Schizophrenia Has Been Diagnosed...

What is schizophrenia?

Posted Jan 06, 2010

A reader sent in this query: My cousin has just been diagnosed with schizophrenia but she has never thought of herself as being two people. Is this diagnosis wrong, is she psychotic and is schizophrenia something you can catch or inherit?

The reader asks several questions which I'll try to answer in order. The first deals with the term schizophrenia. The "schiz" part does indeed come from the word schism - referring to a division or a separation. But, in this case, it doesn't mean a division or a separation of personalities. That's called Dissociative Identity Disorder, formerly referred to as Multiple Personality Disorder. The separation in schizophrenia refers to the patient's inability to discriminate between the worlds of fantasy and reality. It's as though they were dreaming out loud. We all fantasize from time to time but we know the difference between what's in our heads and what's actually out there. The schizophrenic doesn't.

And, yes, schizophrenia is a psychosis as opposed to a neurosis. The difference is that psychotics see and hear things that aren't there while neurotics, who can be seriously disabled, at least don't suffer from hallucinations. There's an old saying in the profession: Neurotics build castles in the air while psychotics try to live in them. It is for this reason that the former are generally treated as outpatients and the latter, suffering a very real break with reality, are more often confined.

Next you asked if schizophrenia is catchy; is this a disease an infected person can pass on to an otherwise healthy individual? The answer here is...no. However, having said that, I would be remiss if I didn't add that some researchers feel a virus may be involved. Of course some researchers also feel that viruses may be involved in certain forms of cancer. But this is far from proven and probably the last thing in the world about which you want to worry is catching a mental disorder or picking up a tumor.

Finally -- and I suspect it's because you're related that you ask your last question -- can you inherit schizophrenia? Unfortunately, this disease does seem to run in families. Identical twins are most at risk but the probabilities drop precipitously from that point. As a cousin, your chances of coming down with the disorder are very small and may reasonably be compared to the chances found in the population at large.

Something you didn't ask is: How do you treat schizophrenia? Since no one is sure of the cause, treatments are usually initiated one-on-one. In other words, let's see what works. Psychopharmacology has come a long way in just the last generation and it's now possible that daily medication will allow for a productive life where institutionalization would have been the only safe course twenty or thirty years ago. One way to judge the degree to which schizophrenia will disable an individual is to consider its direction and severity. If a young adult comes down with symptoms but responds well to medication over time, there is every reason for a positive prognosis. It may not be cured but it shows every sign of being controlled. This may not be seen as an ideal outcome but it's no worse than a daily dose of insulin for diabetes.

People have no problem understanding and accepting organs that prove to be faulty. Taking pills for one's heart, for example, is a perfectly common occurrence and is not in any way seen as devastating to the individual. But the simple fact is that people don't see the brain as just another organ. And yet it can suffer from occasional disorders in much the same way the heart can become irritated and throw a few odd beats. A diagnosis of schizophrenia is very scary and a very serious matter but it's not hopeless by any means. And, what's more, treatment options will only expand and improve as research continues.