Schizophrenia: A misunderstood condition

This complex mental disorder has a significant impact on people who live with it.

Treatment is available

In the film Glass (2019), the main character is a young man whose body houses 24 different personalities, each with distinct traits. This portrayal is what most people imagine when they think of schizophrenia. However, these kinds of depictions are quite different from the actual illness, which is why schizophrenia continues to be widely misunderstood.

Dr Renata du Preez, a psychiatrist at Mediclinic Denmar Mental Health Services, explains that the confusion may have arisen because of the origin of the word: “The term has its roots in the Greek words for split (schizo) and mind (phren). However, clinicians do not use the term ‘split personality’.”

The Diagnostic and Statistical Manual for Disorders (DSM-5) defines the symptoms of schizophrenia as delusions, hallucinations (visual or auditory), disorganised speech, and disorganised or catatonic behaviour, which present for more than a month.

Dr Du Preez notes that many of these symptoms are multifaceted, evidenced by the different types of delusions:

• Non-bizarre delusions are those not entirely out of the realm of possibility, e.g., someone fearing their partner is trying to poison them. While this is unlikely, it's not impossible. 
• Bizarre delusions are both irrational and implausible, e.g., a patient may believe others can hear their thoughts, or that outsiders have inserted their thoughts inside their brain.  
• Somatic delusions are a belief that the patient’s organs have been removed and replaced.
• Capgras delusion is a belief that imposters have taken the place of loved ones.  

“Delusions fall into several categories, including grandiose, persecutory, religious, and erotomanic,” Dr du Preez adds.  

There are also several “negative” symptoms of schizophrenia, she continues:

• Alogia. Patients tend to show little or no emotional expression and may speak less than usual.  
• Avolition. Decreased motivation, and therefore interest in taking part in goal-directed activity.  
• Asocial. Avoidance of social interaction.
• Anhedonia. An inability to find pleasure in activities they previously enjoyed.

“This range of symptoms indicates the complexity of the condition, but its causes are similarly complex, involving heredity, biological processes, and the environment,” she says.

It follows that treatment is also a complicated process, especially since it’s often difficult for healthcare professionals to find the most effective medication with the fewest side-effects. However, it is important to begin treatment as early as possible because the outcome and improvement of the condition are greatly affected by how long it remains untreated.

“Healthcare, including mental healthcare, generally focuses on prevention. For instance, a healthy lifestyle includes a healthy diet, exercise, and regular check-ups to detect and keep certain conditions at bay,” says Dr Du Preez. “But we tend to neglect brain hygiene or mental healthcare, possibly because of the stigma – even today. This is due to a lack of knowledge, even though information on mental illness is readily available nowadays.”  

She emphasises how important it is for people to seek treatment if they have any mental health concerns. “Only through open discussion and normalising mental health issues will we finally end the stigma around mental illness.”

Expert treatment is available at Mediclinic Denmar Mental Health Services or find a Mediclinic psychiatric specialist near you.