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1999 First Web Reports
Schizophrenia is a disorder that affects about 1 in 100 people at different stages in their lives and is very difficult to diagnose. It has many symptoms that typically begin to appear around age 18-30 (2). Signs of Schizophrenia can be misread and sometimes overlooked due to the amount of other disorders that share many of the symptoms. Autism is one example. Symptoms can be classified into "negative" and "positive." Negative symptoms could be seen as those that are absent but should be present. Examples of negative symptoms include lack of motivation or apathy, blunted feelings, depression, and social withdrawal (1). Positive symptoms are those that should be present but are absent. Some examples of positive symptoms are hallucinations, delusions, thought disorder, and an altered sense of self (1). It is thought that hallucinations are the result of an over-sharpening of the senses and of the ability that the brain has to appropriately interpret and respond to incoming messages. Hallucinations could include hearing voices, both complimentary and threatening, that are perceived to be inside or outside the person's body. They could also include seeing something that is not there or experiencing unusual sensations on the body. Delusions could be described as strange, committed beliefs held only by the person diagnosed, who refuses to change the belief despite strong evidence to the contrary. Examples could include believing traffic signals are instructions from aliens, or the belief that they are being watched, spied upon, or plotted against. Thought disorder is a symptom involving the way that a person with schizophrenia processes and organizes their thoughts. Usually their thoughts "race" along so rapidly that the person can not "catch them." Because the person's thinking is so disorganized, their speech can be incoherent, and their emotional responses can be inappropriate. Sometimes the person's words and mood do not coordinate with one another. The symptom of altered sense of self describes the blurring of feelings about who he or she is. Sometimes the feelings involve sensations of being bodiless, or like a non-existent person. The individual sometimes can not decipher where his body stops and the rest of the world begins, as if the body and the person are separated.
Evidence has been found that those diagnosed with Schizophrenia tend to have either too many receptors for the neurotransmitter, dopamine, or that the receptors are overly sensitive to dopamine (1). Dopamine carries messages from certain specific nerve cells, called neurons, to other specific neurons located in the brain. A person who has been diagnosed with Schizophrenia will be overloaded with messages coming along the pathways that may block out other important messages from getting through. With too much input to one area of the brain, a type of overload could occur resulting in the output of some of the psychotic symptoms. Treatment to block the receptors on the neurons from binding with the neurotransmitter, dopamine, can be found in neuroleptics. Neuroleptics are anti-psychotic drugs that deal with the positive symptoms of schizophrenia by blocking the receptors for dopamine. This way, even though a great amount of dopamine could be present, it will not be able to bind to the receptors of neurons and the messages will not get through.
One big question surrounding Schizophrenia is why it usually does not appear until late adolescence. Two psychiatrists, Timothy Crow and Daniel Weinberger, have proposed theories as to the reason for the delayed symptoms. Crow's theory involves enlarged ventricles and a structural defect in the frontal or temporal lobes of the brain (4). Weinberger elaborates to explain that a brain lesion is present from birth or early childhood resulting from injury, defect, malfunction, genetics, a virus, or birth complication (4,5). Numerous experiments and statistics support these theories, showing similarities between Schizophrenic patients such as sharing smaller than average frontal lobes, atrophy in the temporal lobes, enlarged ventricles, and history of complicated births. The symptoms lay dormant until adolescence because this is when the prefrontal cortex, the temporal lobes, and the limbic system reach their full development. The temporal lobes and limbic system house areas of the brain's perception and memory. Disturbances of these areas could account for the commonly experienced hallucinations, delusions, thought disorder, and altered sense of self. In addition to the maturity of certain brain areas in late adolescence, dopamine levels in the body reach their peak as biological and social stress is extremely high which could account for many of the positive symptoms mysteriously appearing in late adolescence (6).
Schizophrenia can be thought of in terms of altering one's "sense of self"(1). What is a "sense of self?" A "sense of self" is an awareness of one's physical body and mental state. It encompasses one's personality, perceptions, and emotions. It also reflects one's conscious decisions and actions. I believe that to have a "sense of self" is to combine one's inside awareness with one's outside awareness. Inside everyone's nervous system lies the "I-Function." This is the experience of I or the self in the brain. The I-Function includes more or less of the nervous system depending on how much is connected and functioning properly. It is having a sense of the self-experiencing. Everyone possesses it and uses it to determine what belongs to them.
Does Schizophrenia change one's self or give one an altered sense of self? Everyone must define their own "sense of self" before examining the effects that schizophrenia has on "self." The Random House Dictionary defines self to be, "a person or thing considered as a complete and separate individual...a person's nature or character...inherent in oneself or itself...independent...automatic... (3)". Alterations in "self" can be painful for the individual because of a confused sense of what is going on inside and outside of the body and mind. If a person's "self" reflects their "character" and stands for the thing that makes a person "complete" and "separate," then does that mean that a person feels that who they are has changed when they have this disorder? This question leads to the way that this disorder alters one's "sense of self," by making the individual and those who are close to him or her question the one thing that makes each person unique, their self.
3)Flexner, Stuart Berg. The Random House Dictionary: Concise Edition. New York: Random House, 1980.
5) C-Sections Urged for Schizophrenia -prone Mothers