Schizophrenia

Manila Bulletin, January 10, 2004 | Go to article overview

Schizophrenia


You must always be puzzled by mental illness. The thing I would dread most, if I became mentally ill, would be your adopting a common sense attitude, that you could take for granted that I was deluded.

Ludwig Wittgenstein (1889-1951), Austrian philosopher

Conversations, 1947-48

Say schizophrenia and I am always reminded of an old joke.

Psychiatrist: (to a mental patient) And may I know your name?

Schizophrenic 1: I, sir, am Jesus Christ!

Psychiatrist: Who told you that?

Schizophrenic 1: God told me! (to which another patient retorts)

Schizophrenic 2: I did NOT!

WHAT is schizophrenia? I am also

reminded of schizophrenia when nuisance candidates make the Comelec a circus before application deadlines. Some are honest and sincere about making a difference, but most are obviously out of touch with reality. In fact, one called himself The Messiah. Another met George W. Bush on TV and managed to get herself engaged to him, Laura Bush notwithstanding. Schizophrenia is a kind of psychosis in which the person is unable to distinguish what is real from what is imagined. Psychosis is a symptom of a disordered brain. Schizophrenia should not be confused with multiple or split personality which is rare and different.

Who gets afflicted? Anyone can get schizophrenia but it typically appears in the teens or early 20s. Men and women are equally affected but it is seen earlier in men. It can be passed on from parent to child. On a chemical level, schizophrenics are either very sensitive to or produce too much of dopamine (a substance that allow nerve cells to communicate with each other). Structural abnormality of the brain has been implicated and so has environmental factors. Adding too much stress, getting a viral infection, can push a predisposed person into schizophrenia.

Types of schizophrenia. In paranoid schizophrenia, the person has false beliefs or delusions of being persecuted or punished. If you saw A Beautiful Mind, the character of Russell Crowe (Prof. John Nash) showed such anguish. In disorganized schizophrenia, confused, incoherent, and jumbled speech is noted. Behavior is inappropriate as well. As an intern in PGH, I was once documented catatonic schizophrenia in a patient who stood rigidly in a pose similar to that of the Sto. Nino. The fourth subtype is undifferentiated. Descriptions that do not fit the others are grouped here.

Signs and Symptoms. Two positive psychotic symptoms stand out in schizophrenia: delusions and hallucinations. No amount of fact or evidence presented will convince a schizophrenic in a delusional state that what he believes is strange and untrue.

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