Schizophrenia: Common Symptoms

by Christina Bruni Patient Expert

Our focus on schizophrenia continues with an overview of some of the common symptoms of this medical condition. We'll start this talk with info about one of the tell-tale signs of SZ.

Xavier Amador, Phd researched anosognosia, the term for the lack of insight that you have an illness. His results showed that nearly 60 percent of the patients with schizophrenia, about 25 percent of those with schizoaffective disorder, and nearly 50 percent of the people with bipolar, were unaware of being ill.

Indeed: those who exhibit the symptom of anosognosia did not stop at denial of their diagnosis: they couldn't even recognize the symptoms they were having, such as though disorder, mania, hallucinations, etc.

Read the 2010 edition of Amador's book, I Am Not Sick, I Don't Need Help to get a clear understanding of how such people can be in denial that their behavior and thoughts are irrational while everyone around them sees the bizarre nature of the symptoms.

Once you understand the dynamic at play you can use motivational interviewing and the LEAP (Listen-Empathize-Agree-Partner) technique to help persuade your loved one to get treatment and stay in treatment.

You can convince someone to take his meds even if he doesn't believe he's sick so doesn't think he needs them.

Anosognosia is caused by lesions in the frontal lobe of the brain thus it is a neurobiological symptom of the illness.

The Amador book is also a useful guide for helping a loved one who is experiencing old-fashioned denial or resistance to taking the meds.

You begin to make progress when you stop trying to convince a loved one that he is sick and stop trying to convince him his beliefs are irrational.

Delusions are fixed false beliefs that cannot be changed and are one of the typical symptoms of schizophrenia. Susan Burns, the woman who allegedly tried to steal the Gaugin, had delusions centered around the CIA, a common theme.

Other delusions often relate to God or having special powers. At 22 years old, I was a disc jockey on the FM radio and thought the government was after me because I had started a revolution through music.

Such false fixed beliefs can focus on things going on in a person's life. A person who fears the effects of global warming might think he could use his power to burst clouds to cause rain, the example given by Milt Greek whose talk I attended at a NAMI convention one year.

Hallucinations, on the other hand, are primarily auditory or visual, such as hearing command voices telling you to harm yourself, or voices keeping up a running commentary in your head, or seeing things that aren't there, like people stabbing you or imaginary people following you.

Some people hear voices non-stop and others with effective medication only hear them occasionally. The lucky among us-and there are a significant number-stop hearing voices completely once they find the drug that works.

It is likely you don't have schizophrenia if you don't experience hallucinations or delusions. Yet not all people who have schizophrenia hear voices or ever heard voices. The presence of delusions can be the sole alarm bell for making the diagnosis, and in the next SharePost I will detail the criteria for diagnosing schizophrenia.

Another symptom of this illness is the random jumbling of words together that is technically called schizophasia, or commonly word salad. A true word salad is caused by an involuntary, compulsive speech disorder. Schizophasia is incoherent and with it correct or incorrect grammar may be used. A famous example is "Colorless green ideas sleep furiously."

On the other hand, clanging is the use of rhyme, such as when a patient greeted Xavier Amador by saying, "Hello Dr. Amadorafloor."

Thought broadcasting is a symptom where a person with schizophrenia thinks his thoughts are broadcast outside his head so other people can hear them. It could involve the thoughts perceived as transmitted via a radio or another person's voice.

Cognitive Behavioral Therapy or CBT can be used effectively to help patients develop coping techniques for managing the symptoms. It is currently the gold standard of treatment for a variety of mental illnesses, including anxiety, panic, OCD and PTSD.

Hearing voices or seeing things is problematic because it affects a person's ability to concentrate and engage in conversations and have relationships.

The symptoms described thus far are called positive symptoms because they add to the experiences a person has, whereas the other type, called negative symptoms, take away from a person's experience.

Negative symptoms include a flat affect or emotionless expression, lack of motivation and volition or desire to do things. These can mirror depression yet as Xavier Amador notes in the Spring 2011 SZ magazine using anti-depressants to treat negative symptoms is like battling a gale force wind without lead weights to hold you down.

The true hallmark of schizophrenia according to leading researchers is the cognitive deficit syndrome that often occurs for a lot of people who develop this illness. In tandem, some of the medications cause cognitive impairment even though they're the very drugs used to treat schizophrenia.

For some of us, reading books is no longer possible. And the cognitive impairments are most likely the one true reason that so many people diagnosed with schizophrenia cannot hold jobs or attend school.

What's the solution? CBT and cognitive remediation can help offset these kinds of impairments.

So these are some of the symptoms of this medical condition.

Christina Bruni
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Christina Bruni

Christina Bruni wrote about schizophrenia for HealthCentral as a Patient Expert. She is a mental health activist and freelance journalist.