Schizophrenia: Nature of the Problem

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Definition- ‘a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.” (oxford dictionary)

Schizophrenia is a mental illness that causes some to have an altered experience of reality. People with schizophrenia experience psychosis, which means they cannot think, express their emotions, sympathize with other people and differentiate between truth and false reality hence making people who suffer from this see hallucinations. There has been plenty of scientific research on investigating the causes for this illness, but till this day there has not been a conclusion on the exact reason for schizophrenia. However, research has shown that certain factors can contribute to increasing the chance of developing schizophrenia. Some of these include:

family history
injuries to the brain
chemical imbalance in the brain such as dopamine
alcohol and drug use, especially cannabis and amphetamine. These effects the level of neurotransmitters in the brain which releases some of the symptoms of schizophrenia.
depression- leads to a chemical imbalance in the brain
6extreme stress or stress over a certain extent leads to depression

Types of schizophrenia

Paranoid schizophrenia-most common form of schizophrenia. people who suffer from this belief that an individual or a group of people are plotting against them or anyone they know or are close to example: An assassin is trying to kill your mum. Individuals who are diagnosed with this suffer from hearing voices
Disorganized schizophrenia-A person with Disorganized schizophrenia will portray illogical thinking and behaviour, also purposeless actions will be shown. This type of schizophrenia is said to be the most severe type. patients will find it extremely difficult to do everyday activities such as cleaning and feeding themselves.
Catatonic schizophrenia- changes in behaviour and actions in extreme measures. Someone who suffers from this might not be showing anybody gestures for a period or they could be moving everywhere showing uncontrollable behaviour. They could also stay silent, showing no sign of talking or they could talk to an extent where they would repeat anything someone says.
Undifferentiated schizophrenia- when someone fits into two or more categories of the different types of schizophrenia.
Residual schizophrenia-When a person has a history of schizophrenia, but they currently have no symptoms. The person may be in suspension from the illness or may later resume to showing symptoms

Signs and Symptoms

Signs -for some individuals the illness appears suddenly without a clue or a sign. But in most cases, it comes gradually, with warnings. Due to the different types of schizophrenia, the signs and symptoms can vary from person to person. However, some of the general signs for Schizophrenia are- trouble paying attention, unemotional gaze, difficulty sleeping, lack of personal hygiene, or irrational beliefs.

Symptoms-Symptoms are typically divided into positive and negative symptoms Positive symptoms are those that appear to show excess or misuse of normal functions and negative symptoms are those that lack important abilities.

Positive symptoms

Delusions -Delusion refers to a strongly held belief despite the evidence. Example You might believe that someone is trying to plot and kill you just because they are walking behind you.

Hallucinations -Thoughts and experience your mind makes up, e.g. hearing voices and seeing objects that are not present around you. Example: you might be talking to your grandparents even though they are not alive.

Disorganized speech/thinking-Disorganized speech typically arises from abnormal thought processes. A person might quickly jump from related subject to another, repeat words or phrases that someone else might say.

Disorganized behaviour- Behavior which people might find unnecessary, which include disruptive/ violent and unpredictable.

Negative Symptoms

Lack of emotional expression – expressionless face, monotone voice,

Lack of interest or enthusiasm – Problems with motivation; lack of self-care.

low interest on what is happening around you – unconscious of the environment; social withdrawal.

The extent of the problem

Aboriginal people have a higher chance of suffering from schizophrenia. They are 1.5 times higher to suffer from schizophrenia than non-aboriginal.
In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%). (aihw)
In 2016, the most commonly used illicit drug by Indigenous Australians was cannabis (16.7%), (aihw)

1,2,3 trend analysis- The reason that Aboriginal and Torres Strait Islanders have a higher chance (1.5x more) of being diagnosed with schizophrenia compared to non-aboriginal, is for the reason being that aboriginal life choices are not appropriate example intake of drugs. Aboriginals have a higher consumption rate of drugs in comparison to others (1.8 times higher) because of recreational use but mostly due to stress relief which is caused by unemployment and living in underdeveloped areas. To get away from these issues, they resolve to use drugs like cannabis, which increases the chance of depression according to McGill University and the University of Oxford. Also, problems like racial discrimination and child removals cause depression which leads to a chemical imbalance in the brain which is one of the main factors which contribute to increasing the chance of having schizophrenia.

*4. There is a higher chance of getting Schizophrenia below age 25(health.gov) Analysis- The reason being for this is that below the age 25 an individual goes through their high school and university life. During this period, the stress level is extremely high because of exams like hsc or vce (depending on which state) which will increase the chance of relying on drugs to get away from these problems which yet again increases the chance of depression and chemical imbalance. This is also the time frame where a person looks to get married, have kids, look for a job to financially support the family which all are factors that increases the burden and stress on an individual. At age 18, an individual becomes independent hence allowing them to go to places like clubs and parties. These places are where drugs are most common to be found and also teenagers believe that drugs are only for recreational use, but they do not see the side effects of them making them ignorant leading them to use drugs, not knowing the harm it has on the body.

*5. Schizophrenia incidence is slightly higher in males than females at a younger age- Men having a slightly higher incidence rate of schizophrenia than females below at a young age could be possibly due to the reason that boys have a higher chance of taking risks, meaning more injuries are common in males. Example not wearing a seat belt while driving. Injuries also include damage to the brain which is another factor that increases the chances of being diagnosed with schizophrenia. Females are more emotional and sensitive to topics like these ,which makes them not wanting to talk about their illness if any signs or symptoms are shown.Also, males are supposed to be the ‘Alpha’ of the family meaning that they are supposed to be the one who should look after the family putting more stress on them which could potentially lead to drug use as a stress reliever.

*6. humans who experienced birth complications have a higher chance of getting schizophrenia (NCBI) Analysis- a complication in birth could lead to underdevelopment of the brain which is another factor leading to mental illness.

Risk and protective factors

What is a risk factor?

According to the World Health Organization ‘A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. Some examples of the more important risk factors are underweight, unsafe sex, high blood pressure, tobacco and alcohol consumption, and unsafe water, sanitation and hygiene.’

According to public safety, ‘protective factors are positive influences that can improve the lives of individuals or the safety of a community. These may decrease the likelihood that individuals engage in crime or become victims. Building on existing protective factors makes individuals and communities stronger and better able to counteract risk factors.’

Individuals need to be aware of the protective and risk factors to prevent the risk of developing any mental illness. In some cases, even if you follow the protective factors, you might end up still having schizophrenia. However, most of the time if you follow the protective factors and stay away from any risks, you will be distant from this mental illness.

Risk factors

Protective factors

Head injury may trigger hallucinations and delusions. Take precaution when doing any activity where the head is at risk. Example where a seat belt or don’t for over the speed limit to prevent you from having severe brain injuries which if were to happen, chance of brain damage is possible (Modifiable

Living a healthy lifestyle with reduced stress. Make good life choices and don’t be lazy to do anything . Example look for jobs if unemployed, taking studies seriously which will help you in later stages of life.(Modifiable)
Use of drugs can affect brain activity and can bring about psychosis (Modifiable Avoiding smoking, drinking, and tobacco to avoid any possible effects on the brain (Modifiable)
Family member with schizophrenia as the condition is found to run in genes (Non-modifiable)

Not being financially stable is another risk factor as it is one of the biggest contributions to stress and depression(Modifiable)

Having a supportive and understanding family to support individuals through tough times. (Non-modifiable). In some cases this might not be possible, so the best option would be relying on friends or seeking help from a trustworthy individual like teachers or the counsellor(Modifiable)

Going to places where drugs are most likely to be available. You might end up being peer pressured by friends hence increasing the chance of schizophrenia (Modifiable)

Having a hobby to focus on. Hobby to focus on will help you put your attention on the activity. Most people have a hobby as a solution to reducing stress example playing soccer for a club to help reduce stress on school studies (Modifiable)

Sociocultural, socioeconomic and environmental determinants

Sociocultural

Sociocultural determinants include family, friends and media. Individuals need to surround themselves with positive-minded and supportive people because they will influence your actions, thoughts, mentality etc. In some cases, you might be surrounded by family members who harm you, in this case, you should resolve to have good friends. Example- If your dad and mum have had a divorce and have decided to live with your dad but he abuses drugs and alcohol, you will most likely end up like him if you do not act upon it. Sometimes you might be stuck with him and cannot do much about it if so, having good friends should be your number one priority. If you decide not to have good peers and are stuck with your dad until you are stable enough to move out, your life choices will be similar or identical to his hence increasing the chances of schizophrenia as drug use like cannabis, affect neurotransmitters which cause chemical imbalance leading to mental illness. Media- Now a day’s media has a positive impact on spreading awareness of mental issues like schizophrenia. 20 years ago, mental illness was not prioritized this may be due to the lack of media, but currently, the media is doing an amazing job at spreading awareness of schizophrenia. On YouTube, there are videos and advertisements regarding schizophrenia also twitters/Instagram users use their social media platform to spread awareness of what schizophrenia is and how it is an illness that people should be more conscious about.

Socioeconomic

socioeconomic factors include income and education. Having a high paying job can have a major impact on a person and can influence the mental illness, schizophrenia. example – If a man has a family of four and is working as a surgeon, getting paid well, he will not have to worry about anything related to money like paying bills and mortgage, reducing the stress level which decreases the risk of developing depression. Also, if a person suffers from schizophrenia and needs medication that is not under the pharmaceutical benefits scheme, they will end up paying the whole amount which in most cases are expensive. If the same person has a high income he obviously will buy it, helping his illness become better. However, if the person is unemployed, the chances of purchasing the medication are low, worsening the condition. Also, the high-income worker can pay for extra visits to the psychologist whereas the low-income worker won’t be able to.

Education- having the right education on the effects of drug use, risk and preventative factors for schizophrenia will most certainly influence the person’s lifestyle choice. If a teenager doesn’t have the right education on drugs, he might end up using them for ‘recreation’ but his actions will lead him to increase the chances of obtaining schizophrenia

Environmental

living in a good environment will most certainly grant you better access to health facilities, however living in an underdeveloped area can worsen your illness or increase the chances of obtaining it. Example- John and Steve both suffer from schizophrenia. John lives in a high-end area with a psychologist 20km away from him, but Steve lives in the middle of Australia where the closest phycologist is 100 km away from him. John will most likely end up going to the psychologist to seek for some help, but Steve needs to consider the travel distance, discouraging Steve to seek for some help worsening the conditions of schizophrenia.

Also having access to technology allows an individual to approach information related to the illness which was not known previously example risk and protective factors. This allows the individual to have variety and the capability to make better choices ,for example not to take drugs which will decrease the chance of developing schizophrenia.

Groups at risk

Aboriginal Torres Strait islanders- Most of them live in rural areas where access to health facilities is low and also the cannabis use rate is much higher compared to others because of stress level which arises from unemployment rates, lifestyle, area living in.

16-25 – This is the time frame where a person goes through their highschool,university and work life. For a young adult or teenagers, this is one of the most stressful life events that take place which increases the chances of being diagnosed with depression which are one of the risk factors involved in schizophrenia people who have been through birth complications- Scientists have proved that birth complication usually results in underdeveloped brain which causes biochemical imbalance hence increasing the probability of being diagnosed with schizophrenia

Females – Females tend not to talk about topics like these as they are more emotional and sensitive about it . This will result in them not seeking any help from professionals,l increasing the severity of the illness.Males with a diagnosis of Schizophrenia received services at a higher rate (101.8 service contacts per 1,000) than females (42.8 service contacts per 1,000) in 2017. Also females go through hormonal change during pregnancy which increases stress level,contributing towards schizophrenia.

Past experiences- some people go through experiences which leads to dramatic and severe depression and anxiety. Example could be a couple that just had broken up after a 6 year relationship. A study by psychologists at the University of Liverpool has found that traumatic life events are the biggest cause of anxiety and depression, but how a person thinks about these events determines the level of stress they experience.

Low socioeconomic status

People who fall under the low ses is for the reason being that they are not financially stable. This contributes to schizophrenia as it restricts access to health services, treatment and medication. Being stable with money is one of the biggest concerns a person has in their lives as it one of things you need in life to get to where you want. Example, paying for university/school, food, mortgage bills and etc.

Living in rural areas- People who live in rural areas is usually because of their low economic status. These remote areas have limited access to health services such as psychologists,gp and psychiatrist. Without the help of these professionals , conditions of schizophrenia will not recover or become better

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