to cut ties with everyone in your life. Your close family members, your good friends, all of your connections don’t hold a candle to the delusion your mind has created that they’re out to get you. My mother cut ties with my entire family for years on end because of this. This in turn led to isolation which only amplified the effects of schizophrenia, creating a negative feedback loop. The largest consequence of this is the large percentage of homelessness and imprisonment of schizophrenic people. According to the NAEH and WebMD, approximately 20% of homeless people and 4% of prisoners suffer from schizophrenia. This jarring statistic makes a lot of sense when you begin to really think about the reality of schizophrenia. Remember all the effects I’ve listed up until now? Now try and fathom how hard it must be to keep a job when suffering from all those effects, let alone get a job in the first place. One research study found that employers only hired about 10% of people with schizophrenia, meaning those who have it are 10x more likely to be rejected from jobs compared to those who don't. In terms of imprisonment, the WebMD article mentions one study that found that most of the common offenses of schizophrenic people were related to drugs and alcohol, followed by theft. In the rare case they commit a violent crime, it’s often under the influence of drugs/alcohol along with being in a psychotic episode. And of course, being homeless or in prison only makes it harder to live with schizophrenia. That’s the true danger of this illness and I can’t emphasize it enough. Its ability to affect every aspect of life and put people in negative feedback loops is the biggest reason why it’s such a serious issue.

I’ve purposefully held off on discussing the causes of schizophrenia up until now because it’s a very complex topic. There is no single cause for schizophrenia and if there even was one, we currently don’t know what it is. There are 4 factors that are known to be involved in causing schizophrenia: psychological, environmental, physical, and genetic. Psychological and environmental go hand in hand in the sense that both can be the direct effect of each other. Some psychological factors include stress and emotional abuse, while some environmental factors include tragic/traumatic experiences with other people (which in turn leads to stress as well). Covington declares that these 2 factors can increase the chances of experiencing schizophrenia although these claims require further study and are currently just linked to schizophrenia. In terms of the physical factor, the National Library of Medicine (NIH) did a study and found that those with schizophrenia did have a higher likelihood of experiencing some kind of head injury before they were diagnosed compared to those who weren’t schizophrenic. Although there was a link between the severity of the head injury and whether or not an individual experienced schizophrenia in their later life, it is still presumed that it only increased the chances and didn’t actually cause the schizophrenia. This leaves only 1 factor which I saved for last: genetics.

Genetics is unanimously the largest factor in whether or not an individual will experience schizophrenia or not. In an aforementioned paragraph, I stated that approximately 1 in 300 people in the United States have the illness. I left out the part that said this statistic is also the same worldwide, not just the United States. Across the globe, spanning all kinds of different lifestyles, financial statuses, and countries of residence, the epidemiology of schizophrenia is more or less the same. Sure, a group of researchers at NIH found that there was a slight increase in schizophrenic incidence within countries of high income inequality, the overarching consensus is that schizophrenia transcends financial and environmental status. This discovery is backed up by the fact that an individual is more likely to have schizophrenia if it runs in the family tree. How much more likely? Well, if a parent or sibling has it, your chances go up by 10%. If both parents have it, then your chances shoot up by 40% (WebMD). I stated earlier that approximately 1% of the general population is at risk of having schizophrenia, what I didn’t state is that this percentage of risk goes up to 10% if you have a first degree relative (parent, sibling, child) with schizophrenia. All this does is solidify the idea that although environmental, psychological, and physical factors are components in increasing the likelihood of schizophrenia, it is ultimately your genetics that plays the largest role. A large Danish study in twins showed that schizophrenia is 79% heritable, meaning 79% of the risk of developing schizophrenia is due to genetic factors alone. So if one of your first degree relatives is diagnosed with schizophrenia, chances are it already runs in the family.

As for the treatments for schizophrenia, this is another difficult thing to talk about. Since the direct cause of schizophrenia is unknown, the direct treatment (if one could exist) for it is also unknown. There exists antipsychotic medicine that helps to reduce the aforementioned effects of schizophrenia such as hallucinations and delusions, but it also comes with its own complications. These kinds of medicine can’t pick and choose what specific parts of the brain and body it affects and so it has some severe side effects, some of which include increasing the chances of depression and anxiety. A part of the reason why so many schizophrenic patients suffer from other mental illnesses is because the medicine they are prescribed causes other complications, which require their own kinds of medicine to deal with. Overall, it’s an endless stream of medicine, but they do help patients greatly. My mother does her best when she is regularly taking her medication and she is at her absolute worst when she isn’t taking them. Besides taking medicine for schizophrenia, however, other treatments that help people are therapy, skill training, and supported employment (Covington). Therapy is for them to be able to talk about their everyday struggles in a safe space, skill training is to improve their communication and social interactions with others, and supported employment helps them prepare for, find, and keep jobs. However, I personally think the best treatment for reducing the effects of schizophrenia is being there for them, communicating with them, and being one of their friends/family members that actually hears them out and provides support. This is more so my own personal opinion rather than some definitive fact, just from seeing how much better my mother was when she was in contact with us and not in isolation. There’s a reason why one of the common types of treatment involves group therapy, discussing your struggles with other individuals who share similar struggles. At the end of the day, humans are social creatures that depend on each other – in one way or another – to survive and live a meaningful life.

I’ll end this off with an update on my mother. My mother was diagnosed with schizophrenia when I was a very young age and it led to many, MANY complications in my family. She left us, cut off all contact for years, and ultimately was driven to the end of her rope because of it. Through a lot of mental hospitals and years of no communication later, she’s started talking to us these past few years and we visit each other every now and then. I actually saw her a week before writing this paper. I asked how she was doing and how her schizophrenia has been affecting her and she said that she’s doing better now that we’re seeing her again. This is just proof that the best way to help is to be there for your loved ones. She moved to London a week ago to live with her family and I am happy to say that she left on a good and happy note. She’s taking her medications again and is doing much better now that she’s regularly taking them again. I hope that things are looking up for her from here on out. It’s a struggle, but I think she’ll be alright from now on. If you know a loved one struggling with schizophrenia – or any ailment for that matter – you can provide the same kind of comfort for them as well, but make sure to look after yourself too. Be there for those that are struggling and be there for yourself. Thank you.

Works Cited “Schizophrenia Treatment Center: Louisiana: Covington Behavioral Health.” Covington Behavioral Health Hospital, 3 Nov. 2020, https://www.covingtonbh.com/disorders/schizophrenia/. “Schizophrenia.” World Health Organization, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/schizophrenia#:~:text=Some%20people%20with%20schizophrenia%20experience,worsening%20of%20symptoms%20over%20time.&text=Schizophrenia%20affects%20approximately%2024%20million,300%20people%20(0.32%25)%20worldwide. “Schizophrenia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Jan. 2020, https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443#:~:text=Schizophrenia%20is%20a%20serious%20mental,with%20schizophrenia%20require%20lifelong%20treatment. “Childhood Schizophrenia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 May 2021, https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483#:~:text=In%20most%20people%20with%20schizophrenia,age%2013%20is%20extremely%20rare. “Schizophrenia Causes & Effects: Covington Behavioral Health.” Covington Behavioral Health Hospital, 8 Oct. 2020, https://www.covingtonbh.com/disorders/schizophrenia/signs-symptoms. Naeh. “New Study Offers Hope for Homeless People with Schizophrenia.” National Alliance to End Homelessness, 9 Jan. 2019, https://endhomelessness.org/blog/new-study-offers-hope-for-homeless-people-with-schizophrenia/#:~:text=Schizophrenia%20affects%20a%20little%20more,and%20experiencing%20homelessness%20each%20day. “Schizophrenia in the Prison System.” WebMD, WebMD, https://www.webmd.com/schizophrenia/schizophrenia-prison-system#:~:text=the%20prison%20cycle.-,How%20Common%20Is%20Mental%20Illness%20in%20Prison%3F,to%204%20percent%20have%20schizophrenia. AbdelMalik, Philip, et al. “Childhood Head Injury and Expression of Schizophrenia in Multiply Affected Families.” Archives of General Psychiatry, U.S. National Library of Medicine, Mar. 2003, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3774653/. Burns, Jonathan K, et al. “Income Inequality and Schizophrenia: Increased Schizophrenia Incidence in Countries with High Levels of Income Inequality.” The International Journal of Social Psychiatry, U.S. National Library of Medicine, Mar. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105302/. Is Schizophrenia Genetic? - Psycom. https://www.psycom.net/schizophrenia/schizophrenia-signs-causes/is-schizophrenia-genetic. Frothingham, Scott. “Is Schizophrenia Hereditary? Genetics & Other Causes.” Healthline, Healthline Media, 23 May 2019, https://www.healthline.com/health/is-schizophrenia-hereditary#:~:text=Schizophrenia%20and%20heredity,-Having%20a%20first&text=While%20the%20risk%20is%201,the%20risk%20to%2010%20percent.