Some very important information for those who suspect they may have the disease, and for friends and families trying to cope with a loved one's suddenly bizzare and disturbing behavior.
“I just couldn't accept the fact that he had an above average I.Q., was good looking, had a good personality-and was so ill.”
-- Parent of a child with schizophrenia
Just as other diseases have signs or symptoms, so does schizophrenia. Symptoms are not identical for everyone. Some people may have only one episode of schizophrenia in their lifetime. Others may have recurring episodes, but lead relatively normal lives in between. Others may have severe symptoms for a lifetime.
Schizophrenia always involves a change in ability and personality. Family members and friends notice that the person is "not the same." Because they are experiencing perceptual difficulties -- trouble knowing what is real from what is not real -- the person who is ill often begins to withdraw as their symptoms become more pronounced. Deterioration is usually observed in:
- Work or academic activities
- Relationships with others
- Personal care and hygiene
- Personality change
is often a key to recognizing schizophrenia. At first, changes may be subtle, minor and go unnoticed. Eventually, such changes become obvious to family, friends, classmates or co-workers. There is a loss or lack of emotion, interest and motivation. A normally outgoing person may become withdrawn, quiet, or moody. Emotions may be inappropriate -- the person may laugh in a sad situation, or cry over a joke -- or may be unable to show any emotion at all.
- Thought disorder
is the most profound change, since it prevents clear thinking and rational response. Thoughts may be slow to form, or come extra fast, or not at all. The person may jump from topic to topic, seem confused, or have difficulty making simple decisions. Thinking may be coloured by delusions -- false beliefs that have no logical basis. Some people also feel they are being persecuted -- convinced they are being spied on or plotted against. They may have grandiose delusions or think they are all-powerful, capable of anything, and invulnerable to danger. They may also have a strong religious drive, or believe they have a personal mission to right the wrongs of the world.
- Perceptual changes
turn the world of the ill person topsy-turvy. Sensory messages to the brain from the eyes, ears, nose, skin, and taste buds become confused -- and the person may actually hear, see, smell or feel sensations that are not real. These are called hallucinations.People with schizophrenia will often hear voices. Sometimes the voices are threatening or condemning; they may also give direct orders such as, "kill yourself". There is always a danger that such commands will be obeyed.People who are ill may also have visual hallucinations -- a door in a wall where no door exists; a lion, a tiger, or a long-dead relative may suddenly appear. Colours, shapes, and faces may change before the person's eyes.There may also be hypersensitivity to sounds, tastes, and smells. A ringing telephone might seem as loud as a fire alarm bell, or a loved one's voice as threatening as a barking dog. Sense of touch may also be distorted. Someone may literally "feel" their skin is crawling -- or conversely, they may feel nothing, not even pain from a real injury.
- Sense of Self:
When one or all five senses are affected, the person may feel out of time, out of space -- free floating and bodiless -- and non-existent as a person.
Someone who is experiencing such profound and frightening changes will often try to keep them a secret.
There is often a strong need to deny what is happening, and to avoid other people and situations where the fact that one is "different" might be discovered. Intense misperceptions of reality trigger feelings of dread, panic, fear, and anxiety -- natural reactions to such terrifying experiences.
Psychological distress is intense, but most of it remains hidden -- so there may be strong denial, born out of fear. The pain of schizophrenia is further accentuated by the person's awareness of the worry and suffering they may be causing their family and friends.
People with schizophrenia need understanding, patience, and reassurance that they will not be abandoned.
EARLY WARNING SIGNS
The following list of warning signs was developed by people whose family members have schizophrenia. Many behaviours described are within the range of normal responses to situations. Yet families sense -- even when symptoms are mild -- that behaviour is "unusual"; that the person is "not the same."
The number and severity of these symptoms differ from person to person -- although almost everyone mentions "noticeable social withdrawal."
- Deterioration of personal hygiene
- Bizarre behaviour
- Irrational statements
- Sleeping excessively or inability to sleep
- Social withdrawal, isolation, and reclusiveness
- Shift in basic personality
- Unexpected hostility
- Deterioration of social relationships
- Hyperactivity or inactivity -- or alternating between the two
- Inability to concentrate or to cope with minor problems
- Extreme preoccupation with religion or with the occult
- Excessive writing without meaning
- Dropping out of activities -- or out of life in general
- Decline in academic or athletic interests
- Forgetting things
- Losing possessions
- Extreme reactions to criticism
- Inability to express joy
- Inability to cry, or excessive crying
- Inappropriate laughter
- Unusual sensitivity to stimuli (noise, light, colours, textures)
- Attempts to escape through frequent moves or hitchhiking trips
- Drug or alcohol abuse
- Strange posturing
- Refusal to touch persons or objects; wearing gloves, etc.
- Shaving head or body hair
- Cutting oneself; threats of self-mutilation
- Staring without blinking -- or blinking incessantly
- Flat, reptile-like gaze
- Rigid stubbornness
- Peculiar use of words or odd language structures
- Sensitivity and irritability when touched by others.