Tuesday, September 24, 2013

Schizophrenia - Paranoia and Delusions

For most of his life, the artist Vincent van Gogh was plagued by madness. His low quality of mental health detracted from his quality of life and his willingness to paint. So deep was van Gogh's suffering that he killed himself before he turned 40. Schizophrenia is a ravaging, all-consuming mental illness that seriously warps the mind of the afflicted. Some cases are so severe that the patient may need to be hospitalized. In recent years, schizophrenia research and treatment has become more streamlined and technological and medical advancements have made treatments more readily available to those who need it.

Schizophrenia is believed to have been around about as long as humans have. An ancient Egyptian medical text called "The Book of Hearts" describes patients suffering from dementia, depression, and other mental disturbances that are conducive to a diagnosis of schizophrenia. Treatment involved bathing the afflicted in specially purified waters. Roman and Greek scientists also recognized psychotic and psychiatric disorders in their writing. However, schizophrenia as we recognize it today did not seem to manifest or was not noted in those societies. In the middle ages, mental illnesses including schizophrenia were believed to be caused by demons possessing the body. Treatment was notoriously unpleasant and included holes being drilled in the patient's skull in hopes of exorcising the evil demon.

German psychiatrist Emil Kraepelin was the first person to properly begin to differentiate between mental illnesses. He famously began to distinguish manic depressive patients from patients with schizophrenia, which he called "dementia praecox." This was revolutionary in the late 1880s, when most psychiatric disorders were lumped together into one general category. Kraepelin recognized and categorized the four types of this peculiar mental illness. Paranoid, with fear and delusions, simple, characterized by slow decline, catatonic, characterized by laziness or lack of movement, and hebephrenic, similar to catatonic. Psychiatrist Eugen Bleuler coined the word "schizophrenia" in a medical journal in 1911. Bleuler pointed out that schizophrenia was not a type of dementia as the patient did not present with brain cell or neuron decay. Researchers and psychiatrists have discovered much about this disease since Bleuler's time.

The symptoms of schizophrenia are variable in their manifestation and severity. The Los Angeles Times recently reported on the tragic case of a six year old girl named Jani. Jani was born with schizophrenia, which is extremely rare. She hallucinates visions of rats who tell her to injure her parents and younger siblings. Large doses of medication that would subdue any grown adult do nothing to curb her hallucinations. On the other end of the spectrum are people whose bouts of schizophrenia come in flares. These more mild cases may just consist of persistent agitation, mood swings, or general malaise. Schizophrenia can be treated with a combination of medication, therapy, and hospitalization. Depending on the severity of the affliction and the patient's willingness to take medication, some variations of schizophrenia can be exceptionally difficult to treat. Science still has much to learn about this complex illness.

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