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The Predictable Signs and Symptoms:

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Alteration of the Senses:

These changes range from enhancement in the early stages of schizophrenic breakdown to a blunting of sensations in the later stages, e.g. pain. The patient may experience flooding of the mind by sensory stimuli or thoughts. Some patients develop excessive religious preoccuptaions and have
"peak experiences".

Inability to synthesize and to respond (also known as 'thought disorder'):

The patient's difficulty in synthesizing visual and auditory stimuli results in inappropriate responses which hamper interpersonal relationships. The altered synthesis produces thought patterns characterized by impaired logic, loose associations, blocking, ambivalence in responses and actions, neologisms, and "word salad".

Altered sense of self:

Due to the inability to synthesize and to sort visual and tactile stimuli, which enable us to differentiate our bodies from the external world of objects and persons, the schizophrenic person experiences distortions and confusion regarding the boundaries between his/her self and other people or things. Body parts may be experienced as dissociated or detached, with lives of their own. Or the person may be confused about his/her sexual characteristics. As an outgrowth of body boundary distortions, sensory overacuteness, faulty synthesis of incoming stimuli and inappropriate responses, the schizophrenic person experiences:

Delusions:

These are basically false ideas which the patient believes to be true, but which cannot be or are not validated by members of his/her culture and to which he adheres in the face of reason. Delusions are also the product of a person's culture, experienced as a logical and coherent pattern, and can only be be evaluated in this context. Two common kinds are:

paranoid delusions: characterized by a belief that one is being watched, followed, controlled, persecuted, attacked (when frightening enough, they may precipitate an attack in self-defense and

grandiose delusions: centered on the belief that one is an exalted figure, often political or religious, and that the patient can exert mind control over others.

Hallucinations:

Hallucinations can be auditory (the most common kind), visual, or auditory-visual combined. They may originate in a stimulus, but are a gross distortion of sensory overacuteness-even to the point of representing something that is not there or was not said.

Changes in emotions:

The earliest changes are fluctuations and exaggerations in feelings. Guilt and fear often predominate. The emotions expressed may be inappropriate, laughter at death, crying over a joke, or they may be flattened, thus impairing empathy with another or others. The physical result is apathy, slowness in movement, lack of drive, often thought to be drug effects, but in actuality a product of the disease itself. Mentally, the person may exhibit poverty of thought and speech; emotionally, he becomes detached from objects and people.

Changes in behavior: (secondary signs):

Withdrawal is one of the major changes. It is a defensive maneuver to slow down sensory inputs and allow time to integrate them or to avoid the horror of other symptoms. Behavior becomes ritualistic, with posturing, gesturing, parroting what others say. Repetitious movements may develop - tics, tremors, tongue movements, and sucking. These movements are in some cases, side effects of anti-psychotic medications. However, they were also obvserved before such medications were available and, in some cases were caused by the disease itself.

The apparent "craziness" in everything a schizophrenic person says and does "has its roots in the disordered brain function that produces erroneous sensory data and disordered thinking. Given the disordered brain function as a starting point, many schizophrenic persons are heroic in their attempts to keep a mental equilibrium. And the proper response of those who care about the unfortunate person with this disease is patience and understanding."

 

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