SchizophreniaDuring the 1950s, mentally disordered people who were harmful to society andthemselves could be treated with medications and were able to return safely to theircommunities. During the 1980s, the cost of health care increased more than any othercost in our national economy. As a result, strategic planning has been made to reducecosts.
The political decision made to deinstitutionalize chronic mental patients startedwith the appearance of phenothiazine medications. Dramatically reducing the instabilityinfluenced by psychosis, these medications were of great significance to manyindividuals with serious mental disorders. At both the state and federal levels,legislators looked at the high cost of long-term psychiatric hospitalization. Socialscientists guaranteed them that community-based care would be in the best interests ofall concerned: the mentally ill and the general, tax-paying public. It wasbelieved that a social breakdown syndrome would develop in chronically mentally illpersons who were institutionalized.
The characteristics of this syndrome weresubmission to authority, withdrawal, lack of initiative, and excessive dependence on theinstitution (Seeds). Schizophrenia is the most common psychoses in the United States affectingaround one percent of the United States population. It is characterized by a deepwithdrawal from interpersonal relationships and a retreat into a world of fantasy. Thisplunge into fantasy results in a loss of contact from reality that can vary from mild tosevere. Psychosis has more than one acceptable definition. The psychoses aredifferent from other groups of psychiatric disorders in their degree of severity,withdrawal, alteration in affect, impairment of intellect, and regression (Insight).
In psychotic disorders, the intellect is involved in the actual psychotic process,resulting in derangement of language, thought, and judgment. Schizophrenia is calleda formal thought disorder. Thinking and understanding of reality are usually severely impaired. The most severe and prolonged regressions are seen in the psychoses,regression. There is a falling back to earlier behavioral levels.
In schizophrenia thismay include returning to primitive forms of behavior, such as curling up into a fetalposition, eating with ones hands, and so forth. The symptoms of schizophrenia usuallyoccur during adolescence or early adulthood, except for paranoid schizophrenia, whichusually has a later onset. The process of schizophrenia is often slow, with theexception of catatonia, which may have an abrupt onset. As an adolescent, a personwho later develops schizophrenia is often antisocial with others, lonely, and depressed.
Plans for the future may appear to others as vague or unrealistic (Seeds). It is possible that there may be a preschizophrenic phase a year or two beforethe disorder is diagnosed. This phase may include neurotic symptoms such as acute orchronic anxiety, phobias, obsessions, and compulsions or may reveal dissociativefeatures. As anxiety mounts, indications of a thought disorder may appear. Anadolescent may complain of difficulty with concentration and with the ability to completeschool work or job-related work. Over time there is severe deterioration of work alongwith the deterioration of the ability to cope with the environment.
Complains such asmind wandering and needing to devote more time to maintaining ones thoughts areheard. Finally, the ability to keep out unwanted intrusions into ones thoughts becomesimpossible. As a result, the person finds that his or her mind becomes so confused andthoughts so distracted, that the ability to have ordinary conversations with others is lost (Insight). The person may initially feel that something strange or wrong is going on.
He or she misinterprets things going on in the environment and may give mystical orsymbolic meanings to ordinary events. The schizophrenic may think that certain colorshold special powers or a thunderstorm is a message from God. The person oftenmistakes other peoples actions or words as signs of hostility or evidence of harmfulintent. As the disease progresses, the person suffers from strong feelings of rejection,lack of self-respect, loneliness, and feelings of worthlessness. Emotional and physical withdrawal increase feelings of isolation, as does an inability to trust or sociate withothers. The withdrawal may become severe, and withdrawal from reality may benoticeable from hallucinations, delusions, and odd mannerisms.
Some schizophrenicsthink their thoughts are being controlled by others or that their thoughts are beingbroadcast to the world. Others think that people are out to harm them or are spreadingrumors about them. Voices are usually heard in the form of commands or belittlingstatements about his or her character. These voices may seem to appear from outsidethe room, from electrical appliances, or from other sources (Insight). There are many different factors that lead to schizophrenia.
The main way toacquire schizophrenia is through heredity. A person has a 46% chance of gettingschizophrenia if his or her mother and father has it. One identical twin has a 46%chance of getting schizophrenia if the other twin acquires it. There are alsosome environmental factors that lead to schizophrenia.
One is if the mother gets the fluduring the second trimester of pregnancy causing brain damage to the unborn child. Another factor is complications at birth that could affect the child mentally. Anotherfactor causing schizophrenia is stress because the mind is overworked and eventuallycant function properly. An important factor concerning schizophrenia is how a child israised. If the child has abusive parents, he or she will have serious mental problems inthe future (Cognitive). Early in this disease, there may be obsession with religion, matters of the supernatural, or abstract causes of creation.
Speech may be characterized by unclearsymbolisms. Later, words and phrases may become puzzling, and these can only beunderstood as part of the persons private fantasy world. People who have been ill withschizophrenia for a long time often have speech patterns that are disoriented andaimless and deficient of meaning to the casual observer. Sexual activity is frequentlyaltered in mental disorders. Homosexual concerns may be associated with allpsychoses but are most prominent with paranoia. Doubts concerning sexual identity, exaggerated sexual needs, altered sexual performance and fears of intimacy areprominent in schizophrenia.
The process of regression in schizophrenia isaccompanied by increased self-fixation, isolation, and masturbatory behavior (Insight). The schizophrenic person finds himself or herself in a painful dilemma. He orshe retreats from personal intimacy or closeness because of the intense fear thatcloseness will be followed by ensuing rejection or harm. This retreat from intimacyleaves the person lonely and isolated. This dilemma often becomes the nursesdilemma. The nurse wishes to form a productive emotional bond but at the same timeseeks to lessen the clients anxiety.
For the schizophrenic person, moves towardemotional closeness will eventually increase anxiety (Cognitive). The dopamine theory of schizophrenia is based on the action of the neurolepticdrugs, better known as antipsychotic drugs. Neuroleptics are the drugs of choice fortreating the symptoms of schizophrenia. The neuroleptics are believed to block thedopamine receptors in the brain, limiting the activity of dopamine and reducing thesymptoms of schizophrenia. Amphetamines, just the opposite, enhance dopaminetransmission. Amphetamines produce an excess of dopamine in the brain and canprovoke the symptoms of schizophrenia in a schizophrenic client.
In large doses,amphetamines can simulate symptoms of paranoid schizophrenia in anonschizophrenic person. Some symptoms of schizophrenia are due basically tohyperdopaminergic activity. Other symptoms, such as apathy and poverty of thought,are related to neuronal loss (Insight). Although the therapy and drugs help the schizophrenics deal with their problemstremendously there is not enough to go around because states are closing their mentalinstitutes for financial reasons.
Even though the cost of mental institutes are high, theschizophrenics are better off being kept in them because they could cause a hugeuproar on the streets. Without the mental institutes the schizophrenics will get worsebecause they are unable to live independently. Many schizophrenics might even beharmful to society because their brain is out of control. The paranoid schizophrenicscould go on a rampage and try to kill everyone in sight because they think thateveryone is out to hurt them. This could be the future of our world if we dont take timeto treat these schizophrenics who desperately need it no matter what the cost (Cognitive).
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