page 5. Schizophrenia: Understanding the Disorder
Can schizophrenia be cured ?
There is no cure, but medication my help reduce many of the symptoms of the disorder, so that rehabilitation, in many cases, is possible. Full recovery may occur in a small number of people, but it cannot be predicted. The delusions and hallucinations that grip young adults in the throws of their disorder, usually most severe while in their 20’s and 30’s, tend to decline somewhat with age. So by the time a person is in their 40’s or 50’s, they may experience few of these positive symptoms. Of course, this is not true for everyone with schizophrenia. Some individuals may still suffer from hallucinations late in life.
Unfortunately, we have no single blood test, x-ray or brain scan from which we can then say with certainty: “yes, that is schizophrenia.” To reach the diagnosis of the disorder, other possible causes must be ruled out. For example, the use of street drugs, like cocaine or LSD, can cause hallucinations and delusions. Other physical disorders can also present symptoms like schizophrenia, such as epilepsy, brain tumors and thyroid disturbances.
Since there is nothing we can measure, no medical test we can perform to help define schizophrenia, we are left left only with the symptoms of the disorder. Because of this, persons with schizophrenia often acquire different “labels” from healthcare providers, before a clear diagnosis can be made. This can be extremely frustrating for patients and their families. But this is a difficult disorder to diagnose – symptoms may either go unrecognized or not show themselves, until the disorder is fairly advanced.
For a doctor to diagnose schizophrenia, the symptoms must be present for at least six months.
That is why the most important information is a detailed patient history. The diagnosis is based on the symptoms – what the person says, what the family can provide about the person’s behavior, and what the doctor observes.
Drugs are the cornerstone of treatment for schizophrenia, just as they are the most important treatment for many physical disorders.
They are not a cure, but are used to help control the symptoms of the disease. Along with medication, social therapy and rehabilitation are very important tools in the treatment of this disorder.
Depending on the severity of the symptoms and the stage of the disorder, the individual with schizophrenia may have to be treated in the hospital, especially if acutely ill. Other individuals are able to manage their disorder outside the hospital with regular visits to their doctor, and other support staff.
The family is very important in treatment of individuals with schizophrenia. Family counseling is often recommended to understand and manage problems associated with the disorder. Education is extremely important. Persons with schizophrenia and caregivers should learn all they can about the treatments and therapies offered, to be able to take an active role in the management of the disorder.
Medications called antipsychotics (or neuroleptics), developed in the 1950’s, have proven to be one of the most important medical advances of the century. As a result, people living with schizophrenia no longer have to be hospitalized for years. Many are able to live in the community.
There are well over 30 different antipsychotics available in North America. Although antipsychotics are the main drugs used in the treatment of schizophrenia, other drugs are often prescribed to treat other symptoms like anxiety, and sleeping difficulties that frequently afflict those with the disorder. In addition, the side effects associated with conventional antipsychotics often make it necessary for people to take other medications to lessen them.
Antipsychotics are not perfect. Although they may help control the positive symptoms of schizophrenia, they have not been proven to be effective against the debilitating negative symptoms of the disorder (ex. Social withdrawal, lack of drive) . Some people with schizophrenia do not respond to these drugs, and the side effects may contribute to people not taking their medication (noncompliance). Without medication, one of the critical steps in the treatment of schizophrenia is missing – and relapses are more likely for these individuals. And remember, with each relapse is the chance that chronic symptoms become more severe, making treatment even more difficult.