Schizophrenia
has always been a mystery. Ever since Emil Kraepelin claimed he had discovered
an incurable, degenerated illness at the turn of the 19th century,
no cure or concrete causes of Schizophrenia has been found. Schizophrenia
is the collective name of negative, cognitive and positive symptoms, like
depression, delusions, hallucinations and paranoid thoughts. Even though there
are other theories which explain the cause of Schizophrenia the two most common
used models are the Medical or Disease Model and the Social Model. The Medical
Model claims that a biological defect in the person’s brain is responsible for
the illness. The Social Model claims that when a person is confronted with an
extremely stressful event, his or her mind puts a defense mechanism in place.
We
all know of a person that is or has been suffering from depression. People who
have experienced this devastating illness know but all too good what it can do
to the mind. In most cases depression can be conquered with the help of
medication or therapy. However when life seems to be going well and new
horizons are being discovered one doesn’t expect to see shadows moving or get
panic attacks; especially when the person is young and life is only just
beginning. Nevertheless there are many young people between 14 and 26 who
experience these symptoms. Some have experienced trauma but others didn’t.
Adolescence
is a period wherein a person develops the last parts of the body and brain.
These are enormous changes and are usually causes much psychological pain and
confusion. Many discoveries like sexuality are made in this period. To
contribute to this confusion and pain, major changes like study, exams, jobs
and relationships are thrown in. Often they come all at once. It is also in
this period that many young people experience with drugs and alcohol. Needless
to say that causes many problems and damages not only a person’s liver but also
the person’s brain. Withdrawal from it after excessive use can cause anxiety,
bad dreams, depression, shaking and vomiting; these are just the mild to
moderate withdrawal symptoms. The more serious symptoms are; hallucinations –
known as delirium tremors and black outs.
Alcohol
use is affecting the neurotransmitters in the cortex, the cerebellum, the
hippocampus, the amygdala, the superior and the inferior colliculi. Cannabis is
mainly affecting the nucleus accumbens, caudate but also the cerebellum and the
hippocampus. These are all located in the mid brain which contains
dopaminegic neurons.
When
in the case of excessive drugs, alcohol use or when experiencing extreme
stress; which adolescence may be filled with, the stress hormones suppress the
activity of the hippocampus. As a result the hippocampus loses its ability to
function normal. The amygdala and the hippocampus are deeply involved in
responding to stressful events. Charles Nemeroff discovered that the
hippocampus is 15% smaller in a person with depression. In some cases the
hippocampus might not be able to distinguish between a piece of asphalt on a
warm day or a turbulent river. In normal circumstances the amygdala sends alarm
messages to the cortex when needed. The hippocampus assists in the transfer of
this information. When the cortex realises that the danger is over it instructs
the amygdala to stand down. This is supposed to happen in a normal situation.
However when this process is distorted the person might develop anxiety, which
may include paranoid thoughts and or delusions. The person might also have
difficulty in concentrating and have low motivation. Anxiety is a very complex
phenomenon and a panic attack can be extremely freighting. Some people even see
shadows moving or see human or animal figures that aren’t real. This is the
brain’s way of dealing with the situation at that moment. A similar thing is
happening when we dream; we digest the things we’d done and work through
situations we yet have to understand.
Schizophrenic
symptoms are frequently also found in other mental disorders, like post
traumatic stress disorder, bipolar disease and obsessive compulsion disorder.
In the 1800’s before psychoanalyses and psycho-pharmacology, 70 % of patients
in hospitals were discharged after their first admission receiving ‘moral
treatment’. They had either improved or recovered from their symptoms. By 1900
the ‘moral treatment was abandoned and replaced with more scientific somatic
treatment, discharge rates dropped to 20-30%. Moral treatment included;
- striving the patient as an individual
- developing a full and accurate history
- encouraging work and sociallising
- never humiliating patients
- only use physical force to prevent a patient form harming themselves or others, never as punishment.
Kleinian
analysts see Schizophrenia as a defense against overwhelming abolition and
tormenting anxieties. They interpret unconscious matters at the level of
greatest anxiety, to develop awareness of the links between reality and
fantasy.
The
dopamine hypothesis is currently the most widely accepted biochemical theory.
According to this hypothesis, Schizophrenia is caused by hyperactive
transmissions in neurons in the brain which use dopamine as a chemical
messenger. By administer patients with anti psychotic drugs these dopamine
neurotransmitters are blocked. Some psychiatrists have come to the
conclusion that drugs are not the answer to curing Schizophrenia and other
mental illnesses. Post mortem on people who suffered from Schizophrenia stated
signs of increased dopamine levels. However it has also been discovered that
anti psychotic drugs not only causes a blockage of dopamine, but also kicks off
an attempt of the brain to compensate for the blockage. In other words, over
activity in the dopamine system is caused by the anti psychotic drugs that are
supposed to threat the illness.
References:
Haracz J, The dopamine hypothesis, Schizophrenia Bulletin 8:438-6
Tyler
A, Street drugs, Holder and Stoughton, London 1995
Read
J, Mosher L.R, Bentall R.P., Models of madness, Routledge New York USA, 2006
Colbert
Ty C, Broken brains or wounded hearts, Kevco Publishing, Santa Anna, California
Scot-Peck
M, The road less
travelled, Arrow books London, 1990
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