What Family Members Can Do to Support Schizophrenic Relation

Biological Psychology: Schizophrenia

Introduction

Schizophrenia is a mental disorder that is characterized by delusions, hallucinations, and distorted thinking. The exact cause of schizophrenia is unknown, but it is believed to be a combination of genetic and environmental factors. Schizophrenia has been described throughout history, with the first known case dating back to the mid-6th century BC. In ancient times, it was considered as being caused by a range of factors (from environmental to spiritual) (Kyziridis, 2005). However, it was not until the early 19th century that schizophrenia began to be recognized as a distinct mental disorder. In 1809, a French physician named Philippe Pinel first described schizophrenia as a “mental derangement” but Emil Kraepelin is generally regarded as first to conceptualize schizophrenia. The term itself, however, was coined in 1911 by Eugen Bleuler, who introduced the term schizophrenia (based on the Greek root words meaning “split mind”) (Kyziridis, 2005). Today, the DSM-5 conceptualizes schizophrenia as a mental disorder characterized by abnormal thinking, emotions, and behaviors. People with schizophrenia may experience hallucinations and delusions (Swingler, 2013). They may also have disorganized speech and think in ways that are hard to understand. Schizophrenia can be a very disabling condition, making it difficult for people to function in work, school, or social situations. However, with treatment, many people with schizophrenia are able to lead productive lives. Over the centuries, there have been many different theories about what causes schizophrenia. This paper will describe the development of the disorder, provide a biological and psychological perspective of theories and causes, discuss treatments, and describe the experience of what it is like living with a schizophrenic family member and its challenges.

Development of the Disorder

The exact cause of schizophrenia is unknown, but it is believed to be a combination of genetic and environmental factors. Owen et al. (2016) refer to it as “a complex, heterogeneous behavioral and cognitive syndrome that seems to originate from disruption of brain development caused by genetic or environmental factors, or both” (p. 86). Research suggests that schizophrenia may be caused by changes in brain structure and function. Symptoms of schizophrenia typically begin in early adulthood, with men often developing the disorder at a younger age than women (Patel et al., 2014). According to Andreasen (2000), there is a phenotype that mutates causing schizophrenia: “the phenotype should be defined on the basis of abnormalities in neural circuits and a fundamental cognitive process” (p. 106). Others posit that schizophrenia is inheritable, while still others suggest it develops in response to one’s environment (Van Os et al., 2010). What is most likely is that schizophrenia results from a conflagration of factors, starting at a crucial stage of development depicted by Erikson as the crisis point the conflict between identity and role confusion during the adolescent stage of psychosocial development (Shriner & Shriner, 2014). It is during this pivotal stage of development that the individual can experience sharp psychosocial stress that could potentially overwhelm proper ordering of chemical pathways in the brain and lead to the progressive debilitation of daily functioning until the individual displays symptoms consistent with a schizophrenia diagnosis.

Biological/Psychological Perspective of Theories and Causes

Heritability and environmental factors are respective biological and psychological perspectives on theories for why schizophrenia occurs. The biological perspective of schizophrenia is underpinned by the theory that the disorder is caused by a chemical imbalance in the brain. According to this view, schizophrenia is the result of a defect in the brain's ability to produce or process certain neurotransmitters. This theory is supported by evidence that schizophrenic symptoms can be relieved by antipsychotic medication, which works by correcting the chemical imbalance (Andreasen, 2000).

The heritability perspective emphasizes the role of genetics in the etiology of the disorder, while the environmental perspective emphasizes the role of therapy and early intervention. Though there is no definitive answer as to which perspective is correct, both perspectives have some merit. For example, studies that compare identical and fraternal twins suggest that genetics does play a role in the development of schizophrenia (Chapter 4, 2016; Patel et al., 2014). However, environmental factors such as exposure to stress or trauma may also be contributors. Additionally, it is worth noting that heritability and environmental factors are not mutually exclusive; it is likely that both play a role in the development of this complex disorder (Kyziridis, 2005).

Environmental factors that could be responsible for the onset of schizophrenia could include stress, trauma, or abuse. Stressful life events have been found to be associated with an increased risk of developing schizophrenia, particularly if those events occur during adolescence or early adulthood. Traumatic experiences, such as physical or sexual abuse, can also lead to the development of schizophrenia. Exposure to toxins or infection during pregnancy has also been linked to an increased risk of the disorder. While the exact cause of schizophrenia is unknown, these environmental factors may play a role in its development (Van Os et al., 2010).

Epigenetic changes in the brain can result in severe trauma that upsets the balance and function of neural pathways, making it difficult for a person to adjust to internal and external stimuli as a normal non-traumatized individual might. Epigenetic changes can be broadly defined as modifications to the genome that do not involve changes in the underlying DNA sequence. These changes can affect the way genes are expressed, and they have been implicated in a wide range of biological processes, including brain development and function. Epigenetic mechanisms are thought to play a role in mediating the effects of environmental factors on the brain, and they have been linked to a number of psychiatric disorders. While much remains to be learned about epigenetics, it is clear that these changes can have profound impacts on brain development and function (Owen et al., 2016).

Treatments

As most scientists today believe that schizophrenia is caused by a combination of genetic and environmental factors, such as exposure to trauma or stress, treatment for schizophrenia typically involves a combination of therapies, including antipsychotic medication, which can help to reduce symptoms, and cognitive behavioral therapy (Kyziridis, 2005). In addition, psychotherapy and support groups can be helpful in managing the condition. Although there is no cure for schizophrenia, with treatment most people with the condition are able to live relatively normal lives.

The range of treatments includes pharmacological (typically touted as having the greatest rate of success), therapeutic (such as CBT, typically most successful when combined with pharmacological treatments), dietary (viewed as more homoepathic and traditional, but a good support nonetheless), and the semi-experimental electroconvulsive therapy (not widely recommended today) (Patel et al., 2014). Risks are involved in any treatment approach, nonetheless. For instance, antipsychotics affect different patients in different ways, while the personalization of treatment is essential for success. Cannabis may be an alternative in some cases, depending on the patient’s preferences, but support systems are imperative in order to manage the disorder most effectively over time (Patel et al., 2014).

Experience of Living with a Schizophrenic Family Member and Its Challenges

One of the first major experiences of living with a schizophrenic family member is fear. There is a lot of stigma associated with mental disorders, and schizophrenia is seen as one of the worst forms of mental disturbance, thanks to horror films like Psycho and even disturbing films like A Beautiful Mind. Family members can feel overwhelmed, upset, worried that it might be “contagious” or “in them” too if it is hereditable, or they may be concerned of the taboo nature of the disorder and how others might see them if it is known that they have a schizophrenic in the family. They may be stressed about the amount of work that will be expected of them to support the schizophrenic person (Schulze & Angermeyer, 2003).

The first step in overcoming this challenge of fear and anxiety for family members is education. The stigma of schizophrenia can upset patients and family and education is needed to alleviate fears. Family members need to know that schizophrenia is very treatable, and patients themselves need to know they can lead normal lives with the right treatment (Patel et al., 2014). This type of education can help calm nerves and introduce stability into a chaotic situation and environment. The more education that family members receive, the less likely they are to feel the fear and anxiety surrounding the stigma of the disorder.

The second thing that happens when living with a person who has schizophrenia is that family members have to figure out how the support system will work. Not all family members may be able to participate in such a support system. Some may have full time jobs, others might not feel comfortable playing a part in that system just yet. Some may have more time to commit or may be better suited for it based on temperament and background. It all depends, because every situation is going to be different. The symptoms of schizophrenia can make it difficult for the affected person to hold down a job, maintain healthy relationships, and take care of their personal hygiene. As a result, people with schizophrenia often rely on their families and friends for support—so there is no getting around it; a person with schizophrenia will need some support, at least initially during the treatment phase (Patel et al., 2014). This can be daunting for some family members if they do not know how to help.

But family members can provide important emotional and practical support to their loved ones. They can provide a listening ear, offer words of encouragement, help with daily tasks, and advocate for their rights. In addition, they can also provide financial support if necessary. By providing love and understanding, family members can play an important role in the life of someone with schizophrenia.

Still, overall, the challenges of living with a schizophrenic family member are numerous. First and foremost, there is the issue of safety. Schizophrenics often suffer from delusions and paranoia, which can lead to violent outbursts. As a result, family members always have to be on guard, especially if the person is not yet diagnosed; family members may not understand what is happening and they will never know when the person might lash out. Additionally, there can be heavy financial strain caused by the person’s condition. The individual would likely be unable to work, and if employed it would become harder for the person to manage to hold down the job until diagnosed and treated. Finally, there is the emotional toll of living with someone with mental illness. This can wear down all family members as they deal with stress in different ways and try to cope with the adversity.