Schizophrenia is a severe mental illness where contact with reality and insight are impaired, an example of psychosis. Symptoms of schizophrenia include psychotic symptoms such as hallucinations, delusions, and thought disorder (unusual ways of thinking), as well as reduced expression of emotions, reduced motivation to accomplish goals, difficulty in social relationships, motor impairment, and cognitive impairment.
Schizophrenia is a severe, long-term mental health condition that requires lifelong treatment, even when symptoms subside. Treatment with medications and psychosocial therapy can help manage the condition. In some cases, hospitalization may be needed.
Medications are the cornerstone of schizophrenia treatment, and antipsychotic medications like Seroquel, Risperdal, Lithium, or Haldol are the most commonly prescribed drugs.
First generation antipsychotic medications, meaning discovered in the 1950s, formed one of the greatest breakthroughs in psychiatry. However, first-generation antipsychotics have frequent and potentially significant neurological side effects, including the possibility of developing a movement disorder (tardive dyskinesia) that may or may not be reversible. Fortunately, for me it was in my case. Newer, second-generation medications are often preferred because they pose a lower risk of serious side effects than do first-generation antipsychotics.
Newer mood stabilizers are also used to treat the condition, as is in my case. Mood stabilizers work for me because the hallucinations and delusions vary based on my mood. For example, on New Year’s Day of this year, I was admitted to the emergency room for breathing problems and an upper respiratory infection that was not COVID but was severe enough to scare me. And with the added stressor of loved ones not being allowed into the room with me, the voices were incredibly terrifying. So, my mood being down, the voices were predominantly negative, suggesting that I take my own life. The following three weeks found no relief since I was put on prednisone, a glucocorticoid, which amplifies feelings and/or conditions. In my case that was the negative voices.
On the other hand, I’m typically even-keeled, and some say optimistic a good portion of the time. So, the limited voices correspond to my mood and reveal themselves to be cathartic, even encouraging, but mainly limited in their ferocity thanks to the mood stabilizer, Abilify, which I’m on maximum dosage. After a few more months of this leveling off, I’ll go back down to a moderate dose. But, after many years of being overly optimistic about my condition, I’ve come to the realization that I’ll be on a mood stabilizer, if not anti-psychotic, the rest of my life.
In addition to medication, there is the ongoing psychosocial therapy. That too, will be lifelong, hopefully not as often as I’m currently required to see the therapist. So, like the 3.5 million others battling this mental illness and the 100,000 new diagnoses each year, I will continue to press onward and upward so that I’m not in the 3.5 times more likely who ultimately take their lives. Schizophrenia isn’t a death sentence and many of us with it choose to say we battle it as opposed to suffer from it.
The most difficult thing to deal with, for many, isn’t the disease itself but the stigma surrounding it; but, for me, that’s probably in part to my social anxiety disorder, which is a comorbidity. Schizophrenia is most often seen in patients that have an underlying or overlapping condition such as depression, anxiety, PTSD, OCD, and panic disorder, which makes it difficult to diagnose and why so many suffer without the therapies, whether medication or psychotherapy, that assists them in battling the condition.