Commonly known as insanity or madness, schizophrenia is a chronic psychotic disorder with onset typically occurring in adolescence or young adulthood. Schizophrenia results in fluctuating, gradually deteriorating, or relatively stable disturbances in thinking, behavior, and perception. Severity can range from mild and subtle with very good adaptation to everyday life, to severely disabling requiring constant supervision in a restricted environment.

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Schizophrenia is a brain disease that interferes with normal brain functioning. It causes affected people to exhibit odd and often highly irrational or disorganized behavior. Because the brain is the organ in the body where thinking, feeling and understanding of the world takes place (where consciousness exists), a brain disease like schizophrenia alters thinking, feeling, understanding and consciousness itself in affected persons, changing their lives for the worse.

Causes of Schizophrenia

Experts now agree that schizophrenia develops as a result of interplay between biological predisposition (for example, inheriting certain genes) and the kind of environment a person is exposed to. These lines of research are converging: brain development disruption is now known to be the result of genetic predisposition and environmental stressors early in development (during pregnancy or early childhood), leading to subtle alterations in the brain that make a person susceptible to developing schizophrenia.

It’s not known what causes schizophrenia. However, researchers believe that an interaction of genetics and environment may cause schizophrenia. Problems with certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate, also may contribute to schizophrenia.

Symtoms Of Schizophrenia

Bizarre or inappropriate behaviour

Preoccupation with spiritual matters

Incoherent illogical speech

Distorted Perceptions of Reality

People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.

Cognitive symptoms (or cognitive deficits) are problems with attention, certain types of memory, and the executive functions that allow us to plan and organize. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most disabling in terms of leading a normal life.

Over time, it becomes difficult to function in daily life. You may not be able to go to work or school. You may have troubled relationships, partly because of difficulty reading social cues or others’ emotions. You may lose interest in activities you once enjoyed.

Diagnosing Schizophrenia

Using mental state features alone (such as third person auditory hallucinations) is not a reliable way to diagnose schizophrenia. After all, psychotic features such as hallucinations and delusions can occur in affective disorders, dementia and acute organic psychoses. It is therefore important to look at the form of the illness as well as the content.

Treatment of Schizophrenia

Patients with schizophrenia often do not respond to treatment or only partially improve and remain functionally impaired. While medication has been found to be effective for the treatment of “positive” symptoms of the disease, treatment of the “negative symptoms” of depression (including lack of energy, motivation, and emotional range) has historically not been very successful. In nearly 25 percent of those patients, the condition is so refractory to neuroleptic pharmacotherapy that they require custodial care.

First, ensure that your loved one is taking prescribed medications. One of the most common reasons that people with schizophrenia relapse into a new episode is that they quit taking medication. Family members might see much improvement and mistakenly assume medications may no longer be needed. That is a disastrous assumption. A later psychotic outbreak will likely happen

The large majority of people with schizophrenia show substantial improvement when treated with antipsychotic drugs. Some patients, however, are not helped very much by the medications and a few do not seem to need them.

Therapy of Schizophrenia

Cognitive Behavioral Therapy has been shown to be good for a person with schizophrenia.

Psychodynamic therapy is quite controversial. The actual therapy does not seem to work so well.

When a person suffers from schizophrenia, it is helpful for the whole family to get support. This usually reduces stress and worry, and helps people cope.



Thanks to samnickel7 for contributing this article to our Depression blog:

Online Depression Support Groups

Can you answer the champ’s question about Depression?:

im not sure if im depressed or is it just anxiety. i have had anxiety attacks before. everytime i think about my girl cheating or wondering why shes not talking to me (just randomly pops in my head and i cant get rid of the thought) i feel like i cant breathe as good and feel the anxiety in my chest (feels kind of cold and like ive lost air) is this anxiety depression…..? and is there anyway to fight this without the use of medication?

Symptoms Of Teenage Depression

Being bipolar and living with the illness means that you should have a bipolar disorder treatment plan in place. This usually begins to be formed from the time that a diagnosis of bipolar disorder is made. Often the bipolar disorder treatment is split into two types – one for treating manic episodes and one for treating depressive episodes. It is essential that this happens so that the person with bipolar disorder is getting the correct bipolar disorder treatment.

During a manic episode the bipolar disorder treatment will start with the elimination of any substances that might could the sufferer harm – many will turn to stimulant drugs so they should be removed as they can further alter the mood. Next an assessment should be made to determine whether the best form of bipolar disorder treatment is to hospitalise the sufferer. In particularly extreme manic episodes this can happen to prevent the sufferer from coming to any harm.

Then mood stabilising drugs need to be administered as the next phase in the bipolar disorder treatment. Lithium tends to be used at this stage as it is can be a highly effective mood stabiliser. If after a week or so the bipolar sufferer will then be given antipsychotic drugs which should help to stabilise the moods. After this stage of bipolar disorder treatment additional drugs may be prescribed along with any therapy that might be needed. By this point the bipolar sufferer should be quite stable and able to continue with their daily life as usual.

During a depressive episode the bipolar disorder treatment is quite similar with lamotrigine or lithium being given to the sufferer initially. If they fail to respond to these many doctors have the opinion that they will have to cope with the depressive episode for as long as it lasts. Strangely antidepressants are not normally included in bipolar disorder treatment plan for depressive episodes as they don’t tend to work very well.

Once the bipolar disorder treatment is underway the next step could be to begin cognitive behavioural therapy (CBT) so that the sufferer can start to recognise what triggers their bipolar disorder and learn ways to avoid these triggers. Therapy of this form can be hugely successful if the sufferer is willing to try this type of bipolar disorder treatment. By being able to manage their different moods a bipolar sufferer is helping to reduce the number and severity of depressive and manic episodes. Alternative bipolar disorder treatments are also quite popular with yoga and meditation being two of the most widely used by sufferers around the world.

Although there is no known cure for bipolar disorder there are a number of ways that bipolar disorder treatment can help sufferers and there is constant research into finding more ways. It may seem as though there is nothing that can be done for someone who is bipolar but as you can see there are several options that sufferers can try to find which is the best bipolar disorder treatment for them.



Thanks to Lina Smith for contributing this article to our Depression blog:

Symptoms Of Bipolar Depression

Has someone told you that you have bipolar disorder or manic-depression? Have you been wondering what having bipolar disorder really means? This article will help you make sense out of what you or a loved one is experiencing.

Bipolar disorder is a mood disorder that is neurobiologic. That is, bipolar disorder is a physical illness involving the brain. It is not a character flaw or laziness. If you have bipolar disorder you are not purposely being “moody.” Nor can you “just snap out of it.” A person who has diabetes cannot “snap out” of having diabetes; neither can you snap out of having bipolar disorder.

However, having bipolar disorder does not mean that you can’t take steps toward recovery from your illness. Many of you with bipolar disorder are struggling with accepting the fact that you have a real condition that prevents your brain from regulating mood properly. You may be reeling from the powerful effect this disorder has had on your life. But the more you learn about bipolar disorder, the more insight you can gain, and that will help you to better manage your illness.

Bipolar literally means two poles, implying that in bipolar disorder there are two basic “poles” or extremes of mood However, thinking of bipolar disorder in terms of two extremes of mood is misleading. It is more accurate to think of bipolar disorder as a wide range of moods.

Our goal in the rest of this article will be to answer these questions: What is mood? What is normal mood? What is depression? What are hypomania and mania? How can I meet the challenges of bipolar disorder?

What is mood ?

Mood is a very strong word. It comes from older words meaning mind, spirit, courage, and to strive strongly, be energetic. An even older word that mood comes from means custom or customary behavior. Thus mood means more than feeling happy or sad. Mood encompasses much of what we need to live. Mind, spirit, and courage, striving and energy, custom and behavior—all are related to mood and our sense of well-being. Thus having bipolar disorder affects us in many ways, presenting challenges as well as abilities such as enhanced creativity and sensitivity to the world around us. Many with bipolar disorder have influenced our lives and culture. These include Abraham Lincoln, Winston Churchill, Virginia Woolf, Georgia O’Keeffe, and Robert Schumann.

Bipolar disorder is about more than whether we feel happy or sad at a particular time. Bipolar disorder can be emotionally painful and have a major impact on our lives. At the same time it is a disorder that involves all aspects of mood. In addition to the challenges it presents, it also bestows gifts of seeing the world differently from others whose moods remain in a normal range.

As mentioned already, thinking of bipolar disorder as being two extremes of mood is misleading even though the term bipolar implies only two poles of mood—depression and mania. It is more accurate to think of bipolar disorder as involving a wide range of moods.

At its core is the brain’s inability to regulate mood. This inability to regulate mood within a normal range results in varying degrees of depression or mania. At times there may even be a mixed mood—a state that has elements of both depression and mania. In bipolar disorder your mood takes on a life of its own that is independent of what is happening in your life. Your mood thus becomes independent of your experiences. This “disconnecting” of mood and experience presents challenges in daily life. Sense of identity and self-confidence can be affected. Symptoms such as extreme irritability can affect relationships. Sadness and hopelessness can become overwhelming and even lead to suicide. The sense of self can be lost by not knowing what to expect from your moods from day to day or even from hour to hour or minute to minute.

What is normal mood?

Beginning with normal mood is important because it is the hardest mood to understand for a person who is experiencing bipolar disorder. Most people take for granted that they feel happy or content most of the time. Happiness or contentment describes normal mood. Especially if you are experiencing bipolar depression, you may not realize that most people feel happy most of the time. Most people have a stable mood that doesn’t have wide swings. Instability of mood is the hallmark of bipolar disorder. Such instability makes it difficult to recognize normal mood. Just as it may be difficult for you to understand normal mood, those around you may have difficulty understanding depression, hypomania or mania. For instance many people with normal mood will say that they are “depressed” when they are having a bad day. This is better described as having a “blue mood,” which quickly passes.

The difference between depression and a blue mood is that the blue mood may vary a bit but it remains within a normal range. Blue mood does not stay at an extreme for very long, but lifts after a short time. Also the ability to enjoy pleasurable activities remains. For example, if someone with normal mood is having a low mood, that person may decide to go to a movie with some friends. This may be enjoyable and may even lift that person’s mood. Depression differs in that it is much more intense and lasts from weeks to months or even years. Going to a movie does not help the person who is depressed to “snap out” of depression. In our example, a depressed person may not be able even to enjoy the movie.

What is depression?

Depression is an intensely sad mood that lasts for at least two weeks. It may be characterized by irritability (usually an anxious irritability), and loss of enjoyment. Take the above example of going to the movies. If you are experiencing depression you may not be able to enjoy a movie or an outing with your friends. Sadness, irritability and loss of enjoyment are emotional features of depression.

Depression also has cognitive features. Cognitive means thinking. In other words, thinking may be affected by depression. Often concentration and focus are impaired. Concentration is being able to pay attention to what you are doing so that you can complete thoughts or tasks. Focusing is keeping on track without forgetting what you are doing or being easily distracted.

A second cognitive feature of depression is that of a sense of worthlessness. This may take many forms. Examples are a belief that you cannot do things right, a belief that you have no friends, or a belief that you are a failure in life. Notice here that I am using the word belief to describe this cognitive feature. That is because a sense of worthlessness may have nothing whatsoever to do with the reality of your accomplishments, the number of friends you have or your success in life. The cognitive feature of a sense of worthlessness has nothing to do with your actual self-worth but everything to do with the thinking that can accompany depression.

Hopelessness is another cognitive feature of depression, which causes you to see the world in an unrealistic way. The thinking process of hopelessness makes sense to you because your thinking process is not working normally. If you feel like harming yourself or others, you need to be in a safe place. That place may be with others who can monitor your behavior, but more likely hospitalization may be needed until the extreme hopelessness passes. When you are in the depths of hopelessness you need to ask for help. This may mean calling your psychiatrist, your therapist, or a trusted person who cares about you. An alternative is to call a suicide hotline (1.800.SUICIDE) or to dial 911. Keep in your purse or wallet a note that says, “I am feeling suicidal. I need help.” When you are not suicidal show it to a few trusted people and give them instructions about how to get help. You can use the note when you feel suicidal but can’t ask for help.

Our bodies are also affected by depression. You may sleep too much or too little, yet always feel tired. You may lose your normal appetite or have too great an appetite. You may have a headache, stomach ache or fatigue. Or you may find yourself crying without being able to stop.

What are hypomania and mania?

Hypomania is a word that confuses many people. Hypo means under and hypomania is a mood that is “under mania.” It is not as extreme as mania but lies somewhere between mania and normal mood. Hypomania is a bit harder to recognize and often remains hidden. Mania is more easily recognized.

Mania is an expansive mood just waiting to be seen by all. Because mania is often pleasurable, you may not want treatment for mania. Getting treatment may feel a bit like giving up a good friend. Unfortunately, the mania’s friendship brings serious challenges into your life that can make it less manageable. Lifelong treatment seeks to even out your moods so that you can be happier and accomplish your goals in life. Untreated mania will lead to instability and will greatly disrupt your life.

There are two kinds of bipolar disorder, Bipolar I and Bipolar II. Bipolar I is characterized by mania; bipolar II differs in that it is characterized by hypomania. Both include swings into depression, but depression tends to be the dominant mood in bipolar II. In order to diagnose bipolar disorder, hypomania or mania must be present at some time and depression must also be present at another time.articleIn the discussion that follows, mania will refer to both hypomania and mania.

We will continue by examining the emotional features of mania. Unstable mood is the hallmark of mania. Mania is an exercise of “catch as catch can” because your mood shifts rapidly. For example, you may have sudden bursts of energy contagious to everyone in the room. You may laugh loudly, tell jokes, and almost perform for those around you. But this mood is unstable and within a short time you may move on to a completely different experience of being unable to sit still. This restlessness might cause you to walk quickly out of the room to begin a different activity.

Another emotional feature of mania is that of irritability. The irritability of depression has an anxious quality. In mania the irritability is one of being easily frustrated. You may feel as though you could crawl out of your skin. The irritability of mania is often mistaken for anger. Anger differs in that it targets a specific focus, while irritability is without a particular focus. Anger’s target could be another person’s actions, a circumstance or perhaps a perceived failure of yourself or others. When you experience the irritability of mania you feel volatile and any little thing can set you off. You are easily frustrated. Mania’s irritability often causes difficulty in relationships, especially if others interpret your irritability as anger.

Mania also has cognitive or thinking features. One of these is grandiosity. With grandiose thinking, you may have ideas and plans so expansive and difficult that they are impossible to accomplish. In mania, however, you are convinced they are well within your capabilities. For example, you may believe you can climb Mount Everest even though you have never even seen a mountain before. Other cognitive features of mania include poor judgment, disorganization and lack of impulse control. When you experience these features of mania, you may have difficulties with relationships, find yourself overwhelmed by clutter, or go on spending sprees. These cognitive challenges can result in troubles at home, work or in your community.

One feature of mania affecting the body is that of increased energy in spite of decreased sleep. You can go for days to weeks with little sleep or even no sleep and yet have high energy. (Compare this to the extreme fatigue often associated with depression.) Mania’s high energy can result in rapid speech or racing thoughts. When you are having these features, you may not perceive them as “rapid” or “racing.” Instead it may seem that the rest of the world has slowed down. Your thoughts can seem intrusive, taking off on topics other than those you want to address. You can feel agitated and as though you cannot sit still or stop moving. However, when mania is less extreme, you may become more productive than normal and may accomplish tasks in a more efficient manner than other people who do not have bipolar disorder.

Psychotic features may also occur such as hearing things that are not present or seeing things that are not there. If these latter symptoms occur you need to call your doctor immediately or even call 911, especially if you feel that you are in danger to yourself or others. If things get this severe, others will often intervene because you may not be able to recognize that you need help.

How can I meet the challenge of bipolar disorder?

The core challenge in bipolar disorder is the brain’s inability to regulate mood. Understanding this is crucial in learning to manage your illness. When your brain is not keeping your mood within a normal range, you are challenged to seek treatment. Medications and psychotherapy, sometimes called talk therapy, can help you. It is important to realize that the goal of treatment is not to take away your personality and creativity. It is to help regulate your moods so that your personality and creativity shine through in a healthy, productive life. Because treatment works you will feel better and be able to accomplish your life goals.

You can also find help through education in your community and through bipolar recovery groups. Bipolar disorder is treatable and you will feel better and be better able to accomplish your life goals if you seek treatment. Support from others helps you learn how to manage the challenges of bipolar disorder.



Thanks to Jane Mountain, MD for contributing this article to our Depression blog:

Clinical Depression Treatment

Depression can be incredibly hard to live with; it permeates every part of a person’s life and leaves them feeling very low and unable to cope with day to day life. Most people will have an encounter with depression during their life and most people cope with it and move on without any problems. For people with bipolar depression life can be quite different.

Bipolar depression tends to come in cycles which are mixed with periods when the sufferer feels intense highs. During these highs bipolar depression is forgotten and the person might feel invincible and this can lead to other problems. When someone who is bipolar is in the middle of a bipolar depression period they tend to go into a deep depression, their sleeping patterns can be affected, they may lose their appetite, they lack motivation and their personal relationships can suffer. If the bipolar depression episode is particularly intense they may even contemplate suicide, so it is essential that they learn effective ways that will help them to live with bipolar depression.

Firstly it is important to try to get bipolar depression under control as this will make life slightly easier for the sufferer. This should be done by getting medical advice and treatment to stabilise the moods of the person with bipolar disorder. Medication to control bipolar depression can be prescribed and many people with bipolar disorder find that this is a huge step forward for them. They will still have periods or episodes of bipolar depression but with the correct medication and management these can become less frequent. By lowering the frequency of these periods, a person who has been diagnosed with bipolar disorder can deal better with them.

As well as medication, another good way to learn to live with bipolar depression is by attending cognitive behavioural therapy sessions which can help a person to pinpoint triggers for their depression. When a person is able to pinpoint these triggers they can then either try to avoid these types of situations, or if they are unavoidable, learn strategies to cope and lessen the impact of bipolar depression when it strikes. Obviously, this type of treatment is not suitable for everyone but many people do benefit from it and it is worth taking a look at if you suffer from bipolar depression.

Exercise can also play an important role in living with bipolar depression as it encourages the production and release of endorphins, a natural chemical that the body produces when it is happy. This also occurs when a person exercises – so it is a good idea for those people who suffer from bipolar depression to take regular exercise as it will benefit them.

Some people also advocate alternative treatments such as taking up yoga or meditation as it allows the bipolar depression sufferer to relax and learn further coping mechanisms. Whilst not everyone would agree, those people who do practice yoga or meditation do find that it improves their mood and general wellbeing which is both useful and valuable.



Thanks to Lina Smith for contributing this article to our Depression blog:

Depression Screening Questions