The torment of Schizophrenia

Another paper written for Abnormal Psychology course.  The films were part of the on-line classroom.

Films on Demand: The torment of Schizophrenia

The film shows us the lives of a few different people suffering from schizophrenia; a young woman, a picture of what schizophrenia looks like in a family, a homeless man, and a father struggling with his son’s disease.  Each story demonstrates a different aspect of the disease, about how the person copes with it, and how others cope. Weaved throughout these stories is the information about schizophrenia such as symptoms, causes and risk factors and treatment.   

The first scene is a group of young adults discussing the onset of their disease, each had onset between the ages if fourteen to twenty.  One girl said she was fine one day (going to school, doing normal things) and then suddenly she’s in the hospital.  A man described feeling as if others could hear his thoughts and, being only fourteen, this greatly confused him.  Another girl described how loud everything seemed to her, so loud that it was painful.

The next story highlights Marie, who started having hallucinations at age fourteen.  She heard voices issuing commands that she cut herself; once she even saw herself crucified.  She described feeling totally overwhelmed; when she looked in the mirror she did not recognize her reflection and felt “like a stranger to myself”.  Sometimes she feels like she is “in everyone’s brain at once”, that she can read their minds and control their thoughts.  She feels above everything, and in everything; she is the tree, she is the sun shining, she is everywhere in everything on every planet... her mind races and she has insomnia for three days. It’s higher than any high, too much to bear, and too strong; a “major compulsion can end in death”.  The narrator of the film explains that a schizophrenic brain cannot sort and filter incoming information and imbalanced exchanges bombard their senses. This due to dysfunction in the cortex (thought, conscious awareness), the limbic system (emotion, memory) and frontal cortex synthesizers which are needed to perceive and function within reality.  Dopamine neurotransmitters are either too weak or too active.  If too active, positive symptoms occur such as hallucinations and delirium; too weak results in negative symptoms (deficits) such as difficulty planning and organizing information.  Chapter 12 of the text highlights negative symptoms such as ‘flat effect’ (showing little or no emotion), ‘alogia’ (language is basic and brief), ‘avolition’ (inability or unwillingness to engage in goal directed activities), and ‘anhedonia’ (lack of pleasure or interest in life activities) (ch 12, page 351).

Richard, age 47, talks to his hand; yells at it.   The talking and voices inside his head seem real to him and he becomes overwhelmed, detaches from reality, loses his social capacity and his language ability, and he a low attention span.  was diagnosed with schizophrenia when he was 24.  His mother also suffered from schizophrenia and admitted to a hospital when he was young, leaving him to be raised by his grandparents and before eventually running away.  Homeless, he did not receive proper nutrition and his living and hygiene conditions were lacking.  This is a demonstration of  factors that contribute to schizophrenia: genetics and stressful life events.  The St. James shelter, for people suffering from mental illness, is one place Richard can recieve help.   Counselors help with controlling his medications, managing his finances and assisting with social issues/problems that might arise.  But what he likes most is that the shelter serves supper every day.

Another example of the genetic prevalence of schizophrenia is family in the film where the grandmother and mother both suffer from schizophrenia.  From the granddaughter’s point of view, Grandma is like a little clown;  when she is laughing, talking incoherently, screaming... that’s just her.  She is flesh and blood and she is important.  Life was different, however, for mother (Elise) who grew up without her own mother, placed in foster care separate from her sister. Grandmother’s relapse occurred after her third child; her husband was away at work at night and she was always afraid a man was coming in with a knife, then she was afraid it was her husband and that he wanted to sever her body.  She would notice herself hitting her children, and she knew it was unusual because that was something she wouldn’t do.  She hated the sound of the telephone ringing, and a timer that ticked really got to her because it made her think of war, which she hated.

Mother (Elise) had her first episode after asking for a divorce her husband, who instead he tried to kill her before committing suicide.  With children ages four and nine, Elise was grief stricken and began hallucinating and hearing voices, which were all negative.  She did’t watch TV, she ‘entered’ it.  Once she thought there were people under her floor and not long after that she was admitted to the hospital.  Elise’s sister was crushed when she found out about the illness; she confirms the difficult childhood, distraught and filled with a longing to see her mother and knowing  she couldn’t.  Elise’s daughter (and the granddaughter previously mentioned) talks about her mother’s illness; she noticed at age eleven or twelve, that little things would make her mother mad and have little fits of anger.  She tried to protect her brother but eventually they too found themselves in foster care, shocked and wondering how abandoning mother was going to help.

Schizophrenia is caused by a combination environmental factors and genetic weakness.  Factors that might provoke an onset of schizophrenia are viral infections, malnutrition, problems with pregnancy, and obstetric factors related to birth.  Family environments where emotions are strongly expressed may not cause illness but can affect behaviors.  Main neurological connections are established between the prefrontal cortex and hippocampus during fetal development, and completion of this communication system occurs during adolescence.  Problems occurring during these critical developmental periods can impact the number and quality of neurological connections in these ares of the brain.

Signs of a possible onset of schizophrenia in an adolescent might include a child who has friends and then suddenly withdraws, displays poor hygiene,  or a sudden decrease in academic performance.  Of course these may be normal, developmentally appropriate behaviors but the idea is to consult a doctor regarding marked changes.  It is also important to talk to a child regularly, find out about their world so that the chances of noticing something out of the ordinary are increased.  If their internal world changes, they might not talk about it; the more talking early on, the better chance of catching potential problems early.  Once schizophrenia begins, progression depends on medications used as well as any comorbid conditions.  

Treatment of schizophrenia has changed in the past fifty years when typical antipsychotic medications were used to reduce hallucinations and delusions; however, these usually cause unbearable side effects such as trembling, tremors, stiffness, apathy and passiveness.  Today there is a new line of medications called atypical antipsychotic medications that better balance the frontal cortex and limbic systems to decrease both positive and negative symptoms with less side effects.  Unfortunately, most people suffering from schizophrenia don’t like to take their medications but early treatment of schizophrenia with medication can help.  If the disease is detected within the first year of onset and treated for at least five years, there is a good chance for the person to live a somewhat normal life.  Community support and programs also help people suffering from schizophrenia take their medication consistently and receive support such as the financial and legal assistance available to Richard at St. James.  This type of assistance is not readily available, however, and usually those suffering from the illness receive less than optimal care.

The last story to highlight is about a father is struggling with the fact that his son suffers from schizophrenia.  It pains the father to know that when he walks down the street with his son, he knows his son doesn’t see, feel, or hear the same street as he as his son does a magical, sweeping hand gesture that is somehow supposed to make everything okay.  The father knows he must get rid of the prejudice he has toward his son’s illness.  He knows his son is not a monster or a mad man but he refuses to take medication and doesn’t accept his illness.  Dad tried to take him in after a hospital stay, but it was very awkward and uncomfortable and ultimately did not work out.  Now his son either lives in supervised residences, in a home, or alone.  

People can and do live their lives with this illness.  As previously mentioned, medications sometimes help, social/community support helps, and sometimes family can help.  Sometimes they can’t.  The last time the father saw his son, he said, “Don’t worry about me, Dad.” To which the father replied, “Well, see ya, son.  I’ll forward your mail.”  Today, Marie isn’t yet ready to return to school or work but she does have goals and dreams, which she feels is significant for her.  Elise is optimistic, has improved with medication and treatment and is even trying to work at a volunteer organization when she can.  Richard still hallucinates; sometimes he is afraid to go to sleep because he’s not sure where he will wake up. He wishes that people would treat him like any other person with a handicap; he just wants to breathe his fair share of the air like everyone else.