Understanding schizophrenia, and putting an end to stigma

Black people suffering from severe depression face higher odds that they will be misdiagnosed as having schizophrenia than white patients, according to a study from Rutgers University. / Net photo

Schizophrenia is a chronic mental illness that is characterised mainly by distortion from reality. It affects how someone thinks, behaves and feels. Schizophrenia is a global burden, as many people have stigma towards schizophrenic patients even though the disease is not contagious.

I got inspired to write this article while doing my clinical rotation for medical school in a psychiatry department. I have seen the stigma given to schizophrenic patients, and I want to raise more awareness of this disease as someone can prevent further complications by knowing the first positive symptoms of the disease and seek for medical help, hence, living a normal life.

Schizophrenia is a disease like other non-communicable disease, the real cause of this disease is unknown, but genetic and environmental factors can act together to bring the disease. Although there is no definitive proof, many suspect trauma before birth (birth asphyxia) and viral infections to contribute to the development of the disease. Stressful experiences may also precede the emergence of schizophrenia. The chemical imbalance of neurotransmitters in the brain, especially dopamine and serotonin, also plays a major role in the occurrence schizophrenia. Some substance use like marijuana and cannabis can also affect the relapse of the disease. So everyone should be concerned about schizophrenia, as we can all get it.

The onset of schizophrenia is insidious, but there are some common warning signs (subjective to individuals) like social withdrawal, deterioration of personal hygiene, depression, unable to concentrate, oversleeping or insomnia, extreme reaction to criticism, etc.

Schizophrenia starts by the positive symptoms, in this case the word “positive” does not mean good, rather, it refers to the exaggerated forms of thinking or behaviours that becomes irrational. 

These positive symptoms according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria of schizophrenia include, hallucinations, delusions, disorganised behaviours and thought disorder. Hallucinations constitute sensory perception of something that does not exist, and they can be associated with all five senses, (visual, auditory, olfactory, tactile and gustatory). Researchers have found that hearing non-existent voices is more common than seeing non-existent visions. When it comes to delusions, these are the false beliefs that someone with schizophrenia has, they include delusions of grandiosity (belief of being famous or an important figure),  erotomanic delusions, where the libido of someone increases considerably, leading to exaggerated sexual urges, delusions of persecution involves bizarre ideas and plots , mystic delusions which is the belief of  having the capacity to read and heal human hearts—here the person starts to preach the gospel everywhere (which is different from how she/he used to be). Some people may also present delusions of jealousy, and etcetera.  Thought disorder is when a person jumps from one subject to another without a logical flow.

When someone presents these positives symptoms, society most of the time doesn’t think that they are sick. People in the community should start to identify schizophrenia, and even consult the hospital when one has symptoms, which means loss of normal function and diminished capacity to experience pleasure, decreased social affiliation, lack of motivation to do something, diminished or increased speech, inability to carry a conversation and or spending most of the day alone.

The first onset of schizophrenia can be unpleasant, and may take a long time to recover, so it is important that a person living with schizophrenia receives full support from family, friends and community services.

As I conclude, I call upon everyone to help me prevent the stigma towards these patients, because the experience of stigma towards these people is common, and may be internalised to patients leading to “self-stigma”. This self-stigma can be damaging and lead to poor response to vocational rehabilitation and treatment adherence. So, everyone who sees the above mentioned symptoms, on him/herself or on someone around should seek for the medical help as soon as possible, because in many cases, someone with schizophrenia can live a relatively normal life if the disease is caught early enough and proper treatment is administered. And please remember, people with schizophrenia need everyone’s help, so we shouldn’t stigmatise them.

The author is a medical student at University of Rwanda.

Article featured in Oli Health Magazine, an international youth health platform.