Friday, October 28, 2011

Obliterating bad information pt.1: schizophrenia and insanity

Note: this is part of an ongoing series in which commonly held beliefs are shown to be wrong and corrected).


Schizophrenia does not mean "split personality."  Somehow that idea crept into the public consciousness and pops up regularly in dinner party conversation, sitcoms, cartoons, movies, etc. It's incorrect, so get it out of your head right now.

The word 'schizophrenia' was coined by a Swiss doctor named Eugen Bleuler sometime in the late 19th or early 20th century.  It is applied to one of the best known forms of mental illness, a diagnosis that is best known in the public mind as crazy, bonkers, insane, wack-o, etc. If someone hears the voice of God telling them to burn down their house with their family in it or decides that wearing a tin foil hat will prevent the CIA & KGB from reading their thoughts, we're probably talking about schizophrenia.  Though not necessarily. Because in medicine we start with symptoms. What are the patient's symptoms? If they symptoms are the scenarios i described above, those are symptoms of what we call psychosis. The person is exhibiting psychotic thinking.  So the next question is, why is he/she psychotic? Side effect of some medication? Drugs? Brain damage from drinking cleaning fluids?

So if schizophrenia doesn't mean 'split personality' what does it mean.  In psychiatric medicine there is a differentiation between thought disorders, mood disorders, paraphilias, etc. Schizophrenia is a thought disorder. It simple terms it means that the schizophrenic brain perceives reality differently than everyone else.  If you and i watch a totally fictional TV movie about a man who can talk to plants, the schizophrenic might watch the same thing and think it's a message from the creator directed at him/her personally, so that he/she finally understands that he/she was put on the earth to go around talking to plants.

That's an oversimplification but it's accurate enough to show you that schizophrenia has nothing to do with a split personality.  The "split" is with reality.  In extreme cases, when a schizophrenic is very psychotic, they may hear multiple voices telling them conflicting things; they may perceive heat as cold or vice versa; they may step on a nail and not feel the pain; they might see a soda machine turn into the face of a demonic robot laughing at them, or shadows on a pond turn into angels who beckon them to come into the water and ignore the fact they can't swim.

While the cause of schizophrenia remains unknown and while some treatments or medications are questionable in some cases, a very large number of persons with this disease have been able to return to something like a normal life by taking anti-psychotic medication.  It typically appears when a person is between 18 and 21, affects people of all races and ethnicities as well as both genders and has what are known as positive as well as negative symptoms. Negative symptoms would be things like not speaking, ignoring people who talk to you, isolating in a room or under a bridge, in short withdrawing into another world. Positive symptoms are things like talking to oneself, doing very bizarre and/or dangerous things, speaking in long rambling nonsensical monologues, etc.  Not all schizophrenics experience the same symptoms or experience them to the same degree. Some never hear voices. Some always hear voices. Some never have hallucinations.  Some are paranoid and angry. Some are not paranoid at all and laugh about anything and everything.  There is no correlation between intelligence and schizophrenia.  Some are very bright. Some are not.

And by the way, "split personality" or "multiple personality disorder" (believing you have different 'selves' controlling your life) doesn't exist. We'll get to that later. The famous book that started it all "Sybil" was a total fabrication. A like. A fake.

Don't believe me? Click here http://www.npr.org/2011/10/20/141514464/real-sybil-admits-multiple-personalities-were-fake

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